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Reproductive Health Class 12th CBSE NCERT
- 1. Reproductive Health Created By:neharohtagi1 CLASS – 12th
- 2. Introduction • As interpretedby the World Health Organization (WHO), an overall well-being in the physical, emotional, behavioral and social regards of reproduction is known as reproductive health. • A reproductively healthy society is a society with people having physically and functionally normal reproductive organs and normal emotional and behavioral interactions among them in all sex related aspects. • India is the first country to initiate action plans at the national level to attain total reproductive health; these programmed were called the Family Planning Programmed and were initiated in 1951. • Family planning projects have been improvised to incorporate even larger number of reproduction-related sphere and are presently running under the well accepted name (RCH) 'Reproductive and Child Health Care programmed'.
- 3. Major Goals ofRCH Creating awareness among people about various reproduction related aspects and providing facilities and support for building up a reproductively healthy society are the major tasks under these programmed. With the help of audio-visual and the print-media governmental and non-governmental agencies have taken various steps to create awareness among the people about reproduction-related aspects. Parents, other close relatives, teachers and friends, also have a major role in the dissemination of the above information. Introduction of sex education in schools should also be encouraged to provide right information to the young so as to discourage children from believing in myths and having misconceptions about sex-related aspects. Proper information about reproductive organs, adolescence and related changes, safe and hygienic sexual practices, sexually transmitted diseases (STD), AIDS, etc., would help people, especially those in the adolescent age group to lead a reproductively healthy life. Educating people, especially fertile couples and those in marriageable age group, about available birth control options, care of pregnant mothers, post- natal care of the mother and child, importance of breast feeding, equal opportunities for the male and the female child, etc., would address the importance of bringing up socially conscious healthy families of desired size. Awareness of problems due to uncontrolled population growth, social evils like sex-abuse and sex-related crimes, etc., need to be created to enable people to think and take up necessary steps to prevent them and thereby build up a socially responsible and healthy society.
- 4. Amniocentesis • It isa prenatal diagnostic technique which includes the sample collection amniotic fluid from the womb of a pregnant female. It is mostly procured during the early stages of fetal development and the cells are cultured and analyzed. • By the means of this procedure, the chromosomal disorders, the sex of the fetus and embryological developmental disorders could be detected for the treatment. Since, it is often misused for gender discrimination and eliminating the normal female fetus.The government has introduced a statutory ban on this technique to legitimately monitor female feticides. • By amniocentesis following genetic diseases can be detected- Down Syndrome, Haemophilia, Sickle-cellAnaemia, etc., • Sex can be determined by this technique and is misused for destroying the normal female fetuses.Thus there is a statutory ban on this technique to legally check female feticides.
- 5. Population Explosion • Theenormous increase in population within a shorter span of time is known as Population Explosion. • However, increased health facilities along with better living conditions had an explosive impact on the growth of population. • 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. • In India, population 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. • Reasons for Population Explosion are: Developing health provisions. Engagement in technology. Comparatively superior lifestyle, have an explosive impact on the growth of population. Decreasing Maternal Mortality Rate (MMR). Descending Infant Mortality Rate (IMR). Spike in the number of individual of the reproductive age
- 6. Consequences of PopulationExplosion Increased crime rate Increased waste generation Unemployment Poverty High Infant Mortality Rate Burden on natural resources Deforestation Pollution Disturbed social fabric
- 7. Birth Control • Themajor step towards controlling the rising growth in population is to bring down the birth rate. • The most important step to overcome this problem is to motivate smaller families by using various contraceptive methods. • Many couples, mostly the young, urban, working ones have even adopted an ‘one child norm’. • Statutory raising of marriageable age of the female to 18 years and that of males to 21 years, and incentives given to couples with small families are two of the other measures taken to tackle this problem.
- 8. An Ideal Contraceptive Inexpensive Easyand simple to use with minimum side effects Rapidly reversible Readily available Highly effective. Can be administered by non- healthcare personnel.
