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Reproductive health - problems and Strategies
RHref001-Reproductive health
1120204 NCERT Questions
You have learnt about human reproductive system and its
functions in Chapter 3. Now, let us discuss a closely related
topic – reproductive health. What do we understand by
this term? The term simply refers to healthy reproductive
organs with normal functions. However, it has a broader
perspective and includes the emotional and social aspects
of reproduction also. 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. Therefore, 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. Why is it significant to
maintain reproductive health and what are the methods
taken up to achieve it? Let us examine them.
Reproductive health - problems and Strategies
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.
These programmes called ‘family planning’ were
initiated in 1951 and were periodically assessed over
the past decades.
Improved programmes covering wider reproduction-related areas are currently in operation under the
popular name - Reproductive and Child Health Care (RCH) programmes.
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 programmes.
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.
Successful implementation of various action plans to attain reproductive health requires strong infrastructural facilities, professional expertise and material support.
These are essential to provide medical
assistance and care to people in reproduction-related problems like
pregnancy, delivery, STDs, abortions, contraception, menstrual problems,
infertility, etc.
Implementation of better techniques and new strategies
from time to time are also required to provide more efficient care
and assistance to people.
Statutory ban on amniocentesis for
Sex-determination to legally check increasing menace of female foeticides,
massive child immunisation, etc., are some programmes that merit
mention in this connection.
In aminocentesis some of the amniotic fluid
of the developing foetus is taken to analyse the fetal cells and dissolved
substances.
This procedure is used to test for the presence of certain
genetic disorders such as, down syndrome, haemoplilia, sickle-cell
anemia, etc., determine the survivability of the foetus.
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.
Do you know
that - Saheli’;
a new oral contraceptive for the females-was developed by scientists at Central Drug Research Institute (CDRI) in Lucknow, India?
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, etc.
all indicate improved reproductive
health of the society.
Population Stabilisation and Birth control
In the last century an all-round development in various fields significantly
improved the quality of life of the people. 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. A similar trend was observed in India too. 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. A rapid decline in death rate, maternal mortality
rate (MMR) and infant mortality rate (IMR) as well as an increase in
number of people in reproducible age are probable reasons for this.
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. Such an alarming growth rate could lead to an
absolute scarcity of even the basic requirements, i.e., food, shelter and
clothing, in spite of significant progress made in those areas. Therefore,
the government was forced to take up serious measures to check this
population growth rate.
The most important step to overcome this problem is to motivate smaller
families by using various contraceptive methods. You might have seen
advertisements in the media as well as posters/bills, etc., showing a happy
couple with two children with a slogan Hum Do Hamare Do (we two, our
two). 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.
Let us describe some of the commonly used contraceptive
methods, which help prevent unwanted pregnancies.
An ideal contraceptive should be user-friendly, easily available,
effective and reversible with no or least side-effects. It also should in no
way interfere with the sexual drive, desire and/or the sexual act of the
user.
A wide range of contraceptive methods are presently available which
could be broadly grouped into the following categories, namely
Natural/Traditional, Barrier, IUDs, Oral contraceptives, Injectables,
Implants and Surgical methods.
Natural methods work on the principle of avoiding chances of ovum and sperms meeting. Periodic abstinence is one such method in which
the couples avoid or abstain from coitus from day 10 to 17 of the menstrual
cycle when ovulation could be expected. As chances of fertilisation are
very high during this period, it is called the fertile period. Therefore, by
abstaining from coitus during this period, conception could
be prevented.
Withdrawal or coitus interruptus is another
method in which the male partner withdraws his penis from
the vagina just before ejaculation so as to avoid
insemination.
Lactational amenorrhea (absence of
menstruation) method is based on the fact that ovulation
and therefore the cycle do not occur during the period of
intense lactation following parturition. Therefore, as long
as the mother breast-feeds the child fully, chances of
conception are almost nil. However, this method has been
reported to be effective only upto a maximum period of six
months following parturition.
As no medicines or devices
are used in these methods, side effects are almost nil.
Chances of failure, though, of this method are also high.
