AIEM — ICSE Exam Prep

Reproductive Health

According to the WHO, reproductive health means total well-being in all aspects of reproduction - physical, emotional, behavioural and social. India was among the first countries to launch national action plans (family planning, 1951) to achieve a reproductively healthy society; these now run as the Reproductive and Child Health Care (RCH) programmes.

Problems and strategies

Key tasks include creating awareness (audio-visual and print media, sex education in schools), providing medical care for pregnancy, delivery, STDs, contraception and infertility, a statutory ban on amniocentesis for sex-determination (to check female foeticide), and supporting research (e.g. Saheli, a non-steroidal once-a-week oral pill developed at CDRI, Lucknow).

Population stabilisation and birth control

World population reached about 7.2 billion (2011) and India crossed 1.2 billion (May 2011). Causes of the explosion: rapid decline in death rate, MMR and IMR and more people of reproducible age. Measures: motivate small families (Hum Do Hamare Do), raise marriageable age (female 18, male 21) and promote contraceptives.

Contraceptive methods

An ideal contraceptive is user-friendly, available, effective and reversible with least side-effects. Categories: Natural (periodic abstinence, coitus interruptus, lactational amenorrhea), Barrier (condoms, diaphragms, cervical caps), IUDs (non-medicated Lippes loop; copper-releasing CuT, Cu7, Multiload 375; hormone-releasing Progestasert, LNG-20), Oral pills, Injectables, Implants and Surgical sterilisation (vasectomy in males, tubectomy in females). Progestogens/IUDs within 72 h of coitus act as emergency contraceptives.

MTP

Medical Termination of Pregnancy (induced abortion) was legalised in India in 1971; it is relatively safe in the first trimester (up to 12 weeks). It is used for unwanted pregnancies (contraceptive failure, rape) or when pregnancy is harmful; misuse for sex-determination is illegal.

STIs

Sexually Transmitted Infections (STI/VD/RTI) include gonorrhoea, syphilis, genital herpes, chlamydiasis, genital warts, trichomoniasis, hepatitis-B and HIV/AIDS. Most are curable if detected early, except hepatitis-B, genital herpes and HIV. Incidence is highest at 15-24 years. Prevent by avoiding unknown/multiple partners, using condoms, and early treatment.

Infertility and ART

Inability to conceive despite unprotected cohabitation is infertility (causes may be physical, congenital, disease, drugs, immunological or psychological - often the male). Assisted Reproductive Technologies (ART): IVF + embryo transfer (test tube baby), ZIFT, IUT, GIFT, ICSI, AI/IUI. These need expensive instrumentation and specialised handling. Legal adoption remains one of the best options for parenthood.