REPRODUCTIVE HEALTH
Ø According to WHO “Reproductive Health
means a total well being in all aspects of reproduction—Physical, social,
behavioral & emotional”.
Ø India’s “Family Planning
Program” initiated in 1951
& improved programs covering wide areas are operated under “Reproductive &
Child Health Care (RCH) Program” creating awareness
regarding various reproduction related aspects & providing facilities and
support to build up a reproductively
healthy society.
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| (RCH Logo) |
Ø AWARENESS: - Educating people via (especially
fertile couple, young & adolescents)Audio-visual & print media, Oral
interaction (teachers, friends, close relatives etc..), Introduction of Sex
Education in schools (NAEP).
Ø EDUCATION:- Myths &
misconceptions, Reproductive organs, Adolescence & related changes, sexual
hygiene, STD’s, safe sex & available
Birth Control methods, Care of Pregnant Mothers, Post natal care of mother –
child, importance of breast feeding, importance to maintain healthy sex ratio.
Ø SUCESSFUL IMPLEMENTATION OF PLANS:- require good
infrastructure, professional experts & material support.
Ø Statutory BAN on “AMNIOCENTESIS” (a sex determination technique based on chromosomal
pattern in amniotic fluid), Massive Child Immunization Program, Awareness
Campaigns, Improved Legal environment (laws/police).
Ø SAHELI:- A new oral contraceptive
for the females ( developed by CDRI Lucknow) is cheap/ low cost, easily
available, highly effective, least/no side effect, properly campaigned{Non
Steroidal preparation, “once a week pill”).
Ø POPULATION EXPLOSION: - “every sixth person in
the world is an Indian”. Rapid decline in Death Rate (MMR/ IMR) due to improved medical
facilities, Increased number of population in reproductive age group.
Ø BIRTH CONTROL METHODS:-
[A] NATURAL METHODS:-
Periodic Abstinence (10th
-17th day of Menstrual
cycle), Withdrawal/coitus interrupts
(separation during coitus before ejaculation to avoid insemination), Lactational
Amenorrhea (absence of menstruation during intense lactation following
parturition)
[B] BARRIER METHODS:
Condoms (latex sheet to cover
penis or vagina & cervix) Advantage:-self inserted, easy disposal, prevent
STD’s. Diaphragm, Cervical caps, Vaults for females. They are reusable.
Spermicidal creams, Jellies & foams are used along with them to enhance
efficiency.
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| (Male Condoms) |
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| (Diaphragm) |
[C] INTRA UTERINE DEVICES
(IUD’S):-
inserted by experts in uterus,
they are categorised as:
(1) Non medicated (eg. Lippes Loop)
(2) Copper
Releasing (eg. CuT, Cu7, Multiload 375)
(3) Hormone
Releasing (eg. LNG-20, Progestasert).
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| (Lippes Loop) |
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IUD’s increase sperm
phagocytosis, Cu2+ ion suppress sperm motility & fertilization
capacity of sperm, make uterus unsuitable for implantation & cervix hostile
to sperm.
[D] ORAL PILLS:-
(progesterone or
progesterone – oestrogen combination for females)taken daily for 21 days
starting within first five days of menstruation, after a gap of 7 days repeat
the process. They inhibit ovulation & implantation. Also, alter the quality
of cervix mucous to prevent/retard entry of sperm.
[E] INJECTABLES: -
same combinations as used in pills can be
given as injections or implants under the skin. Mode of action is similar to
that of pills but effective periods are much longer.
{{Pills/Injectables /Implants /IUD’s used within 72 hrs. of coitus,
are found to be very strong emergency contraceptives in case of unprotected sex
or rape victims to avoid unwanted pregnancies}}.
[F] STERILIZATION:-
(Surgical Method)
Terminal/Final method of
Contraception (PERMANENT). Cutting a
part of Vas Deference in Males (VASECTOMY) & Oviduct/Fallopian
Tube in Females (TUBECTOMY) & tying open ends.
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| (Vasectomy & Tubectomy) |
Ø ILL EFFECTS OF
CONTRACEPTION:- Nausea, Abdominal pain,, Breakthrough bleeding,
irregular menstrual cycle, Breast Cancer
(though rare, but should not be totally ignored).
Ø MEDICAL TERMINATION OF
PREGNANCY (MTP):-
Intentional/Voluntary
termination of pregnancy before full term (INDUCED ABORTION). MTP in first Trimester (
up to 12th week) is SAFE, second Trimester is RISKY.
Ø MTP (In India, 1971) is legal in case of
Casual unprotected Intercourse, Failure of Contraception, Rapes, Pregnancies
fatal to mother, pregnancy of Minors under above mentioned cases.
Ø SEXUALLY TRANSMITTED DISEASES
(STD’s):-
VENERAL DISEASES (VD) OR
REPRODUCTIVE TRACT INFECTIONS (RTI’s) Eg. Gonorrhoea, Syphilis,
Chlamydiasis, Genital Warts, Trichomoniasis,
[Genital Herpes, Hepatitis-B, AIDS.]. Except boxed names, others are
completely curable if diagnosed early & treated properly.
SPREAD OF INFECTION :- {sharing injection
needles/ surgical instruments, unprotected sexual intercourse, infected blood
transfusion, from infected mother to unborn child}
SYMPTOMS:- {itching, fluid
discharge, slight pain, swelling etc.. in genital region, Often Asymptomatic
& undetected for long periods}. Less significant symptoms & Social
Stigma attached to STD’s prevent infected females to visit Doctors. Further
Complications includes complications like Pelvic Inflammatory Diseases (PID),
Abortions, Still Birth, Ectopic Pregnancies, infertility & cancer of
reproductive tract.
PREVENTION:-
(a) Avoid unprotected sex
with unknown partners/Multiple partners
(b) Use Condoms
(c) In case of doubts,
visit a qualified medical practitioner for detection & cure of disease.
Ø INFERTILITY:- Inability to produce children in spite of
unprotected sexual co-habitation for long period (2-3 years) REASONS (Physical,
Psychological, Congenital diseases, Drugs, Immunological conditions).
Ø
Assisted Reproductive Technologies (ART’s):-
In vitro Fertilization (IVF) followed by Embryo Transfer (ET) popularly called TEST TUBE BABY :-
Here, Ova from wife/donor and sperms from husband/donor are collected &
induced to form zygote under simulated conditions in lab. The zygote or early embryo (with up to 8
blastomeres) is transferred in to fallopian Tube/Oviduct { ZIFT—Zygote Intra Fallopian Transfer} & embryo with
more than 8 blastomeres, in to Uterus {IUT—Intra Uterine Transfer} to complete its further
development.
In vivo Fertilization:-
Embryo formed by fusion of gametes within the female could also be used for
transfers/ET to assist those females who cannot conceive.
Ø Gamete Intra Fallopian Transfer (GIFT) :- Transfer of Ovum collected from a donor in to
Fallopian Tube of another Female who cannot produce one, but can provide
suitable environment for fertilization & further development in her body.
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| (GIFT) |
Ø Intra Cytoplasmic Sperm
Injections (ICSI):- Specialized procedure
to form an embryo in laboratory, in which a sperm is directly injected in to
the ovum.
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| (ICSI) |
Ø Artificial Insemination (AI);-Semen collected from a healthy donor/husband is
collected, refined / concentrated & introduced either into the vagina or
into the uterus (IUI-Intra Uterine Insemination)
of female.
courtesy Google Images
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