In barrier methods, ovum and sperms are prevented
from physically meeting with the help of barriers. Such
methods are available for both males and females.
Condoms (Figure 4.1 a, b) are 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 so that
the ejaculated semen would not enter into the female
reproductive tract. This can prevent conception. ‘Nirodh’ is
a popular brand of condom for the male. Use of condoms
has increased in recent years due to its additional benefit of
protecting the user from contracting STIs and AIDS. Both
the male and the female condoms are disposable, can be
self-inserted and thereby gives privacy to the user.
Diaphragms, cervical caps and vaults are also barriers
made of rubber that are inserted into the female reproductive
tract to cover the cervix during coitus. They prevent
conception by blocking the entry of sperms through the
cervix. They are reusable. Spermicidal creams, jellies and
foams are usually used alongwith these barriers to increase
their contraceptive efficiency.
Another effective and popular method is the use of Intra Uterine
Devices (IUDs). These devices are inserted by doctors or expert nurses
in the uterus through vagina. These Intra Uterine Devices are presently
available as the non-medicated IUDs (e.g., Lippes loop), copper releasing
IUDs (CuT, Cu7, Multiload 375) and the hormone releasing IUDs
(Progestasert, LNG-20) (Figure 4.2). IUDs increase phagocytosis of sperms
within the uterus and the Cu ions released suppress sperm motility and
the fertilising capacity of sperms. The hormone releasing IUDs, in addition, make the uterus unsuitable for implantation and the
cervix hostile to the sperms. IUDs are ideal contraceptives
for the females who want to delay pregnancy and/or space
children. It is one of most widely accepted methods of
contraception in India.
Oral administration of small doses of either progestogens
or progestogen–estrogen combinations is another
contraceptive method used by the females. They are used
in the form of tablets and hence are popularly called the
pills. Pills have to be taken daily for a period of 21 days
starting preferably within the first five days of menstrual
cycle. After a gap of 7 days (during which menstruation
occurs) it has to be repeated in the same pattern till the female desires to
prevent conception. They inhibit ovulation and implantation as well as
alter the quality of cervical mucus to prevent/retard entry of sperms. Pills
are very effective with lesser side effects and are well accepted by the females.
Saheli –the new oral contraceptive for the females contains a non-steroidal
preparation. It is a ‘once a week’ pill with very few side effects and high
contraceptive value.
Progestogens alone or in combination with estrogen can also be used
by females as injections or implants under the skin (Figure 4.3). Their
mode of action is similar to that of pills and their effective periods are
much longer. Administration of progestogens or progestogen-estrogen
combinations or IUDs within 72 hours of coitus have been found to be
very effective as emergency contraceptives as they could be used to avoid
possible pregnancy due to rape or casual unprotected intercourse.
Surgical methods, also called sterilisation, are generally advised for
the male/female partner as a terminal method to prevent any more pregnancies. Surgical intervention blocks gamete transport and thereby
prevent conception. Sterilisation procedure in the male is called ‘vasectomy’
and that in the female, ‘tubectomy’. In vasectomy, a small part of the vas
deferens is removed or tied up through a small incision on the scrotum
(Figure 4.4a) whereas in tubectomy, a small part of the fallopian tube is
removed (Figure 4.4b) or tied up through a small incision in the abdomen
or through vagina. These techniques are highly effective but their
reversibility is very poor.
It needs to be emphasised that the selection of a suitable contraceptive
method and its use should always be undertaken in consultation with
qualified medical professionals. One must also remember that
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. No doubt, the widespread use of these 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 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 / 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. Why MTP? Obviously the answer is–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. One disturbing trend observed is that 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. Such practices should be avoided because these are dangerous both for the young mother and the foetus. Effective counselling on the need to avoid unprotected coitus and the risk factors involved in illegal abortions as well as providing more health care facilities could reverse the mentioned unhealthy trend.
