Reproductive health is defined as a state of complete physical, emotional, behavioural, and social well-being in all matters related to the reproductive system and its functions, and not merely the absence of disease or infirmity.
Definitions [4]
Define amniocentesis.
It is a technique in which amniotic fluid is withdrawn from the uterus of a pregnant lady and the amniotic cells are cultured and studied for cytological observations to determine any chromosomal abnormalities.
Definition: Reproductive Health
Definition: Birth Control
Birth Control refers to the regulation of conception by preventive methods or devices to limit the number of offspring.
Definition: Induced Abortion or Medical Termination of Pregnancy (MTP)
Intentional or voluntary termination of pregnancy before full term is called medical termination of pregnancy (MTP) or induced abortion.
Key Points
Key Points: Reproductive Health
- Reproductive health, as defined by WHO, refers to complete physical, emotional, behavioural, and social well-being in all aspects related to reproduction.
- India’s Reproductive and Child Health (RCH) programmes aim to promote reproductive health through family planning, maternal and child care, awareness creation, and access to medical facilities.
- Education and awareness, including sex education for adolescents, help prevent myths, sexually transmitted diseases (STDs), unsafe practices, and promote hygienic and responsible sexual behaviour.
- Preventive measures such as menstrual hygiene, genital cleanliness, planned parenthood, immunisation, and statutory bans on sex determination are essential for a healthy society.
- Sexually transmitted diseases like syphilis and gonorrhoea adversely affect reproductive health, highlighting the need for early diagnosis, treatment, and improved medical infrastructure.
Key Points: Initiatives for Reproductive Health Promotion
- India started family planning programmes in 1951 to improve reproductive health.
- Reproductive and Child Health (RCH) programmes focus on awareness, care and overall reproductive health.
- Education and awareness (including sex education) help remove myths and promote healthy practices.
- Healthcare support and facilities are important for a safe pregnancy, child care and family planning.
- Preventive measures like immunisation and laws (e.g., a ban on sex determination) improve society.
- Research and new methods (like contraceptives such as Saheli) help in better reproductive health.
- These efforts have led to reduced maternal & infant mortality and smaller family size.
Key Points: Population Stabilisation and Control Measures
- Rapid population growth is due to improved health facilities, reduced death rate, MMR and IMR, and increased life expectancy.
- Population explosion leads to scarcity of basic needs like food, shelter and clothing and affects national development.
- Birth control is essential to maintain a balance between the birth and death rates and to ensure the sustainable use of resources.
- Government measures include family planning programmes (RCH), promotion of the small-family norm, raising the marriageable age, and incentives for small families.
- Contraceptive methods and awareness through mass media help prevent unwanted pregnancies and control population growth.
Key Points: Birth Control
| Method | Basis of Action | Advantage | Examples |
|---|---|---|---|
| Barrier | Physical barrier; prevents sperm reaching egg | Protects against STDs; low failure rate | Condoms, Diaphragm, Cervical cap |
| Hormonal | Inhibits FSH → prevents egg development and ovulation | Highly effective; protects against ovarian and endometrial cancer | Mala-D, Saheli |
| IUDs | Increases phagocytosis of sperm; suppresses sperm motility | Highly effective; ideal for females | Cu-T, LNG-20, Lippes loop |
| Natural | Avoid intercourse during fertile periods | No side effects; no expenditure | Abstinence, Withdrawal, Lactational amenorrhea |
| Surgical | Prevents sperm release or egg transport (permanent) | Very reliable | Vasectomy (male), Tubectomy (female) |
Key Points: Natural Contraceptive Methods
| Method | Basis | Key Feature | Limitation |
|---|---|---|---|
| Calendar (Rhythm) method | Calculation of fertile days | Avoids intercourse during fertile period | Ovulation time may vary |
| Temperature method | Change in basal body temperature | Slight rise in temperature after ovulation | Stress/illness affects accuracy |
| Cervical mucus method | Change in cervical mucus | Thin, watery mucus indicates ovulation | Requires daily observation |
| Periodic abstinence | Avoiding coitus on days 10–17 | Prevents sperm–ovum meeting | Needs regular cycle |
| Lactational amenorrhoea | Suppressed ovulation during lactation | Effective during exclusive breastfeeding | Effective only up to 6 months |
Key Points: Artificial Contraceptive Methods
| Method | Type | Mode of Action | Examples |
|---|---|---|---|
| Barrier methods | Physical | Prevent entry of sperms into female tract | Male condom (Nirodh), Female condom (Femidom), Diaphragm, Cervical cap |
| Spermicides | Chemical | Kill sperms chemically in vagina | Creams, jellies, foams, suppositories |
| Intra-uterine devices (IUDs / IUCDs) | Mechanical / Chemical | Prevent implantation; reduce sperm motility | Lippes loop, CuT, Cu7, Multiload 375, LNG-20 |
| Hormonal methods | Hormonal | Inhibit ovulation; alter uterine lining | Combined pills, Mini pill, Saheli |
| Sterilization | Surgical | Permanently block gamete transport | Vasectomy (male), Tubectomy (female) |
| Medical termination of pregnancy (MTP) | Medical | Termination of early pregnancy | Vacuum aspiration (as per MTP Act) |
| Emergency contraception | Hormonal | Prevent pregnancy after unprotected sex | Levonorgestrel pills (within 72 hours) |
Key Points: Induced Abortion or Medical Termination of Pregnancy (MTP)
- Medical Termination of Pregnancy (MTP) is the voluntary termination of pregnancy before full term, also called induced abortion.
