Reproductive Health
Introduction
A total wellbeing in all aspects of reproduction such as physically,
mentally and emotionally is called reproductive health.
All the reproductive organs should be healthy with normal functions.
Fig. reproductive organs- male reproductive system, female reproductive
system, mammary gland
Reproductive health- problems and
strategies
Major problems associated with reproductive health
Over population- explosion in population causes a scarcity of every basic
need and hence affect the well-being of reproductive health.
Sex education- due to lack of sex education people are not concerned
about safe and hygienic sexual practice.
Adolescence related changes- the changes which take place in adolescent
can lead to sex abuse and hence can affect reproductive health.
Sexually transmitted diseases- sexually transmitted diseases can affect
the reproductive health.
Sex abuse and sex related crimes- sex abuse can cause physical injury,
unwanted pregnancy, vaginal discharge, pelvic pain etc.
Female foeticides- female foeticides can affect reproductive and sexual
health of a woman.
Strategies
Family planning-
The increase in human population, health and education of all the children
as well as marriage and child bearing capacity of individuals are some
special concerns for the overall reproductive health.
Keeping in view the concerns of reproductive health, Government of India
initiate ‘Family Planning’ programme in 1951 and ‘Reproductive and Child
Healthcare’ programme (RCH) in 1997.
The major objectives of the programme are to create awareness among
people about various reproductive aspects and maintain a total wellbeing
of the reproductive organs.
Awareness about reproduction and social evils- Government and non-
government agencies have taken various steps to create awareness about
consequences of uncontrolled population growth, social evils like sex
abuse, sex related crimes etc.
Sex education-
Introduction of sex- education in schools and colleges is another step to
provide right information to the youth.
Sex education save the young people from myths and misconceptions
about sex related issues.
Knowledge about birth control methods and care of mother and child- It is
important to provide information to the couples and also who are in
marriageable age group about birth control methods, care of pregnent
mothers, importance of breast feeding, equality to the sex and equal
opportunities to the male and female child etc.
Infrastructural facilities and material support-
Medical assistance be provided should and people should be cared in
reproduction related problems like pregnancy, delivery. STDs, abortions,
menstrual problems etc.
Implementation of better techniques and new strategies from time to time
is also required to provide more efficient care and assistance to people.
Ban on amniocentesis-
Amniocentesis is a foetal sex determination test based on the
chromosomal pattern in the amniotic fluid surrounding the developing
embryo.
Amniocentesis is done to determine sex legally should be banned as it
increases female foeticide.
Fig. amniocentesis
Massive child immunization programme should be implemented to
achieve the goal of reproductive health
Population explosion
The rapid increase in human population over a relatively short
period of time is called population explosion.
Due to overall development in various fields like increased health
facilities, better living conditions the quality of life of people has
been increased which had a great impact on growth of population.
Reasons for population explosion
A rapid decline in death rate, Maternal Mortality Rate (MMR) and
Infant Mortality Rate(IMR).
An increase in number of people in reproducible age.
Control of diseases and better public health care with greater
medical attention.
Steps to control population explosion
People should be educated about the advantages of smaller family.
Statutory raising the marriageable age of male and female is an
effective mean to control the population.
The couples of reproductive age are motivated to family planning by
adopting birth control measures.
Fig. population explosion
Birth control
Various contraceptives methods are available to control the birth of
a child like natural method, barrier methods, intra uterine devices,
oral contraceptives, injecting hormones, surgical methods.
Natural methods- this method avoid chances of meeting of sperms
and ovum.
Periodic abstinence-
1. In this method, couples avoid coitus from day 10 to 17 of the
menstrual cycle when ovulation could be expected.
2. This period is also called as fertile period as the chances of
fertilization is very high during this period.
Withdrawal or coitus interruptus- In the method, the male partner
withdraws the penis from the vagina just before ejaculation to avoid
insemination.
Lactational amenorrhea-
1. The menstrual cycle and ovulation do not occur during intense
lactation and so the chances of pregnancy are low.
2. This method is effective only upto six months after child birth.
Barrier methods- here, barriers are used to prevent the physical contact
of sperms and ovum.
Condoms-
1. The barriers which are made of thin rubber latex sheath to cover the
penis or vagina in males and females respectively are called
condoms.
