Reproduction Health-Notes

1 Reproductive Health Problems, Strategies and Population Explosion

Reproductive Health It refers to the physical, social and mental well being of a person and his/her reproductive organs. 

Problems and Strategies

• RCH – Reproductive and Child Healthcare programme.
• To control the increasing population, family planning programmes were implemented in 1951.
• Sex education encouraged in schools to clarify any misconceptions students have.
• Print and digital media is used to create awareness.
• Sex education is necessary to create awareness about prevention of STDs, promote hygienic practices and safe sexual practices.
• Sex determination of the unborn baby by amniocentesis has been banned to keep a check on increasing female foeticides.

Population Explosion

• Increased health facilities have had an explosive impact on growth.
• World population escalated from 2 billion in 1900 to 6 billion by 2000.
• There is a rapid decline in death rate, maternal mortality rate (MMR) and infant mortality rate (IMR)
• Growth rate is still around 1.7%/year.
• Alarming growth rate could lead to scarcity of basic requirements.
• “Hum do hamare do” slogan was promoted for population control promotion.
• Raising of marriageable age to 18 years for females and 21 years for males helps the cause.

2 Medical Termination of Pregnancy (MTP) and STDs Medical Termination of Pregnancy (MTP)

• It refers to voluntary termination of unwanted pregnancy.
• It may be done in cases where the pregnancy poses risk to the mother or child.
• It was legalized in 1971.
• Rules and regulations are strict to prevent female foeticide.
• MTP is considered safe in the 1st trimester i.e. upto 12 weeks.
• MTP act of 1971 was amended in 2020.
• The amendment included that pregnancy can be terminated upto 20 weeks. If the period exceeds 20 weeks, upto 24 weeks it could be terminated only if medical practitioners believe that: a) The pregnancy would bear risk to the health of the woman. b) The unborn child is at a risk of serious physical/mental abnormality.

Sexually Transmitted Diseases (STDs)

• Diseases transmitted through sexual intercourse.
• Also calledvenereal diseases(VD) or reproductive tract infections (RTI).
• Common STDs are:
  1. Chlamydia
  2. Gonorrhoea
  3. HIV AIDS

4. Genital Warts 5. Syphilis

• AIDS and Hepatitis B are also transmitted through blood transfusion and sharing infected needles.
• Symptoms: Itching, swelling, pain, fluid discharge, etc.
• If condition progresses, it may lead to, infertility, ectopic pregnancy and abortions.
• One should always see a doctor incase of any doubt related to STDs.

3 Birth Control Birth control prevents unwanted pregnancies. It also offers protection against STDs. The methods or devices facilitating birth control are called contraceptives Ideal contraceptives are/have:

1. User-friendly
2. Easily available
3. Effective
4. Least side effects.

• Non- interfering with the sexual drive of a person.

Methods of Contraception1. Natural Methods

• Periodic Abstinence – Refraining from intercourse during day 10 to day 17 of the menstrual cycle.
• Coitus Interruptus – Retraction of penis before ejaculation to prevent insemination
• Lactational Amenorrhoea – Usually till 6 months after the delivery of a baby, there is no ovulation due to breastfeeding.

2. Barrier Methods They block the entry of the sperms into the female genital tract, and hence prevent fertilization.

• Condoms
• Cervical caps
• Diaphragms
• Vaults
• Spermicidal creams, foams, jellies

3. Intrauterine Devices These are inserted into the uterus through the vagina. These are the most commonly used contraceptives. These work by reducing sperm motility, causing phagocytosis of sperms and decreasing fertilising ability.

• Copper T
• Lippes Loop
• Progestasert

4. Oral Contraceptives

• These are oral pills.
• They are taken from the 5th day of menstrual cycle till the 26th day.
• After a gap for menstruation, the dose has to be repeated for the next cycle similarly.
• These work by preventing ovulation or implantation.
• Saheli is a non-steroidal pill developed by CDRI Lucknow.

5. Injectables and Implants

• These are emergency contraceptives, which need to be administered within 72 hours of unprotected intercourse.
• Progesterone or combination hormones can be injected or placed under skin to act as a contraceptive.

6. Sterilisation/Surgical Methods These are terminal methods of contraception, i.e., they offer permanent and irreversible contraception. The male or female ducts are cut and tied to prevent the release of gametes.

• Vasectomy – A portion of the vas deferens is cut and tied.
• Tubectomy – A portion of the fallopian tubes is cut and tied.

4 Infertility

• Inability to produce children is known as infertility.
• Reasons for infertility may be:

1. Physical
2. Congenital
3. Psychological
4. Hormonal
5. Diseases and drugs

Assisted Reproductive Technologies (ART)Assisted Reproductive Technologies (ART) make it possible for childless couples to bear children. These are of the following types:
1. In vitro fertilization (IVF)/Test Tube Baby – Here gametic fusion is carried outside the body in sterile conditions. After the embryo is developed, Embryo Transfer (ET) is done.

2. Zygotic Intra Fallopian Transfer (ZIFT) – Zygote or embryo with =< 8 blastomeres is directly transferred into the fallopian tube or uterus.

3. Gametic Intra Fallopian Transfer (GIFT) – It involves the transfer of gametes from a donor female into the body of a female who can house it but cannot produce an egg. 

4. Intra Cytoplasmic Sperm Injection (ICSI) – Direct injection of sperm into the ovum. 

5. Artificial Insemination (AI) – Sperm from a donor is inserted into the vagina or uterus of a female.