According to World Health Organisation (WHO), Reproductive health is a total well-being in all aspects of reproduction i.e., physical, emotional, behavioural & social.
REPRODUCTIVE HEALTH: PROBLEMS & STRATEGIES
India initiated reproductive health programmes (family planning) in 1951.
Now wider reproduction-related areas are in operation under Reproductive & Child Health Care (RCH) programmes.
Such programmes deal the following:
§ Give awareness about reproduction related aspects for creating a reproductively healthy society.
§ Educate people about birth control, care of pregnant mothers, post-natal care of mother and child, importance of breast feeding, equal opportunities for male & female child etc.
§ Awareness of problems due to population explosion, social evils like sex-abuse and sex-related crimes, etc.
Aims and needs of sex education in schools
§ To provide right information about sex-related aspects. It helps to avoid sex-related myths and misconceptions.
§ To give proper information about reproductive organs, adolescence and related changes, safe and hygienic sexual practices, sexually transmitted diseases (STD), AIDS etc.
· In 1900, world population was about 2 billion. By 2000, it rocketed to about 6 billion and 7.2 billion in 2011.
· In India, population was nearly 350 million at the time of independence. It reached 1 billion by 2000 and crossed 1.2 billion in May 2011. It means every sixth person in the world is an Indian.
· According to the 2011 census report, our population growth rate was less than 2% (i.e. 20/1000/year), a rate at which our population could increase rapidly.
Reasons for population explosion
o Increased health facilities and better living conditions.
o Rapid decline in death rate, maternal mortality rate (MMR) and infant mortality rate (IMR).
o Increase in number of people in reproducible age.
Impacts of population explosion
Scarcity of basic requirements (e.g. food, shelter & clothing).
o Motivate smaller families by using contraceptive methods.
o Aware peoples about a slogan Hum Do Hamare Do (we two, our two). Many couples have adopted a ‘one child norm’.
o Statutory rising of marriageable age of females (18 years) and males (21 years).
Properties of an ideal contraceptive
o User-friendly, easily available, effective and reversible.
o No or least side-effects.
o It should not interfere with sexual drive, desire & sexual act.
1. Natural/Traditional methods
Avoid chances of ovum and sperms meeting. It includes
§ Periodic abstinence: Avoid coitus from day 10 to 17 of the menstrual cycle (fertile period) to prevent conception.
§ Coitus interruptus (withdrawal): Withdraw penis from the vagina just before ejaculation to avoid insemination.
§ Lactational amenorrhea: It is the absence of menstrual cycle & ovulation due to intense lactation after parturition. Fully breastfeeding increases lactation. This method helps to prevent conception. This is effective up to 6 months following parturition.
It has no side effect. But chances of failure are high.
They prevent physical meeting of sperm & ovum. E.g.
§ Condoms (E.g. Nirodh): Made of rubber/latex sheath.
Condoms for male: Cover the penis.
Condoms for female: Cover the vagina & cervix.
Condoms are used just before coitus. They prevent the entry of semen into female reproductive tract.
Condoms are very popular because:
- It protects the user from STDs and AIDS.
- Easily available and disposable.
- It can be self-inserted and thereby give privacy to user.
§ Diaphragms, cervical caps and vaults:
- Made of rubber and are inserted into the female reproductive tract to cover the cervix during coitus.
- They block the entry of sperms through the cervix.
- They are reusable.
- Spermicidal creams, jellies & foams are used along with these barriers to increase contraceptive efficiency.
3. Intra Uterine Devices (IUDs)
These are inserted by doctors or nurses in the uterus through vagina. They increase phagocytosis of sperms.
IUDs are ideal method to delay pregnancy or space children.
Types of IUDs:
o Non-medicated IUDs: They retard sperm motility. Also have spermicidal effect. E.g. Lippes loop.
o Copper releasing IUDs: Cu ions suppress motility and fertilising capacity of sperms. E.g. CuT, Cu7, Multiload 375.
o Hormone releasing IUDs: They make the uterus unsuitable for implantation and the cervix hostile to the sperms. E.g. Progestasert, LNG-20.
4. Oral contraceptives
- Oral administration of progestogens or progestogen–oestrogen combinations in the form of tablets (pills).
- Pills are taken daily for 21 days starting within the first five days of menstrual cycle. After a gap of 7 days (menstruation period), it should be repeated in the same pattern till the female desires to prevent conception.
- They inhibit ovulation and implantation and thicken cervical mucus to prevent entry of sperms.
- Pills are very effective with lesser side effects.
- Saheli: New oral contraceptive for the females. It is developed by Central Drug Research Institute (CDRI) in Lucknow. It contains a non-steroidal preparation. It is a ‘once a week’ pill with very few side effects and high contraceptive value.
5. Injectables & Implants
- Progestogens or Progestogens-oestrogen combination are used by females as injections or implants under skin.
- Their mode of action is like that of pills and their effective periods are much longer.
6. Surgical methods (sterilization)
- It helps to block gamete transport and thereby prevents conception. It is very effective but reversibility is very poor.
- Vasectomy: Sterilization procedure in males. In this, a small part of the vas deferens is removed or tied up through a small incision on the scrotum.
- Tubectomy: Sterilization procedure in 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.
Side effects of anti-natural contraceptives:
Nausea, abdominal pain, breakthrough bleeding, irregular menstrual bleeding, breast cancer etc.