Sexually transmitted infections (STIS) Infections or diseases which are transmitted through sexual intercourse are collectively called sexually transmitted infections (STI) or venereal diseases (VD) or reproductive tract infections (RTI). Gonorrhoea, syphilis, genital herpes, chlamydiasis, genital warts, trichomoniasis, hepatitis-B and of course, the most discussed infection in the recent years, HIV leading to AIDS are some of the common STIs. Among these, HIV infection is most dangerous and is discussed in detail in Chapter 8. Some of these infections like hepatitis–B and HIV can also be transmitted by sharing of injection needles, surgical instruments, etc., with infected persons, transfusion of blood, or from an infected mother to the foetus too. Except for hepatitis-B, genital herpes and HIV infections, other diseases are completely curable if detected early and treated properly. Early symptoms of most of these 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. Absence or less significant symptoms in the early stages of infection and the social stigma attached to the STIs, deter the infected persons from going for timely detection and proper treatment. 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. 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.
Infertility
A discussion on 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 even 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. However, where such corrections are not possible, the couples could be assisted to have children through certain special techniques commonly known as assisted reproductive technologies (ART). In vitro fertilisation (IVF–fertilisation outside the body in almost similar conditions as that in the body) followed by embryo transfer (ET) is one of such methods. In this method, popularly known as test tube baby programme, ova 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. The zygote or early embryos (with upto 8 blastomeres) could then be transferred into the fallopian tube (ZIFT–zygote intra fallopian transfer) and embryos with more than 8 blastomeres, into the uterus (IUT – intra uterine transfer), to complete its further development. Embryos formed by in-vivo fertilisation (fusion of gametes within the female) also could be used for such transfer to assist those females who cannot conceive.
Transfer of an ovum collected from a donor into the fallopian tube
(GIFT – gamete intra fallopian transfer) of another female who cannot
produce one, but can provide suitable environment for fertilisation and
further development is another method attempted. 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.
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 (AI) technique. In this technique,
the semen collected either from the husband or a healthy donor is artificially
introduced either into the vagina or into the uterus (IUI – intra-uterine
insemination) of the female.
Though options are many, all these techniques require extremely high
precision handling by specialised professionals and expensive
instrumentation. Therefore, these facilities are presently available only in
very few centres in the country. Obviously their benefits is affordable to
only a limited number of people. Emotional, religious and social factors
are also deterrents in the adoption of these methods. Since the ultimate
aim of all these procedures is to have children, in India we have so many
orphaned and destitute children, who would probably not survive till
maturity, unless taken care of. Our laws permit legal adoption and it is
as yet, one of the best methods for couples looking for parenthood.
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Click on Assignment
Set 1
1. What do you think is the significance of reproductive health in a society?
2. Suggest the aspects of reproductive health which need to be given
special attention in the present scenario.
3. Is sex education necessary in schools? Why?
4. Do you think that reproductive health in our country has improved in
the past 50 years? If yes, mention some such areas of improvement.
5. What are the suggested reasons for population explosion?
6. Is the use of contraceptives justified? Give reasons.
7. Removal of gonads cannot be considered as a contraceptive option. Why?
8. Amniocentesis for sex determination is banned in our country. Is this
ban necessary? Comment.
9. Suggest some methods to assist infertile couples to have children.
10. What are the measures one has to take to prevent from contracting STDs?
11. State True/False with explanation
(a) Abortions could happen spontaneously too. (True/False)
(b) Infertility is defined as the inability to produce a viable offspring
and is always due to abnormalities/defects in the female partner.
(True/False)
(c) Complete lactation could help as a natural method of
contraception. (True/False)
(d) Creating awareness about sex related aspects is an effective
method to improve reproductive health of the people. (True/False)
12. Correct the following statements :
(a) Surgical methods of contraception prevent gamete formation.
(b) All sexually transmitted diseases are completely curable.
(c) Oral pills are very popular contraceptives among the rural women.
(d) In E. T. techniques, embryos are always transferred into the uterus.
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QAs
Set 1
1. What do you think is the significance of reproductive health in a society?
1. Reproductive health is the total well being in all aspects of reproduction. It includes physical, emotional, behavioural, and social well being.
Sexually transmitted diseases such as AIDS, gonorrhoea, etc. are transferred from one individual to another through sexual contact.
It can also lead to unwanted pregnancies.