2. Also prevent the spread of sexually transmitted diseases
Condoms trap the ejaculate and prevent semen from entering the
vagina
Example- Nirodh, is a popular brand of condoms for males.
Diaphragms, cervical caps and vaults- made up of rubber which are
inserted in female reproductive tract to cover the cervix during coitus to
prevent conception by blocking the entry of sperms through the cervix.
Intra uterine devices-
Inserted by doctors in the uterus through the vagina which
increases the phagocytosis of sperms within the uterus.
These are available as non-medicated IUDs such as CuT, Cu7,
multiload 375 and hormone releasing IUDs such as LNG-20,
Progestasert.
Oral contraceptive pills-
Small doses of progesterone or progesterone-
estrogen combinations are used by the females in the form of
tablets.
These are taken daily for 21 days starting from the fifth day of
menstrual cycle and after a gap of 7 days it has to be repeated
again.
Hormonal pills prevent ovulation and implantation by inhibiting the
secretions of FSH and LH from the pituitary glands.
Saheli, an oral contraceptive pill is a non- steroid preparation used
by females.
Fig. contraceptive pills
Injections of hormones-
Progesterone along with other estrogen are used by females as
injections under the skin,
The effective period is longer than pills but action is similar.
Surgical methods-
Vasectomy-
1. The sterilization process in males is called vasectomy.
2. In this process, a small part of the vas deferens is removed or tied
up through a small incision on the scrotum.
Fig. vasectomy
Tubectomy-
1. The sterilization procedure in the females is called as tubectomy.
2. In this method, a small part of the fallopian tube is removed or tied
up through a small incision in the abdomen or through vagina.
Fig. tubectomy
Medical termination of pregnancy
(MTPs)
Intentional or voluntary termination of pregnancy is called medical
termination of pregnancy.
Medical termination of pregnancy is also termed as
MTPs are used to get rid of unwanted pregnancies and the
pregnancies which could be harmful or fatal to the mother or to the
foetusor both.
MTPs are safe upto 12 weeks i.e. the first trimester or pregnency.
Government of India legalized MTP in 1971.
Fig. abortion
Sexually transmitted diseases
(STD’s)
Diseases which are transmitted through sexual intercourse with infected person are called
sexually transmitted diseases or venereal diseases or reproductive tract infections. (RTI)
Gonorrhoea, syphilis, genital herpes, genital warts, hepatitis, AIDS, chlamydiasis are
sexually transmitted diseases.
STD’s can transmit through-
Sexual contact with infected persons.
Sharing of needles or surgical instruments contaminated with infected blood.
Transfusion of contaminated blood.
STDs can also be transmitted from an infected mother to the foetus.
STDs can be prevented by taking preventive measures like-
Avoid sex with unknown persons or multiple persons.
Always use condoms during sex.
If the early symptoms like itching, fluid discharge, slight pain, swellings occur in the
genital regions, one must consult a doctor.
STDs if left untreated can lead to pelvic inflammatory diseases, abortions, still births, ectopic
pregnancies, infertility or even cancer of the reproductive tract.
Infertility
Inability to give birth to a child or inability to conceive is called infertility.
The reasons for infertility can be physical, hereditary, drugs, psychological etc.
The couples could be assisted to have their own child through certain special techniques
called as assisted reproductive technologies.
Assisted reproductive technologies-
1. In vitro fertilization (IVF)-
IVF involves fertilization of ovum outside the body followed by embryo transfer (EF).
Ova from the wife/donor female and sperms from the husband/donor male are collected
and are induced to get fuse to form zygote in the laboratory.
The zygote is then transferred into the fallopian tube called as zygote intra-fallopian
transfer (ZIFT).
If the embryo is with more than 8 blastomeres, it is transferred into the uterus called
as intra uterine transfer (IUT).
The transferred embryo completes their further development within the uterus.
Fig. embryo formed by IVF
2. Gamete intra fallopian transfer (GIFT)- Here, ovum is collected from a donor female and is
transferred into the fallopian tube of another female who cannot produce ovum, but can
provide suitable environment for fertilization and further development of embryo.
3. Intra cytoplasmic sperm injection (ICSI)- In this method, sperm is directly injected into the
ovum under lab conditions.
Fig. injection of sperm into ovum
4. Artificial insemination or intra uterine insemination - Here the semen collected either from
the husband or a healthy donor is artificially introduced either into the vagina or into the
uterus of the female.
