REPRODUCTIVE HEALTH

Reproductive health is a state of complete physical, mental and social well-being and not merely
the absence of disease or infirmity.

Traditional incision
An Incision is an opening that is made in something with a sharp tool, especially in someone’s
body during an operation. An incision is a cut made into the tissues of the body to expose the
underlying tissue, bone or organ so that a surgical procedure can be performed. An incision is
typically
‘made with a sharp instrument, such as a scalpel, that is extremely sharp and leaves the skin and
tissues with clean edges that are able to heal well.

Female Genital Mutilation (FGM)

This is the partial or total removal of the female external genitalia. External genitals include the
clitoris, labia, mons pubis (the fatty tissue over the pubic bone), and the urethral and vaginal
openings.
The practice of FGM is often called “female circumcision” (FC), implying that it is similar to
male circumcision. However, the degree of
cutting is much more extensive, often impairing a woman’s sexual and reproductive functions. The
traditional custom of ritual cutting and alteration of the genitalia of female infants, girls, and
adolescents, referred to as female genital mutilation (FGM), persists primarily in Africa and among
certain communities in the Middle East and Asia.
Traditionally, a local village practitioner, or midwife is engaged for a fee to perform the procedure,
which is done without anesthesia using a variety of instruments, such as knives, razor blades,
broken glass, or scissors not considering the health indications of using these instruments.

Types Of Female Genital Mutilation

• Circumcision or “Sunna”: This involves the removal of the prepuce and the tip of the
clitoris. This is the only operation which, medically, can be likened to male circumcision.
• Excision or clitoridectomy: This involves the removal of the clitoris, and often also of the
labia minora. It is the most common operation and is practised throughout Africa, Asia, the Middle
East and the Arabian Peninsula.
• Infibulation or Pharaonic circumcision: This is the most severe operation, involving
excision plus the removal of the labia majora and the sealing of the two sides, through stitching or
natural fusion of scar tissue. What is left is a very smooth surface, and a small opening to permit
urination and the passing of menstrual blood. This artificial opening is sometimes not larger that
the head of a match.
• Introcision: In this form of mutilation, When a girl reaches puberty, the whole tribe –
both sexes – assembles. The operator, an elderly man, enlarges the vaginal orifice by tearing it
downward with three fingers bound with opposum string. In other districts, the perineum is split
with a stone knife. This is usually followed by compulsory sexual intercourse with a number of
young men. As soon as a girl reaches maturity, she is intoxicated and subjected to mutilation in
front of her community. The operation is performed by an elderly woman, using a bamboo knife.
She cuts around the hymen from the vaginal entrance and severs the hymen from the labia, at the
same time exposing the clitoris. Medicinal herbs are applied followed by the insertion into the
vagina of a slightly moistened penis-shaped object made of clay.
• Unclassified types of FGM: This includes pricking, piercing or incision of clitoris and/or
labia; stretching of clitoris and/or labia; cauterisation by burning of clitoris and surrounding tissues;
scraping (angurya cuts) of the vaginal orifice or cutting (gishiri cuts) of the vagina; introduction of
corrosive substances into the vagina to cause bleeding or herbs into the vagina with the aim of
tightening or narrowing the vagina; any other procedures which fall under the definition of FGM
given above.

Reasons For Female Genital Mutilation

This procedure has a lot to do with traditions and cultural beliefs. It is believed that cutting or
removal of the tissues around the vagina would prevent women from having pleasurable sexual
feelings. These reasons range from cultural, religious to social.
• This procedure is used for social and cultural control of women’s sexuality and feelings
of sexual arousal.
• FGM is often considered a necessary part of raising a girl properly, and a way to prepare
her for adulthood and marriage
• In its most extreme form, INFIBULATION, where the girl ’ s vagina is sewn shut,
the procedure ensures virginity.
• FGM is often motivated by beliefs about what is considered proper sexual behaviour,
linking procedures to premarital virginity and marital fidelity. FGM is in many communities
believed to reduce a woman’s libido and therefore believed to help her resist “illicit” sexual acts.
When a vaginal opening is covered or narrowed, the fear of the pain of opening it, and the fear that
this will be found out, is expected to further discourage “illicit” sexual intercourse among women.
• In some cultures where female circumcision has been a tradition for hundreds of years,
this procedure is considered a rite of passage for young girls.
• Families fear that if their daughters are left uncircumcised, they may not be
marriageable.
• FGM is associated with cultural ideals of femininity and modesty, which include the
notion that girls are “ clean ” and “ beautiful ” after removal of body parts that are considered
“male” or “unclean”.
• As in most cultures, there is also the fear that the girl might bring shame to the family by
being sexually active and becoming pregnant before marriage.