- 9. Contraceptive Methods Natural Methods Periodic Abstinence Lactation Amenorrhea Coitus Interruptus Barrier Methods Condoms Diaphragms, Vaults and Cervical Caps Spermicidal Creams Intra– Uterine Devices Hormone Releasing Cu Ions Releasing Non – Medicated IUD’s Oral Contraceptives Steroidal Pills Non – Steroidal Pills InjectableAnd Implants Steroidal Implants Surgical Methods Vasectomy Tubectomy
- 10. Natural Methods • Naturalmethods work on the principle of avoiding chances of ovum and sperms meeting.. • Periodic Abstinence: This practice involves the couples to abstain or keep away from having intercourse during which ovulation is expected to occur and chances of fertilization are higher. i.e., around the period of 10-17th day of the menstrual cycle, when ovulation could be expected. As chances of fertilization are very high during this period, it is called the Fertile Period. • Lactational Amenorrhea: When there is an absence of menstruation during periods because of intense lactation following parturition. As ovulation does not occur during this period, chances of conception are almost down to zero.This method is only effective for a maximum period of about six months after parturition and is only caused due to intense lactation. • Coitus Interupptus: This practice involves removal of penis from the vagina before ejaculation and insemination is avoided.
- 11. Barrier Methods • Thefusion of the ovum and sperms is prevented from fusion with the help of barriers. • Contraceptive Barriers are available for both males and females. • Condoms: barriers made of thin rubber or latex sheath, to cover the penis in male or vagina and cervix in females. Usage of condom can keep the sexually active individuals from contracting sexually transmitted diseases. • Diaphragms: Barriers (made of rubber) such as vaults and cervical caps are used by females. Since made from rubber, they can be reused. • Spermicidal Creams: Along with the use of barriers these creams are used to increase contraceptive efficiency.
- 12. Intra – UterineDevices • These devices are inserted by doctors or expert nurses in the uterus through vagina. • Types of Intra-Uterine Devices: Non-medicated IUDs, e.g., lippies loop. Copper releasing IUDs, e.g., CuT, Cu-7, Multiload 375. Hormone releasing IUDs, e.g., progestasert, LNG 20. • Functioning of IUDs: By increasing phagocytosis of sperms. By suppressing sperm motility and thus reducing fertilizing ability (by copper releasing IUDs) of sperms. By making the uterus unsuitable for implantation and the cervix antagonistic to sperms.
- 13. Oral Contraceptives • Oralcontraceptives are hormonal preparations in the forms of ‘Pills’. • They are either progestogens or progestogen-estrogen combinations. • In order to prevent or retard entry of sperms into the female, they alter or cause obstruction in the process of ovulation and implantation. It also modifies the quality of cervical mucus. • Oral contraceptive pills needs to be administered on a daily basis for a period of 21 days starting within the first five days of menstrual cycle.
- 14. SAHELI: A ContraceptivePill • It contains a non-steroidal principle called ormeloxifene or centchroman which is a unique combination of weak estrogenic and potent anti-estrogenic inhibiting the fertilized egg from nidation. • It is once a week pill. • It has few side effects and contraceptive value is high. • Developed by the scientists of Central Drug Research Institute (CDRI) in Lucknow, India. Saheli was renamed 'Chhaya' in 2017.
- 15. Injectable And Implants •The combination of progestogen-estrogen or progestogens is also administered by the means of injections or as implants under the skin. • Though their mode of action is alike to that of oral contraceptives, but have longer effective period.
- 16. Surgical Methods • Theseare terminal methods that are advised for the male or female partners to prevent any further pregnancy and are commonly called sterilisation. • Surgical methods cut off the transport of gametes.Thus, conception is forever ceased. • Vasectomy: It is the sterilisation procedure in males, where a small portion of the vas deferens is removed or tied up, through an incision in the scrotum. • Tubectomy: It is the sterilisation procedure in females, where a small part of fallopian tube is removed or tied up, through a small incision in the abdomen or through vagina. • Advantage and Disadvantage of Surgical Methods: Most effective contraceptive techniques Percentage of reversibility is very poor.
- 18. MedicalTermination Of Pregnancy •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. • Whether to accept MTP or not is being debated upon in many countries due to emotional, ethical, religious and social issues involved in it. Government of India legalized 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. • MTPs are considered to be safe only during the first trimester (upto 12 weeks of pregnancy) whereas MTPs, during the second trimester could be subject to risk.