Hence, it is necessary to create awareness among people, especially the youth, regarding various reproduction related aspects as the young individuals are the future of the country and they are most susceptible of acquiring sexually transmitted diseases.
Creating awareness about the available birth control methods, sexually transmitted diseases and their preventive measures, and gender equality will help in bringing up a socially conscious healthy family.
Spreading awareness regarding uncontrolled population growth and social evils among young individuals will help in building up a reproductively healthy society.
→ AIDS - Acquired immunodeficiency syndrome (AIDS) is a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging your immune system, HIV interferes with your body's ability to fight infection and disease. ↔
→Gonorrhoea - Gonorrhoea is a sexually transmitted infection (STI) caused by bacteria called Neisseria gonorrhoeae or gonococcus. It used to be known as "the clap".
What are symptoms of gonorrhea?
In men
an unusual discharge from the tip of the penis, which may be white, yellow or green. pain or a burning sensation when urinating. inflammation (swelling) of the foreskin. pain or tenderness in the testicles - this is rare.
in women
Painful or burning sensation when urinating;
Increased vaginal discharge; and.
Vaginal bleeding between periods. ↔
2. Suggest the aspects of reproductive health which need to be given
special attention in the present scenario.
2. Reproductive health is the total well being in all aspects of reproduction. The aspects which have to be given special attention in the present scenarios are
(1)Counselling and creating awareness among people, especially the youth, about various aspects of reproductive health, such as sexually transmitted diseases, available contraceptive methods, case of pregnant mothers, adolescence, etc.
(2)Providing support and facilities such as medical assistance to people during pregnancy, STDs, abortions, contraceptives, infertility, etc. for building a reproductively healthy society
3. Is sex education necessary in schools? Why?
3. Yes, introduction of sex education in schools is necessary. It would provide right information to young individuals at the right time about various aspects of reproductive health such as reproductive organs, puberty, and adolescence related changes, safe sexual practices, sexually transmitted diseases, etc.
The young individual or adolescents are more susceptible in acquiring various sexually transmitted diseases. Hence, providing information to them at the right time would help them to lead a reproductively healthy life and also protect them from the myths and misconceptions about various sex related issues.
→ Puberty is the time in life when a boy or girl becomes sexually mature. It is a process that usually happens between ages 10 and 14 for girls and ages 12 and 16 for boys.
It causes physical changes, and affects boys and girls differently.
Between the ages of 11 and 16 years, boys experience:
Growth in penis size and darkening of the skin on their scrotum and testicles. ...
Body hair growth that reaches adult levels. .
A peak growth spurt that averages nearly 4 inches per year.
Development of acne.
Continued cracking of the voice
Girls- Between the ages of 8 and 13 following changes occur-
Breast Development. years old. ...
Body Hair.
Vaginal Discharge. ...
Periods. ...
Increase in Height. ...
Wider Hips. ... ↔
→ Adolescence is the phase of life between childhood and adulthood, from ages 10 to 19. It is a unique stage of human development and an important time for laying the foundations of good health. Adolescents experience rapid physical, cognitive and psychosocial growth. ↔
4. Do you think that reproductive health in our country has improved in
the past 50 years? If yes, mention some such areas of improvement.
4. Yes, the reproductive health has tremendously improved in India in the last 50 years. The areas of improvement are as follows:
(1) Massive child immunization programme, which has led to a decrease in the infant mortality rate.
(2) Maternal and infant mortality rate, which has been decreased drastically due to better post natal care.
(3) Family planning, which has motivated people to have smaller families.
(4) Use of contraceptive, which has resulted in a decrease in the rate of sexually transmitted diseases and unwanted pregnancies.
→ What is the Maternal mortality rate in India?
Maternal mortality ratio is the number of women who die from pregnancy-related causes while pregnant or within 42 days of pregnancy termination per 100,000 live births. The data are estimated with a regression model using information on the proportion of maternal deaths among non-AIDS deaths in women ages 15-49, fertility, birth attendants, and GDP.
India maternal mortality rate for 2017 was 145.00, a 3.33% decline from 2016.
India maternal mortality rate for 2016 was 150.00, a 5.06% decline from 2015.
