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Reproductive health means a total well being in all aspects of, reproduction., , Reproductive health programmes (family planning) initiated, in India 1951,, , Major tasks of Reproductive & Child Health Care (RCH), programmes are:, * To aware people about reproductions related aspects., * Provide facilities and support to create a reproductively, healthy society., , Aims and Needs of Sex Education in Schools, , , , * To provide right information about sex-related, aspects,, , * To avoid sex-related myths and misconceptions., , * Proper information about reproductive organs,, adolescence and related changes, safe and hygienic, Sexual practices, sexually transmitted diseases (STD)., AIDS, ete,, , & Birth Control, , , , Population Explosion, * In.1900, the world population was around 2 billion (2000, million), By 2000, it rocketed to about 6 billion., , * In India, population was nearly 350 million at —, of independence, It crossed 1 billion in May 2000., Means every sixth person in the world is an Indian., , According to the 2001 census report, the population, , , , growth rate was still around 1.7% (ic. 17/1000/, eM, year), @ rate at which our population could double, , in 33 years., Reasons for population explosion, * Increased health facilities and better living conditions., * Arapid decline in death rate, maternal mortality rate, (MMR) and infant mortality rate (IMR)., * Increase in number of people in reproducible age., Impacts of population explesien, , * Scarcity of basic requirements (e.2. food, shelter &, clothing)., , Control measures, , + Motivate smaller families by using contraceptive, methods., , + Aware peoples about a slogan Hum De Hamare De, (we two, our two). Many couples have adopted an ‘ome, child norm’., , * Statutory raising of marriageable age of the female, (18 years) and males (21 years)., , Features of An Ideal Contraceptive, , + User-friendly, easily available, effective and reversible., + No of least side-effects,, , « It should not interfere with sexual drive, desire & sexual, act.

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(Avoid chances of ovum and sperms meeting), |, , . . Lactational amenorrhea, , Periodic abstinence Coitus interruptus «Prevention of conception by, , + Avoid coitus from day 10to 17 of + Withdraw penis from the vagina 3 ild, the menstrual cycle (fertile period) —_just before ejaculation to avoid —_ breast feeding the chi, , Y i ; cle do not, to prevent ee : a / *Ovulation -. Lae ead of tactation, + Chances of fertilisation are high * It is also called withdrawal occur, during this period, therefore it is method. +No side effect and chances of, called the fertile period. conception are almost nil., Effect ve opto Sin month., Barriers, , an, Condoms Diaphragms, , + Arubber, dome-shaped structure, that fits over the cervix and is used, in conjunction with a spermicide., , + It can be inserted by the female, up to 6 hours before intercourse., , * They are made of rubber/latex, sheath., , + They are used to cover the penis or, vagina & cervix, just before coitus, so that the semen would not enter, into female reproductive tract,, , + A vaginal pouch, sometimes called, a female condom, , SY, , , , Cervical caps Vaults, + Acervical cap resembles a * Made of rubber; these are inserted, diaphragm but is smaller and into the female reproductive tract, more rigid. to cover the cervix during coitus., + It fits snugly over the cervix * They block the entry of sperms through, and must be fitted by a health- the cervix, ° e ., , care professional, p + They are reusable., , Condoms are very popular because: Intra Uterine Devices (IUDs), , These are inserted by doctors or expert nurses in the uterus, , * It protects the user from STDs and AIDS., through vagina., , , , , , It is disposable., , It can be self-inserted and thereby give privacy to, user,, , + Non-medicated IUDs (e.g. Lippes loop), , * Copper releasing IUDs (¢.2, CuT, Cu7, Multiload 375), , + Hormone releasing 1UDs (e.g. Progestasert, LNG-20):, Make the uterus unsuitable for implantation and the, cervix hostile to the sperms,, , Although diaphragm use does decrease the risk of, some STDs, it does not fully protect against HIV, infection because the vagina is still exposed., , * Spermicidal creams, jellies & foams are used IUDs increase phagocytosis of sperms,, along with the barriers to increase contraceptive Cu ions suppress motility and fertilizing capacity of, efficiency. sperms,, , * The most widely used spermicide is nonoxynol-9, TUDs are ideal contraceptives for the females who, which kills sperm by disrupting their plasma want to delay pregnancy or space children,, membranes,

