Reproductive health

• Reproductive health

  Healthy reproductive organs with normal functions, including emotional and social aspects of reproduction
• According to the World Health Organisation (WHO), reproductive health means a total well-being in all aspects of reproduction, i.e., physical, emotional, behavioural and social
• A society with people having physically and functionally normal reproductive organs and normal emotional and behavioural interactions among them in all sex-related aspects might be called reproductively healthy
• India was amongst the first countries in the world to initiate action plans and programmes at a national level to attain total reproductive health as a social goal
• Reproductive and Child Health Care (RCH) programmes

  1. Creating awareness among people about various reproduction related aspects

  2. Providing facilities and support for building up a reproductively healthy society
• Successful implementation of various action plans to attain reproductive health

  • Requires strong infrastructural facilities, professional expertise and material support
  • Providing medical assistance and care to people in reproduction-related problems
  • Implementation of better techniques and new strategies from time to time
• Statutory ban on amniocentesis for sex-determination to legally check increasing menace of female foeticides, massive child immunisation, are some programmes that merit mention
• Research on various reproduction-related areas are encouraged and supported by governmental and non-governmental agencies to find out new methods and/or to improve upon the existing ones
• Better awareness about sex related matters, increased number of medically assisted deliveries and better post-natal care leading to decreased maternal and infant mortality rates, increased number of couples with small families, better detection and cure of STDs and overall increased medical facilities for all sex-related problems, all indicate improved reproductive health of the society
• The world population which was around 2 billion (2000 million) in 1900 rocketed to about 6 billion by 2000 and 7.2 billion in 2011
• Our population which was approximately 350 million at the time of our independence reached close to the billion mark by 2000 and crossed 1.2 billion in May 2011
• Through our Reproductive Child Health (RCH) programme, though we could bring down the population growth rate, it was only marginal
• According to the 2011 census report, the population growth rate was less than 2 per cent, i.e., 20/1000/year, a rate at which our population could increase rapidly
• Hum Do Hamare Do


  Slogan promoting smaller families with two children
• Contraceptive methods

  • Natural/Traditional
  • Barrier
  • IUDs
  • Oral contraceptives
  • Injectables
  • Implants
  • Surgical methods
• Ideal contraceptive


  • User-friendly, easily available, effective and reversible with no or least side-effects
  • Does not interfere with the sexual drive, desire and/or the sexual act of the user
• Periodic abstinence


  Avoiding coitus from day 10 to 17 of the menstrual cycle when ovulation could be expected
• Withdrawal or coitus interruptus


  The male partner withdraws his penis from the vagina just before ejaculation
• Lactational amenorrhea


  Ovulation and menstrual cycle do not occur during the period of intense lactation following parturition
• Condoms


  Barriers made of thin rubber/latex sheath that are used to cover the penis in the male or vagina and cervix in the female, just before coitus
• Diaphragms, cervical caps and vaults


  Barriers made of rubber that are inserted into the female reproductive tract to cover the cervix during coitus
• Intra Uterine Devices (IUDs)


  • Devices inserted by doctors or expert nurses in the uterus through vagina
  • Increase phagocytosis of sperms within the uterus and the Cu ions released suppress sperm motility and the fertilising capacity of sperms
  • Hormone releasing IUDs make the uterus unsuitable for implantation and the cervix hostile to the sperms
• Oral contraceptives (pills)


  • Tablets containing small doses of either progestogens or progestogen–estrogen combinations
  • Inhibit ovulation and implantation as well as alter the quality of cervical mucus to prevent/retard entry of sperms
• Progestogens alone or in combination with estrogen

  • Can be used by females as injections or implants under the skin
  • Their mode of action is similar to that of pills and their effective periods are much longer
• Vasectomy

  Surgical intervention that blocks gamete transport in the male by removing or tying up a small part of the vas deferens
• Tubectomy


  Surgical intervention that blocks gamete transport in the female by removing or tying up a small part of the fallopian tube
• Intentional or voluntary termination of pregnancy before full term is called medical termination of pregnancy (MTP) or induced abortion
• Nearly 45 to 50 million MTPs are performed in a year all over the world which accounts to 1/5th of the total number of conceived pregnancies in a year
• Contraceptives are not regular requirements for the maintenance of reproductive health. In fact, they are practiced against a natural reproductive event, i.e., conception/pregnancy. One is forced to use these methods either to prevent pregnancy or to delay or space pregnancy due to personal reasons.
• The widespread use of contraceptive methods have a significant role in checking uncontrolled growth of population. However, their possible ill-effects like nausea, abdominal pain, breakthrough bleeding, irregular menstrual bleeding or even breast cancer, though not very significant, should not be totally ignored.
• Medical Termination of Pregnancy (MTP)

  Intentional or voluntary termination of pregnancy before full term
• Nearly 45 to 50 million MTPs are performed in a year all over the world which accounts to 1/5th of the total number of conceived pregnancies in a year.
• Whether to accept / legalise MTP or not is being debated upon in many countries due to emotional, ethical, religious and social issues involved in it.
• Government of India legalised MTP in 1971 with some strict conditions to avoid its misuse. Such restrictions are all the more important to check indiscriminate and illegal female foeticides which are reported to be high in India.
• Reasons for MTP

  To get rid of unwanted pregnancies either due to casual unprotected intercourse or failure of the contraceptive used during coitus or rapes. MTPs are also essential in certain cases where continuation of the pregnancy could be harmful or even fatal either to the mother or to the foetus or both.
• MTPs are considered relatively safe during the first trimester, i.e., upto 12 weeks of pregnancy. Second trimester abortions are much more riskier.
• A majority of the MTPs are performed illegally by unqualified quacks which are not only unsafe but could be fatal too. Another dangerous trend is the misuse of amniocentesis to determine the sex of the unborn child. Frequently, if the foetus is found to be female, it is followed by MTP- this is totally against what is legal.
• The Medical Termination of Pregnancy (Amendment) Act, 2017 was enacted by the government of India with the intension of reducing the incidence of illegal abortion and consequent maternal mortality and morbidity.
• Grounds for termination of pregnancy under the Act

  • The continuation of the pregnancy would involve a risk to the life of the pregnant woman or of grave injury physical or mental health
  • There is a substantial risk that of the child were born, it would suffer from such physical or mental abnormalities as to be seriously handicapped
• Sexually Transmitted Infections (STIs) or venereal diseases (VD) or reproductive tract infections (RTI) are infections or diseases which are transmitted through sexual intercourse.