India maternal mortality rate for 2015 was 158.00, a 4.82% decline from 2014.
India maternal mortality rate for 2014 was 166.00, a 5.14% decline from 2013. ↔
→
What is the infant mortality rate in India?
The current infant mortality rate for India in 2023 is 26.619 deaths per 1000 live births, a 3.89% decline from 2022. The infant mortality rate for India in 2022 was 27.695 deaths per 1000 live births, a 3.74% decline from 2021. ↔
5. What are the suggested reasons for population explosion?
5. The human population is increasing day by day, leading to population explosion. It is because of the following two major reasons.
(a) Decreased death rate
(b) Increased birth rate and longevity
The death rate has decreased in the past 50 years. The factor leading to decreased death rate and increased birth rate are control of diseases, awareness and spread of education, improvement in medical facilities, ensured food supply in emergency situation, etc.
All this has also resulted in an increase in the longevity of an individual.
6. Is the use of contraceptives justified? Give reasons.
6. Yes, the use of contraceptives is absolutely justified. The human population is increasing tremendously.
Therefore, to regulate the population growth by regulating reproduction has become a necessary demand in the present times.
Various contraceptive devices have been devised to reduce unwanted pregnancies, which help in bringing down the increased birth rate and hence, in checking population explosion.
→
Contraceptives methods are:
caps or diaphragms
→
combined pill -
How it prevents pregnancy ?
The pill prevents the ovaries from releasing an egg each month (ovulation). It also:
thickens the mucus in the neck of the womb, so it is harder for sperm to penetrate the womb and reach an egg
thins the lining of the womb, so there is less chance of a fertilised egg implanting into the womb and being able to grow
condoms - Condoms are the physical barriers made of a thin rubber latex sheath, worn on the erect penis to prevent any exchange of body fluids or semen during sexual intercourse. An intact latex condom forms an effective and impermeable barrier for the body fluids. Using a condom is one of the easiest, practical and effective means of preventing unwanted pregnancies and sexually transmitted diseases. Using latex condoms correctly and consistently reduces the risk of getting infected by any type of sexually transmitted diseases.
There are numerous orally administered pills marketed nowadays. These pills are generally made up of some doses of hormones that obstruct or inhibit ovulation and implantation, as well as alter the quality of cervical mucus to either retard or prevent the entry of sperms. These pills are taken orally and they are unable to provide protection against STDs.
contraceptive implant - Progestogen-estrogen combination or only progestogen can be used in the form of injections or implants under the skin by females.
These implants will release progestogen and work to delay ovulation or prevent fertilisation.
They are effective for longer periods than oral contraceptive pills.
They show the same effectiveness as pills.
It prevents pregnancy by making the mucus of the cervix thick and the lining of the wall of the uterus thin. This makes it harder for sperm to travel to the egg.
contraceptive injection - The contraceptive injection prevents pregnancy by injecting a synthetic version of the hormone progestogen, called Depot medroxyprogesterone acetate, or DMPA. The injection is also called Depo. Depo prevents the body from producing its own hormones and releasing eggs from the ovaries. ↔
→
contraceptive patch - The birth control patch is a type of contraception that contains the hormones estrogen and progestin. You wear the patch to avoid becoming pregnant.
Once a week for three weeks, you place a small patch on your skin, so that you wear a patch for a total of 21 days. During the fourth week, you don't wear a patch — which allows menstrual bleeding to occur.
The birth control patch works similarly to combination birth control pills. The birth control patch prevents pregnancy by releasing hormones into your bloodstream that keep your ovaries from releasing an egg (ovulation). The birth control patch also thickens cervical mucus to keep sperm from reaching an egg.
You'll need a prescription from your health care provider to use the birth control patch. The patch doesn't protect against sexually transmitted infections (STIs). ↔
→
Female condoms
IUD (intrauterine device or coil) - An IUD is a small T-shaped plastic and copper device that's inserted into womb (uterus) by a specially trained doctor or nurse. The IUD works by stopping the sperm and egg from surviving in the womb or fallopian tubes. It may also prevent a fertilised egg from implanting in the womb. ↔
→
IUS (intrauterine system or hormonal coil) - An IUS is a small, T-shaped plastic device that is inserted into your womb (uterus) by a specially trained doctor or nurse. The IUS releases a progestogen hormone into the womb. This thickens the mucus from your cervix, making it difficult for sperm to move through and reach an egg.
