CHAPTER 3

REPRODUCTIVE HEALTH
REPRODUCTIVE HEALTH - It means reproductive organs with normal functions.

WHO - WORLD HEALTH ORGANISATION -

• WHO has defined it as a total well-being in all aspects of reproduction, i.e., physical, emotional,
behavioral & social.
• Reproductive health – problems and strategy: India was among the 1st countries to initiate actions
& plans to attain total reproductive health as social goal.
• These programmes are called as ‘ FAMILY PLANNING’
• Improved programmes currently in operation have a popular name ‘REPRODUCTIVE & CHILD
HEALTH CARE PROGRAMMES’ (RCH).
➢ With the help of Audio-Visual and the print media governmental and non governmental
agencies(NGOs) help to create awareness among people about reproduction related
programmes and provide facilities and support for building up a reproductively healthy
society.
HOW HAS THE GOVERNMENT TAKEN MEASURES?
• Through the help of audio-visuals & print media.
• Even family members, close relations are involved in the awareness.
• sex education was introduced in schools to provide awareness
• Proper information about reproductive organs, adolescence & related changes , safe & hygienic
sexual practices, sexually transmitted diseases, AIDS ETC.

AMNIOCENTESIS - IT IS A technique used to find out chromosomal abnormalities(genetic disorders) in

developing embryo by using amniotic fluid of the developing embryo.
• It is also misused to check foetal sex determination based on the chromosomal pattern in the
amniotic fluid surrounding the developing embryo.
• There is a statutory ban on amniocentasis for sex determination-
• Population explosion & birth control:
• The world’s population being 2 billion in 1900 was relocated to 6 billion in 2000…
• India’s population was about 350 million during independence & almost reached billion .
• A rapid decline in death rate, mmr & imr as an increase in number of people in reproducible age are
the reason for this .

WHY SUCH POPULATION EXPLOSION?

• Most of the urban people are uneducated.
• Girls were given into early marriages at 18 yrs of age.
• Contraceptive methods:
• THROUGH MEDIA – HUM DO HAMARE DO!!!!! (WE 2 , OUR 2)
• SAHELI - it is a contraceptive method developed by scientists in CDRI - central drug research
institute LUCKNOW.

CONTRACEPTIVE METHODS:
1. NATURAL METHODS 4. ORAL CONTRACEPTIVES
2. BARRIERS 5. INJECTABLE IMPLANTS
3. I U D 6. SURGICAL METHODS

1. NATURAL METHODS: Avoids meeting of sperm & ovum.

• PERIODIC ABSTINENCE - avoid coitus from day 10 – 17 of menstrual cycle when ovulation is
expected. Because chances of fertility is very high during this period, hence known as fertile period.
• WITHDRAWAL OR COITUS INTERUPTUS - male partner withdraws his penis from vagina before
ejaculation avoiding insemination of sperms .
• LACTATIONAL AMENORRHEA-absence of menstrual cycle during first six months of intense
lactational period
2. BARRIER METHODS:
• CONDOMS - thin rubber used to cover penis in male or vagina & cervix in females.
• DIAPHRAGMS, CERVICAL CAPS & VALUTS are all barriers for females to cover cervix during coitus.
ADVANTAGES OF BARRIER METHODS:
1. They are disposable.
2. They can be self –inserted.
3. They are reusable.
4. Prevents conception by blocking entry of sperm thru cervix.
3. INTRA UTERINE DEVICES (IUD’S):
• Devices inserted by doctors or nurses in uterus thru vagina. EXAMPLES. CU T, CU7, MULTILOAD 375,
LIPPES LOOP. Cu ions releasing IUDs suppress sperm motility & fertilizing capacity of sperms.
• HORMONE RELEASING IUDS (LNG 20) makes the uterus unsuitable for implantation & cervix hostile
to the sperm.
4. ORAL PILLS:
• Pills are taken daily for 21 days.
• They are very effective with less side effects.
• Saheli - new oral contraceptive contains a non-steroidal preparation.
• it is a ‘once a week ‘pill with high contraceptive value.
• injection or implantation of progesterone /estrogen under the skin.
5. SURGICAL METHOD:
• This method is also called as sterilisation.
• It is advisable for male/female partner as a terminal method to prevent any more pregnancies.
• VASECTOMY- In this surgical method in which a very small parts of Vas deferens is cut and tied up
through a small incision in scrotum. It prevents the sperms from moving into the vas deferens.

• TUBECTOMY- In this surgical method in which a very small parts of fallopian tube is cut and tied up
through a small incision in the abdomen through Vagina. It prevents the sperms from moving into
the vas deferens.

SIDE EFFECTS OF CONTRACEPTIVE METHOD:

It is very important that the selection of contraceptive method should be taken under the consultation
of the doctors.
• possible ill-effects like nausea, abdominal pain, breakthrough bleeding, irregular menstrual bleeding
or even breast cancer.
• These symptoms should not be totally ignored.
WHAT IS MTP (MEDICAL TERMINATION OF PREGNANCY)?
Intentional or voluntary termination of pregnancy before full term is called medical termination of
pregnancy (mtp) or induced abortion.

