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Reproductive _, Health ~, , , , , , , , Reproductive health means a total well being in all aspects of growth rate was still around 1.7% (i.e. 17/1000/, , reproduction. year), @ rate at which our population could double, Reproductive health programmes (family planning) initiated in 33 years., , in India 1951., - Reasons for population explosion, , * Increased health facilities and better living conditions., , * A rapid decline in death rate, maternal mortality rate, (MMR) and infant mortality rate (IMR)., , * Increase in number of people in reproducible age, 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. >., Impacts of population explosion, Aims and Needs of Sex Education in Schools - Scarcity of basic requirements (e.g. food, shelter &, * To provide right information about sex-related Seemann, aspects. Control measures, * To avoid sex-related myths and misconceptions. * Motivate smaller families by using contraceptive, methods., , * Proper information about reproductive organs,, | adolescence and related changes, safe and hygienic * Aware peoples about a slogan Hum Do Hamare De, , sexual practices, sexually transmitted diseases (STD). (we two, our two). Many couples have adopted an ‘ene, AIDS. etc : child norm’., , * Statutory raising of marriageable age ef the female, , Control (18 years) and males (21 years)., , , , , , , , Population Explosion & Birth, , , , * 181900, the world population was around 2 —— _ Features of An Ideal Contraceptive, million}-By 2000, iC rocketed te-ebaut 6 billion., , , , User-friendly, easily available, effective and reversitle., No or 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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(pregnancy in which the fertilised egg implants at 2. Gamete Intra Fallopian Transfer (GIFT):, , i i ® donor into the fal, sites other than the uterus), infertilit cancer of the Transfer of an ovum from @ ‘allopian, Teproductive tract, ete, aa aaa tube of another female who —— ovum,, , 2 can provide suitable environment for fertilization ang, All persons are vulnerable to STDs, These are very high development., among persons in the age group of 15-24 years. 3. Intra cytoplasmic sperm injection (ICSI):, Prevention: . 7 x aco procedure in which a single sperm (from, ectly into an, * Avoid sex wit i Je partner) is injected direct wm CRE (from, ‘x with unknown partners/multiple partners, eeu! partner). Then the fertilised egg is imptanteg, * Always use condoms during coitus., , into the woman’s uterus., *In case of doubt, go to a qualified doctor for early 4, Artificial insemination (Al) technique:, detection and get complete treatment, © The semen collected from the husband or a healthy, , donor is artificially introduced into the vagina or the, bk OTN a ea uterus (IUI — intra-uterine insemination) of the, , * Itis the inability of male or female to produce children, a, ies © ‘This technique is useful for the male partner having, * The reasons for this may be physical, congenital, inability to inseminate female or low sperm counts, diseases, drugs, immunological or even Psychological. etc., Assisted Reproductive ‘Technologies (ART) 5, Surrogacy:, , |, In vitro fertilisation (IVF test tube baby programme):, + Ova collected from the wife/donor and sperms from the, husband/donor are induced to form zygote, , © Here, a woman (surrogate mother) bears a child, for a couple unable to produce children, because, the wife is infertile or unable to carry., , * This is followed by Embryo transfer (ET) © The surrogate is impregnated either through artificial, , © Itis 2 types: insemination or through implantation of an embryo, , produced by in vitro fertilization., © Zygote Intra Fallopian Transfer (ZIFT): Transfer, , rine AR’, of zygote or early embryos (with up to 8 blastomeres) Be Sua, , into fallopian tube. + It requires high precision handling by specialized, ® Intra Uterine Transfer (IUT): Transfer of embryos professionals and ; expensive — instrumentation., , with more than 8 blastomeres into the uterus. Embryo Therefore, these facilities are available only in very few, , formed by im vivo fertilisation (fertilization within oe, , the female) is also used for such transfer to assist * Emotional, religious and social problems., , those females who cannot conceive. ., , Legal adoption is one of the best methods for couples, looking for parenthood.