What is the difference between coil and IUS?
The coil is inserted by a doctor or nurse and lasts anywhere between three to ten years, depending on type or brand. It can easily be removed at any time. The main difference between the IUD and the IUS is that one releases copper (IUD) and one releases hormones (IUS). ↔
→
progestogen-only pill - Progestogens are synthetic forms of progesterone. Progestogens were developed because progesterone could not be absorbed orally, although a method of processing progesterone via micro-ionising is now available.
vaginal ring - The vaginal ring (NuvaRing) is a small soft, plastic ring that is placed inside vagina.
It releases a continuous dose of the hormones oestrogen and progestogen into the bloodstream to prevent pregnancy. ↔
→
There are 2 permanent methods of contraception:
female sterilization (Tubectomy) - Tubectomy is a sterilization method in which a small part of the fallopian tube is removed or tied up. The procedures are minor, usually performed under local anesthesia, cause minimal discomfort, and have no effect on sexual life. This method of birth control is extremely effective.
male sterilisation (vasectomy) - Vasectomy is a surgical procedure for male sterilization or permanent contraception. During the procedure, the male vas deferens are severed and then tied or sealed in a manner so as to prevent sperm from entering into the ejaculate and thereby preventing fertilization. ↔
7. Removal of gonads cannot be considered as a contraceptive option. Why?
7. Contraceptive devices are used to prevent unwanted pregnancy and to prevent the spreading of STDs.
There are many methods, such as natural, barrier, oral, and surgical methods, that prevent unwanted pregnancy.
However, the complete removal of gonads cannot be a contraceptive option because it will lead to infertility and unavailability of certain hormones that are required for normal functioning of accessory reproductive parts.
Therefore, only those contraceptive methods can be used that prevent the chances of fertilization rather than making the person infertile forever.
8. Amniocentesis for sex determination is banned in our country. Is this
ban necessary? Comment.
8. Amniocentesis is a pre-natal diagnostic technique that is used to determine the sex and metabolic disorders of the developing foetus in the mother's uterus through the observation of the chromosomal patterns.
This method was developed so as to determine any kind of genetic disorder present in the foetus. However, unfortunately,
this technique is being misused to detect the sex of the child before birth and the female foetus is then aborted.
Thus, to prevent the increasing female foeticides, it is necessary to ban the usage of amniocentesis technique for determining the sex of a child.
→
Amniocentesis -
What is Amniocentesis?
Amniocentesis is a diagnostic procedure undergone during pregnancy. It is most commonly used to check the baby’s chromosomes.
Amniocentesis is performed occasionally to examine diseases during pregnancy such as infections or genetic disorder. This procedure is done by taking out the amniotic fluid. We do not usually need a local anaesthetic.
The foetus is surrounded by the amniotic fluid that contains foetal cells and other substances such as alpha foetoprotein. It also protects the foetus from any mechanical injury and helps in regulating the temperature of the foetus. The cells and substances present in the amniotic fluid provide important information about the baby’s health before birth.
Why is Amniocentesis performed?
The amniocentesis is performed to check:
If the karyotype (the chromosomes) of the baby is (are) normal
If there is evidence of a neural tube defect (spina bifida or open spine)
If there is evidence that the baby might have had an infection
If the lungs of the baby are ready to breathe
Procedure of Amniocentesis
a. The patient is made to lie down on the table and asked to place the hands behind the head. The blood pressure, heart rate and breathing rate are checked. An ultrasound is performed to scan the heart rate of the foetus, position of the placenta, foetus, umbilical cord and locate the pocket of amniotic fluid../
b. The abdomen is cleansed with an antiseptic and is injected with anaesthesia.
c. A long, thin, hollow needle is inserted into the uterus to collect the amniotic fluid. The collected fluid is placed in a light protected container.
d. The heart rate of the foetus and the patient are reassessed.