- 20. SexuallyTransmitted Diseases • Infectionsor diseases which are transmitted through sexual intercourse are collectively called Sexually Transmitted Infections (STI)/ Venereal Diseases (VD)/ ReproductiveTract Infections (RTI). • Gonorrhoea, Syphilis, Genital Herpes, Chlamydiasis, GenitalWarts, Trichomoniasis, Hepatitis-B and HIV – AIDS are some of the common STIs. • They are transmitted by sharing of injection needles, surgical instruments, etc., with infected persons, transfusion of blood, or from an infected mother to the fetus too. • Except for hepatitis-B, genital herpes and HIV infections, other diseases are completely curable if detected early and treated properly. • Early symptoms are minor and include itching, fluid discharge, slight pain, swellings, etc., in the genital region. Infected females may often be asymptomatic and hence, may remain undetected for long. • This could lead to complications later, which include Pelvic Inflammatory Diseases (PID), abortions, still births, ectopic pregnancies, infertility or even cancer of the reproductive tract. STIs are a major threat to a healthy society.
- 21. Precautions For STI’s •Therefore, prevention or early detection and cure of these diseases are given prime consideration under the reproductive health-care programmes. • Though all persons are vulnerable to these infections, their incidences are reported to be very high among persons in the age group of 15-24 years – the age group to which you also belong. • There is no reason to panic because prevention is possible. • One could be free of these infections by following the simple principles given below: (i) Avoid sex with unknown partners/multiple partners. (ii) Always try to use condoms during coitus. (iii) In case of doubt, one should go to a qualified doctor for early detection and get complete treatment if diagnosed with infection.
- 22. Infertility • A discussionon reproductive health is incomplete without a mention of Infertility. • A large number of couples all over the world including India are Infertile, i.e., they are unable to produce children inspite of unprotected sexual co – habitation. • The reasons for this could be many– physical, congenital, diseases, drugs, immunological or psychological. • In India, often the female is blamed for the couple being childless, but more often than not, the problem lies in the male partner. • Specialised health care units (infertility clinics, etc.) could help in diagnosis and corrective treatment of some of these disorders and enable these couples to have children.
- 23. Assisted ReproductiveTechniques • Specialtechniques are applied to assist the sterile couple (man or woman) produce children when the issue cannot be solved by the corrective treatments are known as the Assisted ReproductiveTechniques (ARTs). • It includes: a. InVitro Fertilization (ZIFT and IUT) b. InVivo Fertilization (GIFT) c. Intra Cytoplasmic Sperm Injection d. Artificial Insemination
- 24. TestTube Baby Programmes •In this method from the wife/donor (female) and sperms from the husband/donor (male) are collected and are induced to form zygote under simulated conditions in the laboratory, known as the IVF (in vitro fertilization). • The zygote is relocated into the fallopian tube of the uterus of the female for further development.This is commonly called the EmbryoTransfer(ET). • There are two ways of embryo transfer: ZIFT –The process of transferring zygote or embryo up to eight blastomeres stage into the fallopian tube. IUT – The process of transferring embryo with more than eight blastomere stage into the uterus.
- 25. InVivo Fertilisation • Embryosformed by In-vivo Fertilisation (fusion of gametes within the female) also could be used for such transfer to assist those females who cannot conceive. • Gamete Intra Fallopian Transfer (GIFT) – transfer of an ovum collected from a donor into the fallopian tube of another female who cannot produce one, but can provide suitable environment for fertilisation and further development. • Intra Cytoplasmic Sperm Injection (ICSI) – is another specialised procedure to form an embryo in the laboratory in which a sperm is directly injected into the ovum. • Artificial Insemination (AI) – Infertility cases either due to inability of the male partner to inseminate the female or due to very low sperm counts in the ejaculates, could be corrected by artificial insemination technique. • Intra Uterine Insemination (IUI) – in this method, sperm is placed directly into a woman's uterus during ovulation to increase the chances of fertilization.