The document discusses reproductive health issues in India. It covers topics like early marriage, lack of knowledge about reproductive health leading to high maternal and infant mortality rates, and population explosion due to lack of family planning programs. It describes various contraceptive methods like natural family planning, barrier methods, IUDs, oral contraceptives, and sterilization. It also discusses infertility treatment methods, sexually transmitted diseases, and strategies to improve awareness about reproductive health issues through various government programs.

1. Chapter 4.
REPRODUCTIVE
HEALTH

2. REPRODUCTIVE HEALTH
• It is the state of physical, emotional, behavioral
and social fitness for leading a reproductive life.
• According to WHO, A total well being in all apects
of reproduction.
• To achieve this family planning” initiated in
1951.
• REPRODUCTIVE HEALTH – PROBLEM AND
STRATEGIES:
• In Indian culture discussing about knowledge of
sex and reproductive health is wrong thing.

3. • Early marriage as soon as girls attains puberty.
• The teen age girl is not fit to bear foetus.
• After marriage, the career of lady is blocked in lot
of family.
• Maternal and infant mortality rate are high in
early marriages.
• There is little knowledge about personal hygiene
to avoid sexually transmitted diseases.
• There may be population explosion with lack of
reproductive health.

4. • STRATEGIES:
• Number of program are lanched under
reproductive and child health care (RCH).
• Awareness programme are conducted for
both male and female to lead healthy
reproductive life.
• Awareness creating about fertility regulating
method.
• Awareness creating about personal hygiene,
• Preventing and Protecting against sexually
transmitted diseases.

5. • POPULATION EXPLOSION AND BIRTH CONTROL:
• The increase in size and growth of human
population is called population explosion.
• The reason for high population explosion are,
1. Decline in death rate.
2. Longer life span.
3. Decline in maternal mortality rate.
4. Decline in infant mortality rate.
5. Some religious belief against birth control.
6. Lack of reproductive health knowledge.

6. • Birth control:
• Family welfare and family planning programs comes
forward to avoid uncontrolled human population
explosion.
• The contraception is the main aim of the birth control.
• Prevention of conception or fertilization of ovum
during sexual inter course is called contraception. The
different types of contraception are,
• Natural method.
• Barrier method.
• Intra uterine device [IUD’s].
• Oral contraception.
• Injection and implantation.
• Surgical method.

7. • Natural methods:
• It work on the principle of avoiding chances of
ovum and sperms meeting.
• Periodic abstinence:
• Is a method in which couple avoid or abstain coitus
form day 10 to 17 of the menstrual cycle when
ovulation could be expected.
• Withdrawal or coitus interruption:
• In this method male partner withdraws his penis
from the vagina just before ejaculation to avoid
insemination.

8. • Lactational amenorrhea:
• It cause due to intense lactation for about six
months after parturition.
• No menstruation occurs during lactation period.
Hence chance of fertilization is abent.
• Physical contraceptive or Barrier methods:
• This method prevents contact of sperm and ovum
by barrier. Such methods available both for male
and female.

9. • Condoms:
• Condom are barriers made of
thin rubber latex sheath.
• The male condom is used to
cover the penis. It is used just
before coitus so that semen not
entered into the female
reproductive tract.
• It also prevents AIDS and STDs.
• The female condoms are
Diaphragm, cervical caps and
vaults made of rubber latex.
• These are inserted into the
female reproductive tract to
cover the cervix.

10. • Intra Uterine Devices (IUDs ):
• These devices are only used by
female. doctor or by expert
nurses insert these into the
uterus through vagina.
• Different types of IUDs are,
• Non-medicated IUDs e.g.
Lippes loop: Acts as barrier.
• Copper releasing IUDs (CuT,
Cu7, Multiload 375):
• Cu ion released suppresses
sperm motility and fertilizing
capacity of sperm.
• It Increase phagocytosis of
sperm within the uterus.

11. • Hormone releasing IUDs
(Progestasert, LNG-20):
• make the uterus unsuitable
for implantation and the
cervix hostile to the sperm.

12. • Chemical contraceptive
• Oral contraceptives: This methods is for female only.
• These are used in the form of tablets popularly called
pills.
• It contain progestogens or progestogen-estrogen
combination.

13. • Pills have to be taken daily for a period of 21 days
started within first five days of menstruation.
• Saheli- a non steroidal preparation used as oral
contraceptive pills

14. • Injections or implants:
• Progestogens alone or in combination with
estrogen used as injections or implants under
the skin of female.
• It is very effective for long periods.

15. • Emergency contraceptives:
• These methods are used within 72 hours of coitus,
casual in unprotected intercourse.
• Administration of progestogens or progestogen-
estrogen combination.

16. • Surgical methods:
• It is also called as sterilization
method advised to both male
and female partner.
• It is permanent method to
prevent pregnancy.
• Sterilization surgery in male is
called ‘vasectomy,
• In vasectomy, a small part of
the vas deferens is removed
or tied up.

17. • Sterilization surgery
in female is called
‘Tubectomy’
• In Tubectomy a small
part of the fallopian
tube is removed or
tied up.

18. • MEDICAL TERMINATION OF PREGNANCY (MTP):
• Intentional or voluntary termination of pregnancy
is called medical termination of pregnancy (MTP)
or induced abortion.
• MTP has significant role in decreasing population.
• Legal restriction is there only to reduce female
foeticide.
• This method is safe within 1st trimester.

19. • SEXUALLY TRANSMITTED DISEASES:
• Diseases or infections which are transmitted
through sexual intercourse are called STDs.
• These are also known as Venereal diseases (VD) or
reproductive tract infections (RTIs)
• Ex: Gonorrhea, Syphilis, Genital herpes,
chlamydiasis, genital warts, trichomoniasis,
hepatitis-B and HIV.
• Except hepatitis-B, genital herpes and HIV
infections, others are curable. Bcoz thee are viral
diseases.

20. • Symptoms:
• Itching, fluid discharge, slight pain, swelling in the
genital region.
• STDs remain asymptomatic in female and remain
undetected for long.
• In the later stage it may leads to Pelvic inflammatory
diseases (PID), abortion, infertility or even cancer in
Reproductive tract.
• Preventions:
• Avoiding sex with unknown partners or multiple
partners.
• Always using condoms during coitus.
• In case of doubt, consulting a doctor for early
detection.
• Getting complete treatment for diagnosed disease.

21. • INFERTILITY:
• The couple unable to produce children inspite
of unprotected sex is called infertility.
Problems of infertility may be in male or
female.
• The reason of infertility may be:-
1. physical,
2. diseases,
3. drugs,
4. immunological or
5. Even psychological.

22. • Methods of infertility control:
1. IVF-ET: In Vitro Fertilization – embryo transfer.
2. GIFT: Gamete Intra Fallopian transfer.
3. ZIFT: Zygote Intra Fallopian transfer.
4. IUI: Intra Uterine Insemination.

23. • Embryo transfer:
• It Is popularly known as test tube baby program.
• In this technique ova from the wife/donor and
sperm from the husband/donor are collected.
These are induced to fertilization to form zygote
under laboratory conditions.
• The zygote or early embryos (with upto 8
blastomeres) could be transferred into the
fallopian tube.
• Further development taken place within the
female body.

24. • Gamete intra fallopian transfer- GIFT
• It is the transfer of ovum collected from the
donor into the fallopian tube of another female
who cannot produce it.
• Artificial insemination (AI) or (IUI-intra uterine
insemination)
• In this technique semen is collected either from
the husband or donor is artificially introduced
into the uterus of the female.
• It is useful in cases either the male partner
unable to inseminate in the female or very low
sperm counts.