According to World Health Organisation (WHO),  Educate people about birth control, care of pregnant mothers,

Reproductive health is a total well-being in all aspects of post-natal care of mother and child, importance of breast
reproduction i.e., physical, emotional, behavioural & social. feeding, equal opportunities for male & female child etc.
REPRODUCTIVE HEALTH: PROBLEMS &  Awareness of problems due to population explosion, social
STRATEGIES evils like sex-abuse and sex-related crimes, etc.
India initiated reproductive health programmes (family Aims and needs of sex education in
planning) in 1951. schools
Wider reproduction-related areas are in operation under the  To provide right information about sex-related aspects. It
Reproductive & Child Health Care (RCH) programmes. helps to avoid sex-related myths and misconceptions.
Such programmes deal the following:  To give proper information about reproductive organs,
 Give awareness about reproduction related aspects for adolescence and related changes, safe and hygienic sexual
creating a reproductively healthy society. practices, sexually transmitted diseases (STD), AIDS etc.

POPULATION EXPLOSION & BIRTH CONTROL

 In 1900, the world population was around 2 billion (2000 It has no side effect. But chances of failure are high.
million). By 2000, it rocketed to about 6 billion. 2. Barriers
 In India, population was nearly 350 million at the time of They prevent physical meeting of sperm & ovum. E.g.
independence. It crossed 1 billion in May 2000. It means
every sixth person in the world is an Indian.
 According to the 2001 census report, our population
growth rate was still around 1.7% (i.e. 17/1000/year), a
rate at which our population could double in 33 years.
Reasons for population explosion
o Increased health facilities and better living conditions.
o Rapid decline in death rate, maternal mortality rate
(MMR) and infant mortality rate (IMR).
o Increase in number of people in reproducible age.
Impacts of population explosion
Scarcity of basic requirements (e.g. food, shelter & clothing).
Control measures
o Motivate smaller families by using contraceptive methods.
o Aware peoples about a slogan Hum Do Hamare Do (we
two, our two). Many couples have adopted a ‘one child
norm’.
o Statutory rising of marriageable age of females (18 years)
and males (21 years).
Properties of an ideal contraceptive
o User-friendly, easily available, effective and reversible.
o No or least side-effects.
o 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 of
the menstrual cycle (fertile period) to prevent conception.
 Coitus interruptus (withdrawal): Withdraw penis from
the vagina just before ejaculation to avoid insemination.
 Lactational amenorrhea: It is the prevention of
conception by breastfeeding the child because ovulation
and the cycle do not occur during the period of lactation.
This is effective up to 6 months following parturition.

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 Condoms (E.g. Nirodh): Made of rubber/latex
sheath. Condoms for male: Cover the penis.
Condoms for female: Cover the vagina & cervix.
Condoms are used just before coitus. They prevent the
entry of semen into female reproductive tract.
Condoms are very popular because:
- It protects the user from STDs and AIDS.
- Easily available.
- It is disposable.
- It can be self-inserted and thereby give privacy to 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.
[Link] Uterine Devices (IUDs)
These are inserted by doctors or nurses in the uterus through
vagina. They increase phagocytosis of sperms.
Types of IUDs:
o Non-medicated IUDs: They retard sperm motility. Also
have spermicidal effect. E.g. Lippes loop.
o Copper releasing IUDs: Cu ions suppress motility and
fertilising capacity of sperms. E.g. CuT, Cu7, Multiload
375.
o Hormone releasing IUDs: They make the uterus
unsuitable for implantation and the cervix hostile to the
sperms. E.g. Progestasert, LNG-20.
IUDs are ideal contraceptives for the females who want to
delay pregnancy or space children.
[Link] contraceptives
- Oral administration of progestogens or progestogen–
estrogen combinations in the form of tablets (pills).
- Pills are taken daily for 21 days starting within the first
five days of menstrual cycle. After a gap of 7 days
(menstruation period), it should be repeated in the same
pattern till the female desires to prevent conception.
- They inhibit ovulation and implantation and thicken
cervical mucus to prevent entry of sperms.
- Pills are very effective with lesser side effects.

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- Saheli: New oral contraceptive for the females. It is 6. Surgical methods (sterilization)
developed by Central Drug Research Institute (CDRI) - It helps to block gamete transport and thereby prevents
in Lucknow. It contains a non-steroidal preparation. It is a conception. It is very effective but reversibility is poor.
‘once a week’ pill with very few side effects and high
- Vasectomy: Sterilization procedure in males. In this, a
contraceptive value.
small part of the vas deferens is removed or tied up
5. Injectables
through a small incision on the scrotum.
- Progestogens or Progestogens-oestrogen combination are - Tubectomy: Sterilization procedure in females. In this, a
used by females as injections or implants under skin. small part of the fallopian tube is removed or tied up
- Their mode of action is like that of pills and their effective through a small incision in the abdomen or through
periods are much longer. vagina.
Progestogens or progestogen-oestrogen combinations &
IUDs are used as emergency contraceptives within 72 hours Side effects of anti-natural contraceptives:
of coitus. It avoids pregnancydue to rapeor casual Nausea, abdominal pain, breakthrough bleeding, irregular
intercourse. menstrual bleeding, breast cancer etc.

