Reproductive Health - Important Points, Summary, Revision, Highlights

Reproductive Health

Reproductive health refers to not only physical well-being, but also to emotional, social, and behavioural well-being. It is important for the development of a country to have a reproductively healthy society.

Reproductive Health: Problems and Strategies

There are various issues concerning reproductive health, including population growth, sexually transmitted diseases, female foeticide, infant and maternal mortality, and various social ills. To ensure reproductive health and prevent population growth, many steps have been taken.

RCH: Reproductive and Child Health Care programmes are aimed at improving the reproductive health of society.

Family planning programmes were introduced in 1951 with the goal of population control.

Creating awareness about reproduction through both print and digital media is becoming increasingly important.

Promoting sex education in schools is essential so that teenagers can receive accurate information and dispel any misconceptions or myths.

Raising awareness about birth control, pre- and postnatal care, educating people about sexual organs and hygiene, safe sexual practices, and STDs (sexually transmitted diseases) has helped people lead healthy reproductive lives.

Making sex determination by amniocentesis or Ultrasonography a criminal offence has been implemented in order to prevent female foeticide.

Increased awareness about the menstrual and reproductive processes has helped to eliminate social stigmas associated with a female giving birth to a female child and other related issues.

The use of amniocentesis and other screening techniques has enabled the detection of genetic disorders in the developing foetus, such as haemophilia, Down Syndrome and sickle cell anaemia.

“Measure for Birth Control”

The main causes of the rapid increase in the world population are:

1. Technological advancement
2. Improved quality of life

Increased life expectancy and decreased death rate

The declining infant mortality rate (IMR) and maternal mortality rate (MMR) are positive indicators of progress.

The number of people with reproducible age has increased.

Various measures taken to control the population explosion include:

Promoting smaller families through increased awareness, access to birth control, and incentives

By increasing the legal age of marriage to 18 years for females and 21 years for males

Birth control measures or contraceptives should be easy to use, accessible, effective, and free of side effects. They are effective in delaying pregnancy or spacing between two children. They can be categorised into the following groups:

1. Natural: Nature is beautiful and powerful.

2. Periodic Abstinence during the fertile period, i.e. from the 10th to the 17th day of the menstrual cycle.

3. Withdrawal or Coitus Interruptus to prevent Insemination

4. Lactational amenorrhea is the lack of menstruation and ovulation for up to six months after delivery. Lactation amenorrhea is caused by the suppression of ovulation during breastfeeding.

5. Barrier Method: Disposable condoms, reusable cervical caps, diaphragms, and vaults can block the entry of sperm and prevent conception. The effectiveness of these methods can be increased by using spermicidal creams, foams, and jellies.

6. Intrauterine Devices (IUDs):
   IUDs are a highly popular form of contraception and come in various forms. They are inserted through the vagina and into the uterus, and work by reducing sperm motility, fertility and by increasing the phagocytosis of sperm.

7. Non-medicated IUDs: Lippes Loop

8. IUDs releasing Cu -

   • CuT
   • Multiload 375
   • Cu7

9. Progestasert - IUD releasing hormone

10. LNG-20 - IUD releasing hormone

11. Oral Contraceptives: Popularly known as “the pill,” oral contraceptives contain a combination of progestogen-estrogen or progestogens, which prevent ovulation. They also inhibit implantation and sperm entry by thickening the cervical mucus. This type of contraception must be administered for 21 days starting from the fifth day of the menstrual cycle, followed by a 7 day break before repeating the course. Saheli is a non-steroidal oral contraceptive pill developed in CDRI Lucknow. It is taken once a week and has been found to be very effective with few side effects.

12. Injectable and Implants: These are effective emergency contraceptives that should be taken within 72 hours of unprotected intercourse. Progestogens, or a combination of progestogens and estrogen, can be injected or implanted under the skin.

