NAME-.............................................

CLASS-12
SUB.TEACHER- Mr.P.P.Yadav

Chapter -3 REPRODUCTIVE HEALTH

Reproductive Health:- Reproductive health refers to the ability of a person to produce a

healthy offering.
According to WHO (World Health Organisation), reproductive health means a total well being in
all aspects of reproduction, ie, physical, emotional, behavioral and social.

Causes of Population Explosion in India

A sudden and unexpected increase in the population of a particular place is called population
explosion.

Following are the main reasons for population explosion in India:

1. Early marriage or child marriage: Child marriage is prevalent (प्रचलन) in many states like
Rajasthan, Madhya Pradesh etc. Although today it has been legally abolished. Child marriage is
the main reason for population growth.

2. Importance of son: If there are girls in the family, then the hope of a boy increases in the
family. Son has special importance in Indian society.

3. Illiteracy: Today only 74.04% of the population in India is educated. Due to illiteracy, people
do not understand the importance of family planning and do not make any effort for child control.

4. Blind faith: Indian society is a conservative society. It is because of blind faith that children
are considered to be the gift of God. Parents with more children are considered more fortunate.

5. Low social living standard: Low living standard is considered to be the reason for
population growth. Due to lack of means of entertainment among people of lower status, only
sexual pleasure remains the only means.

6. Imbalance in natality(birth rate) and mortality (death rate) : Due to increase in medical
facilities in India, the death rate,maternal mortality rate (mmr) and infant mortality rate (imr) has
reduced, but the birth rate remains high.

7. Hot climate: The climate of India is hot, which makes the genitals and related organs quickly
sexually mature (onset of puberty) and makes them capable of procreating children.
8. Compulsion of marriage: There is a belief in Hindu families that men and women become
complete only after marriage and there is an increase in population growth.

RESULT OF POPULATION GROWTH

1) Overuse of natural resources eg- water, land, soil, natural forest.

2) Increase in food demand (कमी)
3) Increase in waste generation (pollution).
4) Increase demand for medical facilities.
5) shortage of education facilities.
6) Unemployment
7) Increase crime
8) Overcrowding
9)Poverty

POPULATION CONTROL OR BIRTH CONTROL

Population growth/explosion can be controlled by the following methods-

1.By stop child marriage
2. By avoiding blind faith that childrens are God's gift.
3.By explaining the importance of small families in the society.
4.By explaining the demerits of population explosion in the society.
5. By government law in relation to small family
6.By family planning

BIRTH CONTROL/FAMILY PLANNING AND CONTRACEPTIVE DEVICES

Contraceptive devices are the means which aim to prevent the meeting of sperm and ovum. It
prevents pregnancy.

Contraceptives divided into two broad categories-

1.Non-hormonal Contraceptive
2.Hormonal Contraceptive
1.NON- HORMONAL CONTRACEPTIVES
Non-hormonal contraception methods prevent pregnancy by creating a physical barrier between
sperm and egg, or by other means.
The main methods are:

A. Natural Family Planning (NFP)

This involves the strategies where no external (protection)l is used i.e., chances of pregnancy
are avoided in a natural way. It involves following methods.
(1) Periodic abstinence: This involves avoiding sex, around the most fertile period during the
woman's monthly sex cycle (menstrual cycle). This is called periodic abstinence. The most
fertile period is the 10th to 17th day of menstruation.

2) The withdrawal method (coitus interruptus): This involves withdrawing the penis before
ejaculation. It is not a reliable method and cannot be considered as contraception because
some sperm can leak out.

(3) Lactational amenorrhea (absence of menstruation): This method is based on the fact that,
during intense lactation (breast feeding after pregnancy), ovulation does not occur and chances
of getting pregnant are almost nil. However, this method has been reported to be effective only
up to maximum period of six month followingParturition.

These are physical barriers that stop the sperm coming into contact with the egg, thereby
preventing Fertilisation.

B. Barrier Methods
These methods include condoms(male and female condom) , diaphragms, sponges, and
cervical caps.

Condom: A condom is a thin sheath, usually made up of latex, which is rolled onto an erect
penis before sexual contact. The condom acts as a barrier and the ejaculated semen does not
get deposited into the female vagina.

The diaphragm and the cap: The diaphragm inserted into the upper part of the vagina to cover
the cervix (neck of the womb). They act as a barrier to sperm.
Caps are smaller than diaphragms, but both are available in several types and sizes. These can
be reused. Caps and diaphragms are 92 to 96% effective at preventing pregnancy.