The collected fluid is sent to the laboratory for examination.
Risks Involved In Amniocentesis
a. Miscarriages
b. Risk of Injuries.
c. Cramping
d. Leaking of amniotic fluid from the puncture site or vagina
e. Injuries to the baby by the needle are rare now as the procedure is done under ultrasound guidance.
Care after the Amniocentesis
Complications of the amniocentesis are rare, but in order to be on the safe side, one can follow the following precautions.
No lifting of goods or baby, no aerobic exercises or jogging, strenuous activity etc. ↔
9. Suggest some methods to assist infertile couples to have children.
9. Infertility is the inability of a couple to produce a baby even after unprotected intercourse.
It might be due to abnormalities present in either male or female, or might be even both the partners. The techniques used to assist infertile couples to have children are as follows.
(a) Test tube babies
This involves in-vitro fertilization where the sperms meet the egg outside the body of a female.
The zygote, hence produced, is then transferred in the uterus or fallopian tube of a normal female. The babies produced from this method are known as test tube babies.
(b) Gamete Intra fallopian transfer (GIFT)
It is a technique that involves the transfer of gamete (ovum) from a donor into the fallopian tube of the recipient female who is unable to produce eggs, but has the ability to conceive and can provide right conditions for the development of an embryo.
(c) Intra Cytoplasmic sperm injection (ICSI)
It is a method of injecting sperm directly into the ovum to form an embryo in laboratory.
(d) Artificial insemination
Artificial insemination is a method of transferring semen (sperm) from a healthy male donor into the vagina or uterus of the recipient female.
It is employed when the male partner is not able to inseminate the female or has low sperm counts.
10. What are the measures one has to take to prevent from contracting STDs?
10. Sexually transmitted diseases (STDs) get transferred from one individual to the other through sexual contact.
Adolescents and young adults are at the greatest risk of acquiring these sexually transmitted diseases.
Hence, creating awareness among the adolescents regarding its after-effects can prevent them from contracting STDs.
The use of contraceptives, such as condoms, etc. while intercourse, can prevent the transfer of these diseases.
Also, sex with unknown partners or multiple partners should be avoided as they may have such diseases. Specialists should be consulted immediately in case of doubt so as to assure early detection and cure of the disease.
11. State True/False with explanation
(a) Abortions could happen spontaneously too. (True/False)
(b) Infertility is defined as the inability to produce a viable offspring
and is always due to abnormalities/defects in the female partner.
(True/False)
(c) Complete lactation could help as a natural method of
contraception. (True/False)
(d) Creating awareness about sex related aspects is an effective
method to improve reproductive health of the people. (True/False)
11. (a) Abortions could happen spontaneously too.
True
(b) Infertility is defined as the inability to produce a viable offspring and is always due to abnormalities/defects in the female partner.
False
Infertility is defined as the inability of the couple to produce baby even after unprotected coitus. It might occur due to abnormalities/defects in either male or female or both.
(c) Complete lactation could help as a natural method of contraception.
False
Complete lactation or lactational amenorrhea is a natural method of contraception. However, it is limited till lactation period, which continues till six months after parturition.
(d) Creating awareness about sex related aspects is an effective method to improve reproductive health of the people.
True
12. Correct the following statements :
(a) Surgical methods of contraception prevent gamete formation.
(b) All sexually transmitted diseases are completely curable.
(c) Oral pills are very popular contraceptives among the rural women.
(d) In E. T. techniques, embryos are always transferred into the uterus.
12. (a) Surgical methods of contraception prevent gamete formation.
Correction
Surgical methods of contraception prevent the flow of gamete during intercourse.
(b) All sexually transmitted diseases are completely curable.
Correction
Some of the sexually transmitted diseases are curable if they are detected early and treated properly. AIDS is still an incurable disease.
(c) Oral pills are very popular contraceptives among the rural women.
Correction
Oral pills are very popular contraceptives among urban women.
(d) In E. T. techniques, embryos are always transferred into the uterus.
Correction
In embryo transfer technique, 8 celled embryos are transferred into the fallopian tube while more than 8 celled embryos are transferred into the uterus.