REPRODUCTIVE HEALTH | Master Biology

Chapter focus: reproductive well-being

Reproductive health is total well-being in all aspects of reproduction: physical, emotional, behavioural and social. The chapter covers awareness, population stabilisation, contraception, MTP, STIs and infertility management.

Awareness & RCH→Birth control→MTP→STIs→Infertility & ART

WHO perspectiveReproductive health is broader than normal reproductive organs and functions; it includes emotional, behavioural and social well-being.

3.1 Reproductive health: problems and strategies

India initiated national family-planning programmes in 1951. Broader programmes now operate as Reproductive and Child Health Care (RCH) programmes. Their central tasks are awareness, facilities and support for a reproductively healthy society.

Accurate information on reproductive organs, adolescence, safe and hygienic sexual practices, STIs and AIDS helps young people avoid myths and misconceptions.
Education of fertile couples and people of marriageable age should cover birth-control options, care during pregnancy and after birth, breast-feeding and equal opportunity for male and female children.
Medical support is needed for pregnancy, delivery, contraception, menstrual problems, abortions, STIs and infertility.
Amniocentesis can detect some genetic disorders, but its use for sex determination is legally banned to check female foeticide.

NCERT factSaheli, developed by CDRI Lucknow, is a non-steroidal oral contraceptive with once-a-week use and high contraceptive value.

3.2 Population stabilisation and birth control

Improved health facilities and living conditions lowered death rate, maternal mortality rate and infant mortality rate, contributing to rapid population growth. Promoting small families, raising marriageable age and providing contraception help control population growth.

An ideal contraceptive is user-friendly, easily available, effective, reversible and has no or least side-effects without interfering with sexual drive, desire or act.

Major categories

Natural / traditional: periodic abstinence, withdrawal and lactational amenorrhoea.
Barrier: condoms, diaphragms, cervical caps and vaults; condoms also protect against STIs and AIDS.
IUDs: non-medicated, copper-releasing and hormone-releasing devices inserted into uterus by trained professionals.
Hormonal methods: pills, injectables and implants inhibit ovulation/implantation and alter cervical mucus.
Surgical methods: vasectomy and tubectomy block gamete transport and are terminal methods.

Emergency contraceptionProgestogen or progestogen-oestrogen combinations, or IUDs, used within 72 hours of coitus can avoid possible pregnancy after unprotected intercourse.

3.3 Medical termination of pregnancy (MTP)

MTP, or induced abortion, is intentional or voluntary termination of pregnancy before full term. It may be needed for unwanted pregnancy after unprotected intercourse, contraceptive failure or rape, or when continued pregnancy threatens the mother or foetus.

MTP was legalised in India in 1971 under strict conditions to prevent misuse.
It is relatively safe during the first trimester, up to 12 weeks; second-trimester procedures are riskier.
Illegal procedures by unqualified persons can be dangerous or fatal.
Sex determination followed by female foeticide is illegal and unethical. Counselling and appropriate health-care facilities are vital.

3.4 Sexually transmitted infections (STIs)

STIs are also called venereal diseases (VD) or reproductive tract infections (RTI). Common examples include gonorrhoea, syphilis, genital herpes, chlamydiasis, genital warts, trichomoniasis, hepatitis-B and HIV infection leading to AIDS.

Except for hepatitis-B, genital herpes and HIV, STIs are completely curable when detected early and treated properly.
Early symptoms may be minor: itching, fluid discharge, slight pain or swellings in genital region. Females may often be asymptomatic.
Untreated infection can cause PID, abortions, stillbirths, ectopic pregnancies, infertility and reproductive-tract cancer.
Prevent by avoiding unknown/multiple partners, using condoms and seeking early diagnosis and complete treatment from a qualified doctor.

RememberHepatitis-B and HIV can also be transmitted via contaminated needles/instruments, blood transfusion and from infected mother to foetus.

3.5 Infertility and assisted reproductive technologies

Infertility is inability of a couple to produce children despite unprotected sexual cohabitation. Causes may be physical, congenital, disease-related, drug-related, immunological or psychological, and may involve either partner.

Where corrective treatment is not possible, assisted reproductive technologies (ART) can help:

IVF-ET: ova and sperm are collected and fertilised in laboratory conditions, then the embryo is transferred.
ZIFT: zygote or early embryo up to 8 blastomeres is transferred to fallopian tube; embryos with more than 8 blastomeres are transferred to uterus by IUT.
GIFT: a donor ovum is transferred to fallopian tube of a woman who cannot produce ova but can support fertilisation and development.
ICSI: one sperm is injected directly into ovum in laboratory. AI/IUI: semen is introduced artificially into vagina or uterus.

Social perspectiveART requires specialised expertise and costly equipment. Legal adoption remains an important path to parenthood.

NCERT summary: rapid recall

Reproductive health covers physical, emotional, behavioural and social well-being.
RCH programmes combine awareness with accessible reproductive and child-health care.
Contraceptives help avoid, delay or space pregnancy; choices should be made with qualified medical guidance.
MTP has a defined legal and medical context; unsafe and sex-selective practices must be avoided.
Prevention, early detection and treatment of STIs protect individual and public health.
ART can assist infertile couples, while adoption is also an important option.