C.Intra-Uterine Contraceptive Devices (IUCDs)

The intra-uterine contraceptive device (IUCD) or coil (commonly called Copper-T or CuT) is a
small plastic and copper device, which is fitted into the uterus by a doctor. It is designed to
prevent the sperm from meeting the egg.

Various types of IUCDs are available. These are non-medicated IUCDs (i.e., Lippes loop),
copper releasing IUCDs (i.e., CuT, Cu7, multiload 375) and hormone releasing IUCDs (l.e.,
Progestasert and LNG-20).

Cu reduces sperm motility. LNG-20 makes the uterine wall unsuitable for Implantation.

D. Sterilization( surgical method)

This is a surgical method to permanently prevent fertilization.
These operations are not easily reversible.

(1) Vasectomy: Men are sterilized in a procedure called a vasectomy. It involves cutting or tying
the tubes (vas deferens) the testicles to the penis. As a result the ejaculated semen does not
contain sperms.

(2) Tubectomy: ln this method, both fallopian tubes (oviducts) are cut, tied or blocked, often
through keyhole surgery. As a result the ovum can not meet the sperms. The alternative is a
hysterectomy, removal of the womb, after which pregnancy is impossible.
 1. HORMONAL CONTRACEPTIVES
Hormonal contraceptives are birth control methods that use hormones to prevent pregnancy.
The main methods are:

A.Pills:- Birth control pills, also called oral contraceptives, are medications you take by mouth to
prevent pregnancy.
Pills have to be taken daily for a period of 21 days.
After a gap of 7 days (during which menstruation
occurs) it has to be repeated in the same pattern till the female desires to prevent conception.

B.Patches:- A contraceptive patch, also known as Evra, is a small, thin, sticky patch that's
applied to the skin to prevent pregnancy. It works by releasing hormones into the bloodstream,
which stop the ovaries from releasing eggs

C.Injection:- Depo-Provera is given as an injection every three months. Depo-Provera typically

suppresses ovulation.
The contraceptive injection releases the hormone progestogen into your bloodstream to prevent
pregnancy.

D.Implant :- The implant is about 4 cm small, flexible plastic rod.It is inserted by a doctor or
nurse. It releases the hormone progestogen, which can stop your body from releasing an egg.

E.EHC(Emergency contraception)
This is a two-tablet treatment containing the progestogen levonorgestrel. Although often called
the "morning-after pill", it is actually effective for up to 72 hours after unprotected sex.
EHC is available under the brand name Levonelle.

Reproductive and Child Health Care (RCH) programmes

India was amongst the first countries in the world to start some action plans to achieve total
reproductive health as a social goal. In this regard, in 1951, 'Family Planning' programmes'
were initiated in India. programmes with much broader goals are under operation with popular
name 'Reproductive and Child Health Care (RCH) programmes
The important goals of these programmes are:

(1) Creating awareness among people about various aspects of reproductive health
(ii) Providing facilities and support for building a reproductively healthy society.
(iii) Creating awareness among people about child health, breast feeding and vaccination.

To keep the family size small, a slogan was given 'Hum do hamare do'. In this context, the
government is providing many contraceptive devices free of cost. Male condoms (with popular
name 'Nirodh') and female contraceptive pills 'Saheli' are available free of cost in all District
hospitals across the country.
It is to be noted here that, 'Saheli' was developed by Indian scientists at CDRI (Central Drug
research Institute, Lucknow).

Medical Termination of Pregnancy (MTP)

Medical Termination of Pregnancy (MTP) is also called induced abortion.
Any qualified gynaecologist (MS/ DGO) can perform MTP.
MTP is allowed for following indications :
1. Failure of contraception.
2. Possible hazards on physical / mental health of the mother.
3. Pregnancy caused by rape.
4. Possible hazard to the health of a growing fetus.
MTP is legally permitted up to 20 weeks of gestation.
MTPs are considered relatively safe during the first trimester, i.e., upto 12 weeks of pregnancy.
Second trimester abortions are much more riskier.

Amniocentesis Techniques
Amniocentesis (amniotic fluid test; AFT) is a medical procedure used in prenatal diagnosis of
chromosomal abnormalities and fetal infections, and also for sex determination.
is a medical proceduration, in which a small amount of amniotic fluid/fetal DNA is examined.
The most common abnormalities detected are Down syndrome (trisomy 21), Edwards syndrome
(trisomy 18), and Turner syndrome (monosomy).

