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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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0 ral contraceptives, , Oral administration of Progestog, estrogen combinations in the fo, , €nS OF progestoge, n—~, rm of tablets (pits), , , Pills are taken daily for 21 days Starting wit, - ave days of menstrual cycle. 7, , , After a gap of 7 days (during which m, it has to be repeated in the same pa, desires to prevent conception., , . They inhibit ovulation and implantation as w, the quality of cervical mucus to prevent entry, , hin the firs, , €nstruation occurs), ttern till the female, , ell as alter, of sperms., » Pills are very effective with lesser Side effects,, Saheli, « New oral contraceptive for the females. It contains, a non-steroidal preparation., * Itis a “once a week’ pill with very few side effe, and high contraceptive value., , , , cts, , , , 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, effective periods are much longer., , Surgical methods (sterilization):, , , , , , , To block gamete transport and thereby, tis very effective but reversibiljgee, , ‘onception., bor., , , , Tubectomy, | Sterilization procedure in, females, , , , , , ization procedure in, males, , , , , , , , In this, a small part of the, fallopian tube is removed, or tied up through a small, incision in the abdomen or, , through vagina., , In this, a small part of the, vas deferens is removed, or tied up through a small, incision on the scrotum., , , , mad, , , , Side effects of Anti-natural contraceptives: ah ”, Nausea, abdominal pain, breakthrough bleeding, irregu, , Menstrual bleeding, breast cancer etc., rae Lee,, , , , Medical Termination of Pr, , , , ; E _ fore, Intentional or voluntary termination of pregnancy be, full term is called MTP or induced abortion., , i all, 45 to 50 million MTPs are performed Me eeeained, ®ver the world (i.e., 1/Sth of total number 0, , Pregnancies)., MTP helps to decrease the population., , ek ocia, Because of emotional, ethical, religious and s, Many countries have not legalised MTP., , | issues, , , , , , , , , , , , , , , , , galised MTP in 1971 with, heck indiscriminate and illegal, € reported to be high in India., , An abortion may be spontaneous (naturally occurring;, , also Called a miscarriage) or induced (intentionally, performed)., , Government of India le, Some strict conditions to cl, female foeticides which ar, , Importance of MTP, , * To avoid unwanted pregnancies. due 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 illegally., , * Misuse of amniocentesis (a foetal sex determination, , test based on the chromosomal pattern in the amniotic, fluid)., , * If the foetus is female, it is followed by MTP. Such, , practices are dangerous for the young mother and, foetus., , , , Sexually Transmitted Diseases (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 pallidum), genital herpes, chlamydiasis(a, sexually transmitted disease caused by the bacterium, Chlamydia trachomatis), genital warts, trichomoniasis,, hepatitis-B & HIV leading to AIDS., , Hepatitis-B & HIV are also transmitted by:, * By sharing of injection needles, surgical instruments ete., , * By transfusion of blood. a, , * 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, social stigma deter the infected Persons to ¢, , doctor. This leads to pelvic inflammat, (PID), abortions,, , and the, Onsult 9, diseases, *Snancies, , . ory, still births, ectopic pr

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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.