The Harmful Effects of Female Genital Mutilation

FGM has no health benefit instead it causes a lot of harm to the girls and women involved in many
different ways. It involves removing and damaging healthy and normal female genital tissue, and
this interferes with the natural functions of girls’ and women’s bodies. Infections can also come
through the use of the various sharp objects or instruments that have been used.
Immediate complications can include severe pain, shock, haemorrhage (bleeding), tetanus or sepsis
(bacterial infection), urine retention, open sores in the genital region and injury to nearby genital
tissue.

Long-term consequences can include:

• recurrent bladder and urinary tract infections;
• cysts;
• infertility;
• an increased risk of childbirth complications and newborn deaths;
• the need for later surgeries.
• For example, the FGM procedure that seals or narrows a vaginal opening needs to be
cut open later to allow for sexual intercourse and childbirth. Sometimes it is stitched again several
times, including after childbirth, hence the woman goes through repeated opening and closing
procedures, further increasing and repeated both immediate and long-term risks.

Care and Protection of the Reproductive System

This is done through:
1. Circumcision of the male at childbirth reducing the effect of micro-organisms on the fore
skin of the penis.
2. Regular bathing of the individual and drying of the reproductive organs.
3. Shaving of the pubic hair to avoid the growth of bacteria and fungi.
4. Ensuring thorough cleanliness of the toilet system to avoid contracting diseases, such as
candidacies.
5. Washing of undies (pants) regularly.
6. Using sanitary pads by females during menstruation to avoid getting stained and
infections.
7. Using tissue paper to clean up after urinating.

PRENATAL CARE
Prenatal care is essential for monitoring the growth of the foetus and the health of the mother.
Prenatal care is the healthcare you receive while pregnant. Regular prenatal care throughout your
pregnancy helps to catch potential concerns early and reduces the risk of pregnancy and birth
complications.

IMPORTANCE OF PRENATAL CARE

1. It helps the doctor to identify patient who may be at risks or complications during
pregnancy
2. It helps to prevent complications during pregnancy by keeping both the mother and the
baby safe
3. Women must ensure that the medication they take is safe for them and the foetus
4. It helps to keep track of baby’s development
5. It helps the mother to get accurate nutritional information
 6. It helps to learn about labour and delivery

Sexually Transmitted Infections (STIs)

These are highly infectious diseases that are spread by sexual contact. They are referred to as
venereal diseases (VD). These diseases are caused by bacteria and can survive in human body.
The two most common STIs are syphilis and gonorrhea. Other examples include, HIV/AIDS,
genital herpes, etc.
Syphilis
This is caused by a spirochete bacterium called Treponema pallidum. The pathogen enters the body
through a break in the skin or mucous membrane. The bacteria may attack any kind of body tissue.
This disease is highly contagious. In its early stages, the symptoms appear about 10-25 days after
sexual contact with an infected person. The first sign is usually a large but painless ulcer which
often appears on the penis or vulva. Other symptoms include nervousness, fever, anaemia, loss of
weight and pain in the bones and joints. In the final stages, syphilis may attack the brain, spinal
cord and valves of the heart, resulting in paralysis, insanity, blindness, etc.
Treatment
In the early stages, the disease can be cured by a four – day treatment with penicillin injection.
Penicillin administered to a pregnant woman will also kill any spirochetes in her foetus. People
allergic to penicillin can be given tetracycline or other drugs.
Gonorrhoea
This is caused by a bacterium called Neissueria gonorrhoeae and sometimes called gonococcus.
There is a white discharge from the urinary tract and a burning sensation during urination in an
infected person. The symptoms may be noted 3-5 days in the males. The female may show no
symptoms at all. This leads to sterility, blindness in children, etc.
Treatment
A single dose of penicillin injection can cure gonorrhea if it is diagnosed at an early stage.