Sexually Transmitted Diseases (STDs)

Sexually transmitted diseases (also called STDs, or STIs (sexually transmitted infections) or
venereal diseases (VD) are the infections/diseases, which can be transferred from one person
to another through sexual intercourse.

These infections may be bacterial, viral, protozoan, etc.

Bacterial
●​ Chlamydia infection (Chlamydia trachomatis)
●​ Gonorrhoea (Neisseria gonorrhoeae)
 ●​ Syphilis (Treponema pallidum)
Viral
●​ Herpes (Herpes simplex virus)
●​ AIDS (Human Immunodeficiency Virus) or (HIV)
●​ Genital warts (Human Papillomavirus) or (HPV)
●​ Hepatitis-B

Parasites
●​ Pubic lice (Phthirus pubis)
●​ Scabies (Sarcoptes scabiei)
Protozoan
●​ Trichomoniasis (Trichomonas vaginalis).

Prevention of STDs
Prevention is better than cure. So persons should follow following three steps:

(a) Avoid sex with unknown partners/multiple partners.

b) Always use condoms during coitus
(c) In case of any doubt, immediately go for a proper medical examination and get complete
treatment.

INFERTILITY
Infertility is the medical term for the inability to conceive a child after a year or more of regular,
unprotected intercourse.

1.The most common male infertility factors include azoospermia (no sperm cells are produced)
and oligospermia (few sperm cells are produced). Sometimes, sperm cells are malformed or
they die before they can reach the egg.
In rare cases, Infertility in men is caused by a genetic disease such as cystic fibrosis or a
chromosomal abnormality.

2.The most common female infertility factor is an ovulation disorder. Other causes of female
infertility include blocked fallopian tubes. Congenital anomalies (birth defects) involving the
structure of the uterus and uterine fibroids are associated with repeated miscarriages.

Treatment of Infertility
Assisted reproductive technology (ART) is used to treat infertility. It includes fertility treatments
that handle both eggs and sperm.
1.​ Fertility medication which stimulates the ovaries to release eggs.
2.​ Surgery: Surgery of block reproductive part e.g. fallopian tubes.
3.​ In Vitro Fertilization (IVF):In infertile couples, where women have blocked or absent
fallopian tubes, or where men have low sperm counts, in vitro fertilization (IVF) offers a
chance of having a "biologically related" child.

In IVF, eggs are surgically removed from the ovary and mixed with sperm outside the
body in a Petri dish ("in vitro"). After about 40 hours, the eggs are examined to see if
they have become fertilized by the sperm and are dividing into cells. These fertilized
eggs (embryos) are then placed in the women's uterus, thus bypassing the fallopian

tubes.
First of all, a couple named Lesley and Gilbert Brown of Olgham city of England gave
birth to Louise Joe Brown as the world's first test tube baby on July 25, 1978. Scientists
are generally adopting this medical method all over the world.
4.​ Intra cytoplasmic sperm injection (ICSI) In this technique, a single sperm is injected
directly into an egg; the fertilized egg is then placed in the woman's uterus as in IVF.
5.​ Zygote intrafallopian transfer (ZIFT) - In this technique, eggs are removed from the
woman, fertilized with sperm and then placed in the woman's fallopian tubes rather than

the uterus.

6.​ Gamete intrafallopian transfer (GIFT)- In this technique, eggs are removed from the
woman, and placed in one of the fallopian tubes, along with the man's sperm. This
allows fertilization to take place inside the woman's body.

7.​ Donor or artificial insemination :-This process involves the woman being artificially
inseminated with donor sperm or her husband's sperms. These are introduced either into
the vagina or directly into the uterus (Intra-uterine insemination) during the fertile period.

8.​
 —----------------------

●What is IMR?
Infant mortality is the death of an infant before the infant's first birthday.

●What is MMR?
The maternal mortality rate (MMR) is the number of maternal deaths per 100,000 live births in a
given year.
E.T.= Embryo Transfer

Surrogacy( सेरोगेसी)
Surrogacy is an arrangement, often supported by a legal agreement, whereby a woman agrees
to childbirth on behalf of another person(s) who will become the child's parent(s) after birth.

The gestational carriers(woman) are usually being referred to as surrogate mothers.