WHY MTP?
• MTP is done to get rid of unwanted pregnancies due to casual unprotected intercourse or failure of
the contraceptive used during coitus or rape.
• MTPs are also essential in certain cases where continuation in pregnancy could be harmful or even
fatal to the mother or to the foetus or both.

SEXUALLY TRANSMITTED DISEASES ( STDS)/ SEXUALLY TRANSMITTED INFECTIONS( STIS)

• Diseases or infections which are transmitted sexually through sexual intercourse are called as
sexually transmitted diseases (STDS) OR venereal diseases (VDS) OR reproductive tract infections.
• STDS can be classified as viral, bacterial, protozoan, fungal, etc.

HOW ARE STDS CAUSED?

• Depending on the disease, STDs can be spread with any type of sexual activity.
• STDs are most often caused by viruses and bacteria.
• Various types of sexually transmitted diseases: the various types of sexually transmitted diseases
include gonorrhoea, syphilis, genital herps, trichomoniasis, hepatitis -B
• The most common HIV leading to AIDS.
• HIVs and AIDS can be transmitted
✓ Sharing of injection needles and surgical intruments with infected person.
✓ Transfusion of blood
✓ Infected mother to foetus.
CHLAMYDIASIS
• chlamydiasis is a sexually transmitted disease in humans caused by the bacterium chlamydia
trachomatis. Chlamydiasis is a major infectious cause of human genetial and eye diseases.
• chlamydiasis was once the most important cause of blindness. The infection can spread from eye to
eye by fingers, shared towels, eye seeking flies, and cloths etc.

PREVENTION STDS ARE A MAJOR THREAT TO A HEALTHY SOCIETY.

Therefore early detection or prevention and cure of these diseases are given prime consideration
under reproductive health-care programmes though all person are vulnerable to these infections, their
incidences are reported to be very high among the age group of 15-24years.

PREVENTED BY FOLLOWING A FEW SIMPLE RULES

• Avoid sex with unknown partners or multiple partners
• Always use condoms during coitus
• In case of doubt, go to a qualified doctor for early detection and get complete treatment if
diagnosed with disease.

INFERTILITY
a large no of couples all over india are infertile, i.e., they are unable to produce children in spite of
unprotected sexual co-habitation. The reasons for this could be many-physical, congenital, diseases,
drugs, immunological or even psychological. Assisted reproductive technologies (ART) are special
techniques that assist couples to have children.

TYPES OF ASSISTED REPRODUCTIVE TECHNOLOGIES ( ART) ·

1. IN VITRO FERTILIZATION (IVF)

It is the fertilization outside the body in almost similar conditions as that in the body. In this method,
popularly known as test tube baby programme, ova from the wife / donor (female) and sperms from
the husband / donor (male) are collected and are induced to form the zygote under simulated
conditions in the lab. The zygote or early embryos could then be transferred into the fallopian tube
(zift -zygote intra fallopian transfer)

2. ZYGOTE INTRA FALLOPIAN TRANSFER (ZIFT) the zygote with 8 blastomeres can be transferred into
the fallopian tube.
3. INTRA cytoplasmic sperm injection (icsi) intra cytoplasmic sperm injection (icsi) is another
specialized procedure to form an embryo in the lab in which a sperm is directly injected into the
ovum.
4. GAMETE INTRA FALLOPIAN TUBE (GIFT) transfer of an ovum collected from a donor into the
fallopian tube of another female who cannot produce one, but can provide suitable environment
for fertilisation and further development is another method attempted.
5. ARTIFICIAL INSEMINATION (AI) infertility cases either due to inability of the male partner to
inseminate the female or due to very low sperms counts in the ejaculates could be corrected by
artificial insemination. In the technique, the semen collected either from the husband or a healthy
donor is artificially introduced into the vagina or into the uterus (iui - intra uterine insemination)
of the female.
6. ADOPTION – can be done from orphanage / relatives. Counseling and information on infertility it
is important to involve both partners in all aspects of management. Discussions of wishes, plans,
beliefs and motives are important.

NCERT QUESTIONS
1. What do you think is the significance of reproductive health in a society?
Ans. Reproductive health in a society is significant because the people are aware of:
(i) Birth control methods, maintaining the population size and prevention of unwanted pregnancies.
(ii) Sexually transmitted diseases and methods to avoid them.
(iii) Importance breast feeding and post natal care of the mother and baby.
(iv) Equal opportunities for the male and female children.
(v) Manage disordered related to reproductive health.
2. Suggest the aspects of reproductive health which need to be given special attention in the present scenario.
Ans.The aspects of reproductive health which need to be given special attention are :
(i) Creating awareness to the individuals, especially to the young minds about reproductive organs, accessory
organs of reproduction, secondary sexual characters, adolescence and related changes.
(ii) Providing knowledge about available birth control methods, care of pregnant mothers, post-natal care of the
mother and child, importance of breast feeding etc.
(iii) Creating awareness about consequences of uncontrolled population growth and social evils (sex abuses and
sex-related crimes, use of drugs, tobacco and alcohol etc.) among young people.
(iv) Crime like rape should strickly death with.