HIV/AIDS
• HIV- Human Immunodeficiency Virus
• AIDS – Acquired Immune Deficiency Syndrome
This disease is caused by a virus called Human Immunodeficiency Virus (HIV). An infected person
with HIV has no symptoms of the disease for some years and can infect others without realizing
that they are infected.
HIV can be transmitted sexually through intercourse with an infected person, from infected mother
to the child during pregnancy or as a result of breast feeding, during transfusion of infected blood,
using unsterilized sharp instruments, etc. however, HIV cannot be transmitted through handshakes,
insect bites, water or food.
HIV infects special cells in the immune system called the lymphocytes and monocytes. It
eventually destroys these cells and this leaves the individual susceptible to other diseases. This
leads to vulnerability to opportunistic infections like tuberculosis, pneumonia, meningitis and
possible death.
Meaning Of Breast Feeding
Breastfeeding is the normal way of providing young infants with the nutrients they need for healthy
growth and development. Virtually all mothers can breastfeed, provided they have accurate
information, and the support of their family.
Colostrum, the yellowish, sticky breast milk produced at the end of pregnancy, is recommended by
WHO as the perfect food for the newborn, and feeding should be initiated within the first hour after
birth.
Exclusive breastfeeding is recommended up to 6 months of age, with continued breastfeeding along
with appropriate complementary foods up to two years of age or beyond.

Importance of breastfeeding for mother

Research shows that breastfeeding has significant health benefits for mothers.
Breastfeeding:
• Assists the uterus return to its pre-pregnant state faster.
• Can help women to lose weight after baby’s birth.
• Reduces the risk of ovarian cancer and pre-menopausal breast cancer.
• Reduces the risk of osteoporosis.
• Reduces the risk of mothers with gestational diabetes developing Type 2 diabetes.

Importance of breastfeeding for baby

• It supplies all the necessary nutrients in the proper proportions.
• It protects against allergies, sickness, and obesity.
• It protects against diseases, like diabetes and cancer.
• It protects against infections, like ear infections.
• It is easily digested – no constipation, diarrhea or upset stomach.
• Babies have healthier weights as they grow.
• Breastfed babies score higher on IQ tests.

Causes of Infants Mortality

The death of a baby before his or her first birthday is called infant mortality. Most of these babies
die because they are;
• Born with a serious birth defect.
• Born too small and too early (i.e., preterm birth; birth before 37 weeks gestation).
• Victims of Sudden Infant Death Syndrome (SIDS).
• Affected by maternal complications of pregnancy.
• Victims of injuries (e.g., suffocation).

Causes of Birth Defects

Birth defects are structural or functional abnormalities present at birth that cause physical or mental
disability. Some may be fatal. Birth defects have a variety of causes, such as:
• Genetic problems caused when one or more genes doesn ’ t work properly or part of a
gene is missing
 • Problems with chromosomes, such as having an extra chromosome or missing part of a
chromosome
• Environmental factors that a woman is exposed to during pregnancy, such as rubella or
German measles while pregnant, or using drugs or alcohol during pregnancy.

Importance of Knowledge of Genetic Disorder in Family

A genetic disorder is a disease that is caused by an abnormality in an individual’s DNA. In other
word, genetic disorder is an illness caused by abnormalities in genes or chromosomes.
Abnormalities can range from a small mutation in a single gene to the addition or subtraction of an
entire chromosome or set of chromosomes. Sickle cell disease, cystic fibrosis, cancer, obesity,
mental illness, Alzheimer disease and Tay-Sachs disease are examples of genetic disorders
Knowledge of genetic disorder may assist the family by:
• Identifying the likelihood that certain diseases or conditions may develop based on
genetic information, and then anticipating the timing of the expected disorder in the person’s life
cycle.
• Helping families prepare pragmatically and emotionally for expected challenges, such as:
living with uncertainty, care giving strains, and losses associated with various genetic conditions as
they may unfold.
• Helping families create meaning that sustains hope and promotes mastery.
• Identify effective treatments, or teaching coping skills for disorders with little hope for
treatment.
• Can lead to better care and management of the patient and ultimately to improved quality
of life