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Chapter 4
Reproductive Health
Reproductive Health: The complete well-being with respect to all aspects of reproduction like physical, emotional,
behavioural and social
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4
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The goal was to attain total reproductive health
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Reproductive and Child Health Care (RCH) Programs are being operated with the aim of creating awareness
among people about various reproduction related aspects and providing facilities and support for building a
reproductively healthy society
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➢ Educating people, especially fertile couples and marriageable individuals about birth control options,
pre and post-natal care, infant and child care, importance of breast feeding, equal opportunities for
males and females, will help in bringing up socially conscious and healthy families of desired size
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➢ Provision and availability of strong infrastructural facilities, professional expertise and material
support for successful implementation of health plans
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➢ Implementation of newer, better and upgraded facilities with respect to reproductive health
➢ Complete ban on foetal sex determination to check female foeticide
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Improved reproductive health of the society is indicated by:
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Smaller families,
Better detection and cure for STDs
Overall increased medical facilities
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3: Population Explosion and Birth Control
Population Explosion: The rapid growth of population of a particular species, specifically of the humans in the world
since the end of World War II
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This will lead to increased stress on all resources
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Ideal Contraceptive:
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Should be easy to use
Should be easily available
Should be effective
Should not have side effects
Should be reversible
Should not interfere with the sexual drive, desire or act of the individual

Methods of Contraception:
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3
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5
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Natural or Traditional
Barrier Methods
Intra-uterine devices (IUDs)
Oral contraceptives
Injectable and implants
Surgical Methods

1
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• Periodic Abstinence: In this method couples avoid coitus between 10th and 17th day of the menstrual
cycle as during this period the chance of ovulation is maximum
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Therefore, he prevents the release of semen and thus prevents
insemination
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As there is no menstruation it is believed that during this period there is no ovulation and therefore
decreased chances of pregnancy
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As no chemicals are used the chances of side effects are nil
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2
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• Condoms: Barriers made of thin rubber or latex sheath that cover the penis in males and the cervix in
females
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As use of condoms prevents contact of genital fluids it also helps in preventing STDs
Reusable barriers like diaphragms, cervical caps and vaults are inserted into the female cervix during
coitus to prevent the entry of sperms through the cervix
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3
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• Non-medicated IUDs like Lippes Hoopes increase phagocytosis of sperms
• Copper releasing IUDs like Copper-T, Copper-7, Multiload 375 decrease motility of sperms
• IUDs that release hormone like Progestasert, LNG-20 make the uterus unsuitable for implantation
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These devices are ideal contraceptives for the females for family planning and are among the most widely
used methods of contraception
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Oral Contraceptives:
This involves the oral administration of progestogens or progesterone-oestrogen combinations in the form of
pills
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After a gap of 7 days (during which menstruation occurs) the cycle is repeated until the female wishes to
conceive
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5
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Such injectables and implants are functionally similar to pills and their effective period is much longer
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Surgical Methods:
Surgical intervention functions by blocking the transport of gametes and thereby prevent conception
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Sterilisation in males is
called as vasectomy and in females is called as tubectomy
• Vasectomy: Vas deferens is tied up or removed through a small incision in the scrotum
• Tubectomy: A small part of the fallopian tube is tied up or removed through a small incision in the
abdomen or the vagina
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Contraceptive methods help in checking population explosion
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4
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MTP has a significant role in decreasing population though it is not meant
for that purpose
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Why MTP?
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To prevent unwanted pregnancies
In cases where continuation of pregnancy is harmful or even fatal to the mother or foetus or both
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However MTPs during the second trimester are riskier
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Also use of amniocentesis or other methods of pre-natal sex determination may lead to female foeticide as the
preference for male child is very high
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4: Sexually Transmitted Diseases:
Diseases or infections of the reproductive tract which are transmitted through sexual activities and intercourse are
called sexually transmitted diseases (STD) or venereal diseases (VD) or reproductive tract infections (RTI)
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Among these, HIV infection is most dangerous
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Except for Hepatitis-B, genital herpes and HIV infections, other STDs are curable if detected early
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Individuals may remain asymptomatic for a long time
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This could lead to complications later, which include pelvic inflammatory diseases (PID), abortions, still births, ectopic
pregnancies, infertility or even cancer of the reproductive tract
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Hence prevention along with early detection and cure of these diseases are given prime importance under
reproductive health-care programmes
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4
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Reasons could be physical, congenital, diseases, drugs, immunological or even psychological
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Specialised health care units like infertility clinics could help in corrective treatment of some of these disorders
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In vitro Fertilisation (IVF): This involves fertilisation of gametes outside the body in conditions that mimic body
conditions
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The embryo is then transferred
in to the uterus of the female
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Intra-Uterine Transfer (IUT): Embryos with more than 8 blastomeres can be transferred directly into the uterus
Gamete Intra Fallopian Transfer (GIFT): The ovum from the donor is collected and transferred into another
female who cannot produce one but can provide conditions for fertilisation and further development
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Artificial insemination (AI) technique: In this technique, the semen collected either from the husband or a
healthy donor is artificially introduced either into the vagina or into the uterus (IUI – intra-uterine
insemination) of the female
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They also need expensive
instrumentation
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