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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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Contraceptive Methods, , , , , , , , , Periodic abstinence, - Avoid coitus from day 10 to 17 o, e menstrual cycle (fertile perigd, , to pre : i, *Chances of fertilisation are hig, , during this period, thereforg #js :, called the fertile period. gg, , , , , , , , before ejaculation to ayffd, insemination., , , , , , , , , , (No side effect and chances of, conception are almost nil., , , , , , , , , , , ¥, , , , , , , Condoms iaphragms, hey are made of rubberflatex © A rubber, dome-shaped aay, that fits over the cervix and is use, : in conjunction with a spermigya#, *Wacy are used to covg#the penis or, Linkin ‘ an be inserteg.d emale, , vapee Ty ft before coitus, so that the semen would not enter, into female reproductive tract., , up to 6 hours before intercourse., , + A vagin ometimes called, , a femal, , , , , , al pouch, , +, , Cervical caps, , . A cervical cap resgyefes a «Made of rubber; these;, Meapbracm b maller and I Productive tract, , more rigid. to cover the cervix during coitus., , , , , , , , , , , , , , , , , , J, , Vaults, , , , , , , , , , + It fits snugly oy ;, must be fitted by a health, care professional., , + They block the entry of sperms through, the cervix., , , , , , , , , , , , , t protects the user, * It is disposable., , « It can be self-inserted and thereby give priv, , user. e.2, CuT, Cu7, Multi 5, , Hormone releasing [UDs (e.g. ProgestaStfG LNG-20):, Make the uterus unsuitable for implantation and the, , cervix hostile he sperms. ee, IUDs increase phagocytosis of sperms,, , Cu ions suppress motility 3nd fertilizi, sperms., , ——————, IUDs are ideal contrace, , * 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, along with the barriers to increase contracepti, , efficiency., , , , , , , , * The most widely used spermicide is nonoxynol-9,, which kills sperm by disrupting their plasma, membranes,

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oral contraceptives, , Oral administration of Progestog, estrogen combinations in the fo, , ‘ *nS OF progest, ogen—, , rm of tablets (pits),, , , Pills are taken daily for 21 days startin, , £ Withi, - ve days of menstrual cycle. n the first, , , After a gap of 7 days (during which, it has to be repeated in the same P, desires to prevent conception., , menstruation Occurs), attern till the female, , . They inhibit ovulation and im, , ! plantation as well as alter, the quality of cervical mucus t, , © prevent entry 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 fe, and high contraceptive value., , , , , W side effects, , , , 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, effective periods are much longer., , and their, , Surgical methods (sterilization):, , To block gamete transport and thereby prevents conception., ltis very effective but reversibility is poor., , , , , , Vasectomy Tubectomy, Sterilization procedure in | Sterilization procedure in, males females, , , , 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., , , , , , , , Side effects of Anti-natural contraceptives: are, Nausea, abdominal pain, breakthrough bleeding, regu, , Menstrual bleeding, breast cancer etc., nro meee, before, , , , , , Medical Termination of, , , , Intentional or voluntary termination of pregnancy, full term is called MTP or induced abortion., , 45 to 50 million MTPs are performed os :, ver the world (i.e., 1/Sth of total number, , Pregnancies). :, MTP helps to decrease the population., , cat jal issues, Because of emotional, ethical, religious and soci ), Many countries have not legalised MTP., , year all, nceived, , galised MTP in 1971 with, to check indiscriminate and illegal, h are reported to be high in India., An abortion may be 5, also called a miscar, performed),, , Importance of MTP, , Government of India le, Some strict conditions, female foeticides whic, , pontaneous (naturally occurring:, riage) or induced (intentionally, , * 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 amniatic, fluid)., , * If the foetus is female, it is followed by MTP. Such, , practices are dangerous for the young mother and, foetus., , , , Sexually Transmitted Dise, , , , ases (STDs), , , , * Diseases transmitted through sexual intercourse are, called Sexually transmitted diseases (STDs)/Venereal, diseases (VD) or Reproductive tract infections (RTD., 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, swell., ings, etc., in the genital region., , + Absence or less significant early symptoms, social stigma deter the infected Persons to, doctor. This leads to pelvic, (PID), abortions, still births, , and the

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(pregnancy in which the fertili, Sites other than the uterus), infe, reproductive tract, ete., , d egg implants, , ility, canc the, , * All persons are vulnerable to STDs. These are very high, among persons in the age group of 15-24 years., Prevention:, , * Avoid sex with unknown partners/multipkesi, , * Always use condoms during coitus., , * In case of doubt, go to a qualified doctg, detection and get complete treatment., , EEE ee, , It is the inability of male or female to produce children., , The reasons for this may be physical, congenital,, diseases, drugs, immunological or even psychological., , Assisted Reproductive Technologies (ART), , |. 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, , * This is followed by Embryo transfer (ET)., * Itis 2 types:, , © Zygote Intra Fallopian Transfer (ZIFT): Transfer, , of zygote or early embryos (with up to 8 blastomeres), into fallopian tube., , ® Intra Uterine Transfer (IUT): Transfer of embryos, with more than 8 blastomeres into the uterus. Embry, formed by in vivo fertilisation (fertilization within, the female) is also used for such transfer to assist, those females who cannot conceive., , , , , , , , , , , , , , , , , , , , , © the fallopian, A dnnot produce Ovum, byt, vironment for fertilization and, , als partner) is injected directly into an 8g (from, female partner). Then the fertilised egg is implanteq, into the woman’s uterus., , 4. Artificial insemination (AT) technique:, © The semen collected from the husband or a healthy, , donor is artificially introduced into the vagina or the, , uterus (IUI — intra-uterine insemination) of the, , female., , ® This technique is useful for the male partner having, inability to inseminate female or low sperm counts, etc,, , 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, insemination or through implantation of an embryo, produced by in vitro fertilization., , Problems of ART, andling by specialized, , sive —_ instrumentation., S are available only in very few, , , , Therefore, these faciliti, , Emotional, religious and social problems., , Legal adoption is one of the best methods for couples, looking for parenthood.