13. Surgical Sterilization: Surgical methods of sterilization are recommended as a last resort for birth control. These methods are highly effective, but the reversal process may be challenging.

14. Vasectomy - Male sterilization in which a small portion of the vas deferens is tied and cut.

15. Tubectomy: Female Sterilization, a small portion of the Fallopian Tubes is tied and removed.

All the contraceptive methods are able to check the uncontrolled growth of population, however, there are some side effects associated with them such as nausea, pain, irregular and heavy menstrual bleeding, etc. In rare cases, it may even lead to breast cancer.

Medical Termination of Pregnancy (MTPs)

It is used to prevent unwanted pregnancies, or if the pregnancy could be detrimental to the mother or fetus.

It refers to the induced abortion or voluntary termination of an unwanted pregnancy.

The Medical Termination of Pregnancy Act was passed in 1971, but with stringent regulations to prevent its misuse for female foeticide.

In 2017, the Medical Termination of Pregnancy (MTP) Amendment Act was put into effect to further decrease unlawful abortion and maternal mortality. According to the Act, a pregnancy may be ended before 12 weeks with the advice of one registered medical practitioner. If the termination is to be done after 12 weeks of pregnancy, then two doctors must be consulted and the pregnancy must be terminated before 24 weeks. After this point, it is not safe for the mother to end the pregnancy.

Sexually Transmitted Diseases or Infections (STDs or STIs)

STIs, also known as reproductive tract infections (RTIs) or venereal diseases (VD), are diseases or infections that are transmitted by sexual intercourse.

The common STIs include:

• Viral Infections:
  • AIDS (HIV Infection)
  • Herpes
  • Genital Wart
  • Cervical Cancer (Human Papillomavirus, HPV Infection)
  • Hepatitis B

Bacterial Infections:

• Syphilis
• Gonorrhoea
• Chlamydia

AIDS and hepatitis-B can also be transmitted through contaminated surgical instruments or infected needles during a blood transfusion, or can be passed from an infected mother to her fetus.

There have been vaccines developed to prevent Hepatitis-B and HPV. In addition to AIDS and Genital Herpes, other infections can be cured if they are detected and treated in the early stages.

Early symptoms of a genital infection may include:

• Vaginal discharge
• Itching
• Pain
• Swelling in the genital region

If not treated properly, it may lead to various complications such as infertility, ectopic pregnancies, abortions, stillbirths, PIDs (Pelvic Inflammatory Diseases) or even cancer.

It is essential to practice good hygiene of external genital organs to prevent infections. Additionally, one should abstain from unprotected sex and refrain from having multiple or unknown partners. If in doubt, do not hesitate to seek medical advice.

Infertility

Inability to produce children is referred to as infertility. Infertility can be caused by congenital, physical, psychological, hormonal, or disease- or drug-related factors.

For couples who were unable to conceive even after corrective treatments, the use of various assisted reproductive technologies (ART) has made it possible for them to have children.

Test tube baby or IVF (in-vitro fertilization): Fertilization of gametes outside the body under controlled conditions is referred to as IVF. Subsequently, the embryo is transferred to the uterus, this is known as embryo transfer (ET). Zygote intrafallopian transfer (ZIFT) involves the transfer of a zygote or early embryo (up to 8 blastomeres) to the fallopian tube. Intrauterine transfer (IUT) involves the transfer of an embryo with more than 8 blastomeres directly to the uterus.

Embryos created through in-vivo fertilization can also be used for transfer

Gamete Intrafallopian Transfer (GIFT): The transfer of an ovum from a donor to another female, who is able to provide a suitable environment for fertilization and further development, but is unable to produce an ovum of her own.

Intracytoplasmic Sperm Injection (ICSI): In this process, a single sperm is directly injected into the ovum in a laboratory setting.

Artificial Insemination (AI): Healthy sperm from either the husband or a donor is inserted into the female’s vagina or uterus, known as Intrauterine Insemination (IUI).