- MTP is done in cases of unwanted pregnancy or when fetal abnormalities are detected, often using amniocentesis.
- Amniocentesis is a diagnostic test that collects amniotic fluid to study fetal chromosomes and detect genetic defects.
- MTP is legally allowed in India under the MTP Act (1971, amended 2017), with conditions and is generally safe in the first 12 weeks.
- It requires the woman’s consent and a doctor’s approval, and is allowed only when pregnancy risks the mother’s life or involves serious fetal abnormalities.
Key Points: Sexually Transmitted Diseases (STD) or Sexually Transmitted Infections (STI)
Key Points: Infertility
- Infertility is the inability to conceive after 12 months or more of regular unprotected intercourse and may be due to male, female, or both partners.
- Male infertility includes low sperm count, no sperm production, poor sperm motility, or abnormal sperm structure.
- Female infertility may result from hormonal imbalance, poor egg production, or defects in reproductive organs like the ovaries, fallopian tubes, uterus, or cervix.
- Mechanical or physiological problems, such as blocked reproductive tracts or thick cervical mucus, can prevent fertilisation.
- Infertility is diagnosed and treated by identifying the cause and using methods like hormonal therapy, surgery, or lifestyle changes.
- Assisted Reproductive Technologies (ART) help infertile couples and include IVF, ICSI, GIFT, ZIFT, AI, and IUI, which assist in fertilisation and conception.
Key Points: Assisted Reproductive Technologies (ART)
- ART refers to special techniques used to help infertile couples have children; it includes IVF, ZIFT, IUT, GIFT, ICSI, and AI.
- IVF (In Vitro Fertilisation) - Fertilisation occurs outside the body in a lab ("test tube baby"); the zygote/embryo is then transferred into the female.
- ZIFT - Zygote or embryo with up to 8 blastomeres is transferred into the fallopian tube; IUT - embryo with more than 8 blastomeres is placed directly into the uterus.
- GIFT (Gamete Intra Fallopian Transfer) - Ovum from a donor is transferred into the fallopian tube of a female who cannot produce eggs but can support fertilisation.
- ICSI (Intra Cytoplasmic Sperm Injection) - A single sperm is directly injected into the ovum using a microneedle; used in cases of low sperm count.
- AI (Artificial Insemination) - Semen from husband/donor is introduced into the vagina or uterus (IUI); used when the male cannot inseminate naturally or has a low sperm count.
- Disadvantages of ART - Requires specialised professionals and expensive equipment; affordable to only a limited number of people; emotional, religious and social factors are also deterrents.
Concepts [10]
- Concept of Reproductive Health
- Initiatives for Reproductive Health Promotion
- Population Explosion and Control Measures
- Birth Control
- Natural Contraceptive Methods
- Artificial Contraceptive Methods
- Induced Abortion or Medical Termination of Pregnancy (MTP)
- Sexually Transmitted Diseases (STD) or Sexually Transmitted Infections (STI)
- Infertility
- Assisted Reproductive Technologies (ART)
