Reproductive Health - Notes | Class 12 | Part 1: Problems and Strategies, Birth Control Methods
Reproductive Health: Problems & Strategies, Population Stabilization & Birth Control
Reproductive Health: Problems & Strategies
According to the World Health Organisation (WHO), reproductive health is a total well-being in all aspects of reproduction, i.e., physical, emotional, behavioural, & social.
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 with 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 breastfeeding, equal opportunities for male & female children, 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.
Population Stabilization & Birth Control
In 1900, the world population was about 2 billion. By 2000, it rocketed to about 6 billion and reached 7.2 billion in 2011.
In India, the population was nearly 350 million at the time of independence. It reached 1 billion by 2000 and crossed 1.2 billion in May 2011. This 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
Increased health facilities and better living conditions.
Rapid decline in death rate, maternal mortality rate (MMR), and infant mortality rate (IMR).
Increase in the number of people in reproducible age.
Impacts of Population Explosion
Scarcity of basic requirements (e.g., food, shelter, & clothing).
Control Measures
Motivate smaller families by using contraceptive methods.
Aware people about the slogan Hum Do Hamare Do (we two, our two). Many couples have adopted a ‘one child norm’.
Statutory raising of the marriageable age of females (18 years) and males (21 years).
Properties of an Ideal Contraceptive
User-friendly, easily available, effective, and reversible.
No or least side effects.
It should not interfere with sexual drive, desire, & sexual act.
Contraceptive Methods
1. Natural/Traditional Methods
Avoid chances of ovum and sperms meeting. It includes:
Periodic abstinence: Avoid coitus from day 10 to 17 (fertile period) of the menstrual cycle to prevent conception. The fertile period is the period with chances of fertilization.
Coitus interruptus (withdrawal): Withdraw the 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 and is effective up to 6 months following parturition.
Natural methods have no side effects, but the chances of failure are high.
2. Barriers
They prevent the physical meeting of sperm & ovum. Examples include:
Condoms (e.g., Nirodh):
Made of rubber/latex sheath.
Condoms for males: Cover the penis.
Condoms for females: Cover the vagina & cervix.
Condoms are used just before coitus. They prevent the entry of semen into the female reproductive tract.
Condoms are very popular because:
They protect the user from STDs and AIDS.
Easily available and disposable.
They can be self-inserted, thereby giving privacy to the 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 the vagina. They increase phagocytosis of sperms.
IUDs are an ideal method to delay pregnancy or space children.
Types of IUDs:
Non-medicated IUDs: They retard sperm motility and have a spermicidal effect. E.g., Lippes loop.
Copper-releasing IUDs: Cu ions suppress motility and the fertilizing capacity of sperms. E.g., CuT, Cu7, Multiload 375.
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 the menstrual cycle. After a gap of 7 days (menstruation period), they should be repeated in the same pattern until the female desires to prevent conception.
They inhibit ovulation and implantation and thicken cervical mucus to prevent the entry of sperms.
Pills are very effective with lesser side effects.
Saheli: A new oral contraceptive for females, developed by the 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 progestogen-oestrogen combinations are used by females as injections or implants under the skin.
Their mode of action is like that of pills, and their effective periods are much longer.
Progestogens or progestogen-oestrogen combinations & IUDs are used as emergency contraceptives within 72 hours of coitus. They avoid pregnancy due to rape or casual intercourse.
6. Surgical Methods (Sterilization)
They help to block gamete transport and thereby prevent conception. They are 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 the vagina.
Side Effects of Anti-Natural Contraceptives
Nausea, abdominal pain, breakthrough bleeding, irregular menstrual bleeding, breast cancer, etc.
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