3. Is sex education necessary in schools? Why?

Ans. Yes, sex education is necessary in school. The reasons are given as:
(i) It provides the first information about reproductive organs, accessory organ and about reproductive health.
(ii) To make to students about the sex and the misconception about it that is prevailing around them.
(iii) Also to ensure them that there nothing to hide it so they can freely tell to their parents and teachers regarding
any issues.
(iv) To tell them about the physical changes taking place at the time of puberty. The should know about the
menstrual cycle and its precaution at right age.
(v) To made aware about sexually transmitted diseases and to good touch and bad touch.

4. Do you think that reproductive health in our country has improved in the past 50 years? If yes, mention some
such areas of improvement.
Ans. Yes, the reproductive health in country has improved in the past 50 years.
The areas of improvement are year as:
(i) Massive child immunization programme, which helps in reducing infants mortality rate.
(ii) Maternal and infant mortalityrate has been decreased drastically due to post natal care.
(iii) Increasing use of contraceptives which results in decrease in sexually transmitted diseases and unwanted
pregnancies.
(iv) Family planning motivates people to have small family

5. What are the suggested reasons for population explosion?

Ans. Reasons for population explosion are as follows:
(i) Increased medical facilities along with better living conditions, which in turn increases the longevity of an
individual.
(ii) Decline in Death rate like decline in Maternal Mortality Rate decline in Infant Mortality Rate
(iii) Increase in the number of people in the reproductive age.
(iv) Illiteracy causes people to unaware of birth control leads to unwanted pregnancies.

6. Is the use of contraceptives justified ? Give reasons.

Ans. Yes, the use of contraceptives is absolutely justified.
This is because of the following reasons given as:
(i) At the present time, the population is increasing tremendously use of contraceptive devices and methods
reduces the unwanted pregnancies, thus controlling birth rate.
(ii) It also prevents sexually transmitted diseases such as AIDS.

7. Removal of gonads cannot be considered as a contraceptive option. Why?

Ans. The removal of gonads cannot be considered as a contraceptive option because removal of gonad in male and
female is carried out by vasectomy and tubectomy respectively, which results in infertility. If gonads are removed
gametogenesis is ceased.
Contraceptives can be reversed but not the surgical methods like gonad removal.

8. Amniocentesis for sex determination is banned in our country. Is this ban necessary? Comment.
Ans. Amniocentesis is a process to find out any abnormalities in foetus. However, thus technique was misused to
determine the sex of child. Some parents used to about their female child before birth. Thus in order to prevent
killing of female foetus it is necessary to ban amniocentesis for sex determination.
9.
Ans. Assisted Reproductive techniques are those medical procedures which are used to treat infertility. A few of
assisted reproductive technique are in-vitro fertilization, intra cytoplasmic sperm injection, Gamete Intrafallopian
Tube Transfer, Zygote Intrafallopian Tube Transfer etc.
(i) In vitro fertilization: Mother’s egg and her Father’s sperm are collected and mixed together in a laboratory to
achieve fertilization outside the body. The embryo produced may then be transferred into the female uterus. It is
commonly known as test tube baby programme.
(ii) Gamete Intra Fallopian Transfer (GIFT): A procedure in which eggs are retrieved from a woman, mixed with
sperm and immediately replaced in one or other of the women’s fallopian tubes so that they fertilize inside the
body (in-vivo).
(iii) Intra Cytoplasmic Sperm Injection (ICSI): In this method, sperm and eggs are retrieved from both the parents. A
single sperm is injected directly into an egg, then the fertilized egg is implanted into the woman’s uterus.
(iv) Artificial insemination: In this technique, the semen is collected either from husband or a healthy donor and is
artificially introduced either into the vagina or into the uterus of the female (IUI-Intra uterine insemination).

10. What are the measures one has to take to prevent from contracting STDs?
Ans. (i) Avoiding sex with unknown partner/multiple partners.
(ii) Always use condoms and protection during intercourse.
(iii) In case of doubt, go for medical professional for early detection and get complete treatment if diagnosed with
disease.
(iv) Complete abstinence from sex with infected individuals.

12. Correct the following statements:

(a) Surgical methods of contraception prevent gamete formation.
(b) All sexually transmitted diseases are completely curable.
(c) Oral pills are very popular contraceptives, among the rural women.
(d) In E.T. techniques, embryos are always transferred into the uterus.

Ans. (a) Surgical methods of contraception prevent gamete transport and thereby prevent conception.
(b) Except for hepatitis-B, genital herpes, and HIV infections, other STD diseases are completely curable if detected
early and treated properly.
(c) Oral pill are very popular contraceptives among the educated urban women.
(d) In E.T . techniques, embryos with 8 blastomeres are transferred into fallopian tube and more than 8
blastomeres are transferred into the uterus.