Ashoka (Saraca asoca) is primarily used in traditional Ayurvedic medicine for a variety of gynecological conditions, including afterbirth pain (pain experienced after childbirth due to uterine contractions as the uterus returns to its pre-pregnancy size). Classical Ayurvedic texts such as the Charaka Samhita and Sushruta Samhita mention Ashoka as a remedy for disorders of the female reproductive system, including menstrual disorders, uterine pain, and excessive bleeding.

Its use in managing afterbirth pain is largely based on these traditional sources, which describe Ashoka as having stambhana (astringent) and balya (strengthening) properties that help tone the uterus and reduce discomfort. Formulations like "Ashokarishta," which contain Ashoka as a main ingredient, are commonly prescribed in Ayurveda for postpartum care.

Modern scientific evidence for Ashoka’s efficacy specifically in treating afterbirth pain is limited. While some pharmacological studies suggest that Ashoka bark extract may exert uterotonic effects and have anti-inflammatory properties, these studies are preliminary and often do not directly address afterbirth pain in clinical settings. There are no well-designed clinical trials confirming its effectiveness for this indication.

In summary, Ashoka’s use for afterbirth pain is justified by traditional Ayurvedic practices and historical use, but robust scientific validation is lacking. The evidence rating reflects the strong traditional support with limited modern research.