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oral contraceptives, , . Oral administration of progestogens, trogen combinations in the form of bk oe, , Saheli, , + New oral contraceptive for the females, |, , pills are taken daily for 21 da, , five days of menstrual cycle., , . After a gap of 7 days (during which, it has to be repeated in the same, desires to prevent conception., , + They inhibit ovulation and implantation as, , the quality of cervical mucus to prevent ent, , Pills are very effective with lesser side effects,, , ts (pills)., 'YS Starting within the first, , Menstruation Occurs), Pattern till the female, , well as alter, try Of sperms,, , {contains, , a non-steroidal preparation., , » Itisa ‘once a week’ pill with very few sid, , le effects, , and high contraceptive value., , Injectables, , Progestogens alone or in combination with oestrogen are, used by females as injections or implants under skin., , Their mode of action is similar to that of pills and their, _ eective periods are much longer., , Surgical methods (sterilization):, , To block gamete transport and thereby Prevents conception., lis very effective but reversibility is poor., , , , [Vasectomy, , ‘Tubectomy, , , , Stenlization procedure in, males, , Sterilization procedure in, females, , , , In this, a small part of the, vas deferens is removed, ortied up through a small, incision on the scrotum., , , , In this, a small part of the, fallopian tube is removed, or tied up through a small, incision in the abdomen or, through vagina., , , , Side effects of Anti-natural contraceptives: = See, : abdominal pain, breakthrough bleeding. trregu!, Menstrual bleeding, breast cancer etc., , PIMlegii ce ed, , , , i y before, Intentional or voluntary termination of pregnancy be!, , full term is called MTP or induced abortion., , * 45 to 50 million MTPs are perform, , ed in a year all, , ived, over the world (ie., 1/Sth of total number of conceiv, Pregnancies). ~, : lation., . MTP helps to decrease the popu a, , Because of emotional, ethical, religious =~, , Many countries have not legalised MTP., , Nahi, , , , Government of India legalised MTP in 1971 with, Some strict conditions to check indiscriminate and illegal, female foeticides which are reported to be high in India,, , An abortion may be spontaneous (naturally occurring;, , also called a miscarriage) or induced (intentionally, Performed),, , Importance of MTP, , * To avoid unwanted Pregnancies duc to casual, , intercourse or failure of the contraceptive used during, coitus or rapes,, , * Essential in cases where continuation of the pregnancy, could be harmful to the mother or to the foetus or both,, , * MTPs are safe during the first trimester, (up to 12 weeks, of pregnancy). 2nd trimester abortions are very risky., Problems related with MTPs, * Majority of the MTPs are performed iMegally,, , * Misuse of amniocentesis (a foetal sex determination, , test based on the chromosomal pattem in the amniotic, fluid)., , * If the foetus is female, it is followed by MTP. Such, practices are dangerous for the young mother and, foetus., , exually Transmitted Dis:, , , , , , (STDs), , * Diseases transmitted through sexual intercourse are, called Sexually transmitted diseases (STDs)/Venereal, diseases (VD) or Reproductive tract infections (RTI)., E.g.. Gonorrhoea, syphilis (caused by the bacterium, Treponema pailidum), genital herpes, chlamydiasis(a, sexually transmitted disease caused by the bacterium, Chlamydia trachomatis), genital warts, wichomoniasis,, hepatitis-B & HIV leading to AIDS,, , Hepatitis-B & HIV are also transmitted by:, , + By sharing of injection needles, surgical instruments etc., + By transfusion of blood, “, + From infected mother to foetus., , + Except hepatitis-B, genital herpes & HIV, other diseases, are completely curable if detected early and treated, , properly., , Early symptoms: Itching, fluid discharge, slight pain, ‘swellings, etc., in the genital region., , + Absence or less significant early Symptoms and the, social stigma deter the infected Persons to consult a, doctor. This leads to pelvic inflammatory diseases, (PID), abortions, still births, ectopic Pregnancies

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ta Fallopian Transfer (GIFT):, , Transfer of an ovum from a donor into the fallopian, fle who cannot produce Ovum, byt, , velopment., , 3. Intra cytoplasmic sperm injection (ICSI):, A laboratory procedure in which a single sperm (from, male partner) is injected directly into an egg (from, female partner). Then the fertilised egg is implanteq, , into the woman’s uterus., * In Cake of doubt, golto a quplified Jloctor for early 4. Artificial insemination (AI) technique:, detection and get compete trealmen © The semen collected frget the husband or a healthy, , donor is artifici d into the vagina or the, , Prevention:, , * Avoid sex with unkn ers, , * Always use condoms, , , , , , , , ute erine insemination) of the, * Itis the inability of male or fi ale to produce ste. female., ° is useful for the male partner havj, The reasgns for may be fphytical, conkenital, 0 This moe eas P aving, , 5. Surrogacy:, , © Here, a woman (surrogate mother) bears a child, for a couple unable to produce children, because, the wife is infertile or unable to carry., , ® The surrogate is impregnated either through artificial, wo hes a insemination or through implantation of an embryo, produced by in vitro fertilization., , & blastomeses) Problems of ART, , into fallopianfube. It requires high precis, , professionals, , , , ® Intra Utering Transfef (IUT): Transfof embryos, with more thai 8 blastoNeres into the uterus. Embryo, formed by if vivo fertilisation (fertilization within, the female) is also used for such transfer to assist °, those females who cannot conceive. ., , , , e environment for fertilization and _