MEDICAL TERMINATION OF PREGNANCY (MTP)

 Intentional or voluntary termination of pregnancy before o It is essential in cases where continuation of pregnancy
full term is called MTP or induced abortion. could be harmful to the mother or to the foetus or both.
 45 to 50 million MTPs are performed in a year all over
the world (i.e. 1/5th of total number of conceived MTPs are safe during the first trimester, (up to 12 weeks of
pregnancies). pregnancy). 2nd trimester abortions are very risky.
 MTP helps to decrease the population. Problems related with MTPs
 Many countries have not legalised MTP due to emotional,  Majority of the MTPs are performed illegally.
ethical, religious and social issues.  Misuse of amniocentesis (a foetal sex determination test
 Government of India legalised MTP in 1971 with some based on the chromosomal pattern of foetal cells in the
strict conditions to check illegal female foeticides. amniotic fluid). If the foetus is female, it is followed by
Importance of MTP MTP. Such practices are dangerous for the young mother
o To avoid unwanted pregnancies due to casual intercourse and foetus.
or failure of the contraceptive used during coitus or
rapes.

SEXUALLY TRANSMITTED DISEASES (STDs)

 Diseases transmitted through sexual intercourse are called  Absence or less significant early symptoms and the social
Sexually transmitted diseases (STDs)/Venereal diseases stigma deter the infected persons to consult a doctor. This
(VD) or Reproductive tract infections (RTI). E.g. leads to pelvic inflammatory diseases (PID), infertility,
Gonorrhoea, syphilis, genital herpes, chlamydiasis, genital ectopic pregnancies, abortions, still births, cancer of the
warts, trichomoniasis, hepatitis-B & HIV leading to reproductive tract etc.
AIDS.  All persons are vulnerable to STDs. These are very high
 Hepatitis-B & HIV are also transmitted among persons in the age group of 15-24 years.
o By sharing of injection needles, surgical instruments etc.  Prevention:
o By transfusion of blood. i. Avoid sex with unknown partners/multiple partners.
o From infected mother to foetus. ii. Always use condoms during coitus.
 Except hepatitis-B, genital herpes & HIV, other diseases iii. In case of doubt, go to a qualified doctor for early
are completely curable if detected early and treated detection and get complete treatment.
properly.
 Early symptoms: Itching, fluid discharge, slight pain,
swellings, etc. in the genital region.

INFERTILITY
 It is the inability to conceive or produce children even 1. In vitro fertilisation (IVF) or
after 2 years of unprotected sexual cohabitation. Test tube baby programme
 The reasons for this may be physical, congenital, diseases, In this method, ova from the wife/donor and sperms from the
drugs, immunological or even psychological. husband/donor are collected and are induced to form zygote
ASSISTED REPRODUCTIVE TECHNOLOGIES (ART)
These are the technologies used to correct the infertility
problems. Some of them are given below:
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under simulated conditions in the laboratory. This is
followed by Embryo transfer (ET).
ET is 2 types:
 Zygote Intra Fallopian Transfer (ZIFT): Transfer of
zygote or early embryo (with up to 8 blastomeres) into
fallopian tube.
 Intra Uterine Transfer (IUT): Transfer of embryo with
more than 8 blastomeres into the uterus.
Embryo formed by in vivo fertilisation (fertilisation within
the female) is also used for such transfer to assist those
females who cannot conceive.

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 2. Gamete Intra Fallopian Transfer (GIFT) This technique is useful for the male partner having inability
Transfer of an ovum from a donor into the fallopian tube of to inseminate female or low sperm counts etc.
another female who cannot produce ovum, but can provide 5. Surrogacy
suitable environment for fertilization and development. Here, a woman (surrogate mother) bears a child for a couple
3. Intra cytoplasmic sperm injection (ICSI) unable to produce children, because the wife is infertile or
It is a laboratory procedure in which a single sperm (from unable to carry.
male partner) is injected directly into an egg (from female The surrogate is impregnated through artificial insemination
partner). After fertilization, the embryo is implanted into the or implantation of an embryo produced by IVF.
woman’s uterus. Problems of ART
o It requires specialized professionals and expensive
4. Artificial insemination (AI) technique
instrumentation. Therefore, these facilities are available
The semen collected from husband or a donor is artificially
only in very few centres.
introduced into the vagina or the uterus of the female.
o Emotional, religious and social problems.
Artificial insemination into the uterus is known as intra-
uterine insemination (IUI). Legal adoption is a good method for couples looking for
parenthood.

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MODEL QUESTIONS
1. Is sex education necessary in school? Justify your answer.
2. Removal of gonads cannot be considered as contraceptive method. Why?
3. Match the following
A B C
Lactational amenorrhea Vasectomy ‘Once a week’
IUD Saheli Breastfeeding
Sterilization Natural method Lippes loop
Oral contraceptive Inserts in uterus Reversibility is poor
4. Note the relationship between the first two words and fill up the fourth place
a. Male: vasectomy Female: ……………………
b. LNG-20: Hormone releasing IUD Multiload 375: ………………..
c. IUD: Intra-uterine device IUI: ……………….
5. Condoms are more popular than other contraceptive devices. Give reasons (any 4)
6. Consider the following contraceptive methods.
 Lactational amenorrhea
 Condoms
 Oral contraceptive pills
a) Which method, in your opinion, is more desirable? Why?
b) Mention other 2 methods of contraception like Lactational amenorrhea. What is the main advantage
of these methods?
7. Match the following
A B C
ZIFT More than 8 blastomeres Direct injection of sperm into egg
GIFT Very low sperm count Embryo to oviduct
IUT Up to 8 blastomeres Ovum to oviduct
ICSI Transfer of egg Uterus
8. Expand the following
a) IVF b) ZIFT c) GIFT d) ICSI
9. “Female foeticide is very high in India. So MTP (Induced abortion) must be completely banned”. Do you agree
with this statement? Why?
10. Anil said that IUD, IUT and IUI are the three methods of ART.
a. Do you agree with this statement? Justify. b. Expand the above abbreviations.
11. A person is affected with itching, fluid discharge, swelling etc. in his genital region. But he did not consult a doctor.
a. Mention the type of disorder affected him.
b. Can you give any advice to him about the importance of consulting the doctor?
c. How to prevent such type of diseases?