Reproductive Health
–Refers to healthy reproductive organs with normal function.
It also includes emotional and social aspects.
WHO – Total well-being in all aspects of reproduction in physical , emotional , and social.
Reproductive Health – Problems and strategies
India initiated family planning programs in 1951.
Currently modified to
Reproductive and Child Health Care(RCH)
- Creating Awareness for building up a reproductively healthy society.
- Introduction of Sex Education in school prevented children from believing in myths and misconceptions.
- Proper Knowledge of : *Reproductive organs
*Adolescence and related changes
*Safe and hygienic sexual practices
*Sexually transmitted diseases
- Educating fertile couples and marriageable age groups.
- Birth control options
- Care of pregnant mothers
- Post-natal care of mother and child
- Breast feeding
- Equality in sex
- Statutory Ban on amniocentesis .
A test for karyotyping where the foetal sex is determined and leads to foeticide.
- Research on various reproduction related areas are encouraged.
* Saheli – A new oral contraceptive for females developed by scientists of CDRI.
Population Explosion and Birth control
World Population which was around 2 billion in 1900 rocketed to about 6 billion by 2000.
In India 350 million during independence reached 1 billion by May 2000, due to
- Rapid decline in death rate
- Maternal mortality rate (MMR)
- Infant mortality rate (IMR)
- Increase in number of people in reproductive age.
To overcome the problem of population explosion;
- Motivate smaller families.
- Statutory rising of marriageable age.
- Incentives for couples with smaller families.
- Wide range of contraceptive methods are presently available, broadly grouped into:-
Natural Methods
– Periodic abstinence
– Withdrawal /
– Lactational amenorrhea
(No side effects)
Barrier method: – Preventing ovum and sperms from
physically meeting.
Condoms: –Available for both male and female.
-Protection from STD’s and RTI’s.
-These are disposable.
Diaphragms, Caps & Vaults:-
- Barriers used in female
- Covers cervix
- Blocks entry of sperms through cervix
- Reusable
- Spermicidal cream, jellies and foam used along with these barriers to increase contraceptive efficiency
Progestogen/Progestogent Estrogen
Used as injections/ implants
- Action is just as pills
- Effective periods are much longer
Or IUD`s within 72 hours of certes very effective emergency contraceptive used to avoid possible pregnancy due to rape/casual unprotected intercourse. Or breast cancer should not be totally ignored.
Surgical Methods:
Called sterialisation
- Done for males or female as terminal method
- Prevent any more pregnancies.
- Block gamete transport therefore conception
Sterilization in females-vasectomy
In females tubectomy Small part of vasdeferences removed or tied up through small incessin in scrotum.
A small part of fallopian tube removed or tied through a small incessin in abdomna/through ‘vagina’
NOTE highly effective but partially
- Contraceptive methods and its use should be under qualified medical professionals
- It is actually practiced against the natural events
- possible ill effects – nausea, abdominal pain, break through bleedings, irregular meastruatal bleeding
Medical Termination of Pregnancy (MTP)
- 45-50 millions performed every year
- Majority done illegally by unqualified quacks
- Whether to accept/ legalise MTP- a major debate in many countries- due to emotional, social, ethical and religious issues
NOTE- Indian govt legalized in 1971 with strict conditions to avoid misuse
- To prevent unwanted pregnancy due to rape
- To prevent harmfulfatalsituationeither to mother / foetus
- It is safe only during first
Sexually transmitted diseases(STD’s)
Transmitted through sexual intercourse
STD’s / VD (venereal disease)/RTI (reproductive tract infection)
Eg: gonorrhea with infected persons
Syphilis transfusion of blood
Genital herps infected mother to foetus
Chlanydiasis
Genital warts transmitted by sharing of injection needles
Trichomoniasis surgical instruments etc.
Hepatitis-B
AIDS (caused by HIV) àmost dangerous
Except these
Others are completely cureable if detected early and treated
Symptoms: itching, fluid discharge, sliqut pain, swelling etc.
- Infected female asymptomatic-undetcted for cong
- Social stigma attached to STD`s-prevents timely detection
- Leads to complication later
- Pelvic inflammatory diseases (PID)
- Abortions
- Still birth
- Ectopic pregnancies
- Infutitity/even cancer rep. tract
- All persons are vulnerable to these infection
- Vulnerable among age group 15-24 years
- Prevention is possible if you follow simple principles
- Avoid sex with unknown partners or multiple partners
- Always use condoms during coites
- Incase of doubt go to a qualified doctor for early detection and complete treatment if diagnosed
Infertility
many couples with no children may be due to
physical
congenital
diseases
drugs
immunological
psychological
-corrections not possible – but they could be assisted-assisted reproductive technology (ART)
Invitro fertilization (IVF)
Fertilization outside the body
Similar to the body conditions
Followed by embryo transfer (ET)
Popularly known as test tube baby
Ova from wife or donar
&
Sperm from husband /donar
Collected and induced from zygote under
simulated conditions
IUI-intra-uterine- zygote / early embryo (splastomeres)
insemination
semen intr. artificially from
husband/healthy donor into
vagina or uterus transferred to fallopian tube
ZIFT– zygote intra fallopian transfer if embryo with mere tra&blestomere-
Transferred directly to uterus
IUT– intra utrine transfer
Embryo formed by in-vivo fertilization also could be used for transfer to anist the female who cannot conceive
GIFT – gamete intra fallopian
Is transferred from donor to another female who can not
ICSI- intra cytoplasmic sperm injection
Directly injected into ovum
AI – artificial inscrimination if male unable to incriminate