Hello everyone hope you all are doing well by the grace of Almighty. All of us have become involved in our materialistic lifestyle that most of us are not taking into account of our 'Reproductive Life'. What exactly I'm referring in this blog is not only about the functioning of our reproductive organs but also to be able to maintain a healthy state of mind including emotional, behavioural and social interactions in all sex-related aspects. To correlate this with the definition of Reproductive health given by WHO is ,
Reproductive health means a total well-being in all aspects of reproduction, i.e, physical, emotional, behavioural and social.
- image source: Slideshare
Merely the absence of disease or infirmity doesnot simply refers to Reproductive health. Therefore, a society with people having physically and functionally normal reproductive organs and normal emotional and behavioural interactions among them in all sex-related aspects might be called reproductively healthy. I'll basically deal with problems and strategies for reproductive health in this blog.
Firstly I would like to address the issues and problems that are directly or indirectly affecting the reproductive health. After that we will discuss strategies and methods of birth control. Since Sex Education is one of the most important topic for any age group, we will dive into it briefly.
1. Over Population :
Current population of the world is around 7.5 billion and around 35% of that strictly are from China and India. India was among the first countries in the world to initiate action plans and programmes at a national level to attain total reproductive health as a social goal.These programmes called 'Family planning' were initiated in 1951 and were periodically assessed over the past decades.These programmes were popularly named Reproductive and Child Health Care (RCH) programmes. The major tasks carried out under these programme are to provide facilities and support for building up of a reproductively healthy society.
2. Awareness about reproduction :
For highly populated countries like India, it is important to create awareness among people about reproduction in humans. Parents, close relatives, friends and teachers have a major role in it. Audio-visual and print media, governmental and non-governmental bodies are seem to be doing a good job to create awareness among people regarding this.
3. Sex education:
Sex education in school should also be introduced and encouraged to provide right information about myths and misconceptions about sex-related aspects. Proper information about reproductive organs, adolescence , safe and hygienic sexual practices , sexually transmitted diseases (STD's) e.g AIDS would help to lead a reproductively healthy life .
4. Birth control devices and and care of mother and child:
Fertile couples and people of marriageable age group should know about available birth control devices, care of pregnant mother, postnatal care of mother and child , importance of breast feeding and equal importance of male and female child.
5. Amniocentesis- meaning and use:
Amniocentesis is a foetal sex and disorder determination test based on the chromosomal pattern of the embryo's cells in the amniotic fluid surrounding the developing embryo.
- image source: Scientific animations
Amniotic fluid contains cells from the skin of the foetus and other sources. These cells can be used to determine the sex of the infant, to identify some abnormalities in the number of chromosomes and to detect certain biochemical and enzymatic abnormalities. If it is established that the child is likely to suffer from a serious incurable congenital defect, the mother should get the foetus aborted.It is really unfortunate that it is being used to know the sex of the unborn baby followed by medical termination of foetus in case it's female.
Measures to control over populations :
a. Education :
People paticularly those in the reprdoductive age group , should be educated about the advantage of a small family. Mass media and educational institutions can play an important role in this campaign. It is being seen that many couples have already been adopted ''one child norm''.
b. Marrigeable age :
Raising the age of marriage is a more effective way to control the population. Indian government has raised the marriageable age of female to 18 years and that of males to 21 years.
c. Incentives :
Couples with small families should be given incentives. This will have a large scale impact on rural couples with lack of basic sex education and unemployment issue.
Methods Of BIrth Control :
Contraceptives :
These are the devices which prevent conception of pregnancy without interferring in the reproductive health of the individuals in any way. Characteristics of an ideal contraceptive are -
i) User friendly, i.e.,comfortable and easy to use.
ii) Absence of side effects.
iii) Reversible, i.e., when the user wants to conceive , it should be easy to interrupted.
iv) Completely effective against pregnancy.
There are several methods of contraceptions- natural or traditionl, barriers, IUD's, oral contraceptives, injectables, implants and surgical methods.
Couple protection is the process of bringing elligible couples under family planning measures. In India, it is over at 59% at present and is voluntary in nature. In 2004 there were 6 million IUD insertions , 4.8 million surgical interventions, 24.9 million condom users and 8.7 million oral pill users. [Data by Geneva Foundation for Medical education nd Research]
- image source : Shutterstock
1. Natural Methods :
These are the methods which do not require any device, medicine or religious sanction. Natural methods are of three kinds- safe period, withdrawal and breast feeding.
i) Safe period (Rhythm method) :
Ovulation occurs roughly about the middle of menstrual cycle.Fertility period when fertilization can occur is upto 24 hours after ovulation. Avoiding sex during the fertility period will naturally prevent conception. Ovulation period can be known as the basal body temperature rises by about 1°F during ovulation. Period prior to ovulation is safe. Period after fourth day of rise in temperature is also considered safe. It is however always better to avoid sex from 10-17 of the menstrual cycle.
ii) Withdrawal Method (Coitus interruptus) :
The method is based on withdrawal of penis before ejaculation. This method has a high failure rate due to pre-ejaculatory emission of sperms or failure to withdraw penis before ejaculation.
iii) Lactational Amenorrhoea :
Just after parturition, there is a phase of amenorrhoea or absence of menstruation. It is also the phase of intense lactation.Breast feeding the child fully prevents conception. This method is however effective only upto a maximum of six months.
As no medicines or devices are used in these methods, side effects are almost nil. Chances of failure, though, of these methods are also high.
2. Barrier Methods :
They are mechanical devices which prevent the deposition of sperms into vagina and their passage into uterus. Further they can be self-inserted by user in complete privacy. The common barrier methods are condoms, diaphragms, fem shields and cervical caps.
i) Condoms :
Condoms are barriers made of thin rubber/ latex sheath which is used to cover the penis in the male or vagina and cervix in the female, just before coitus so that the ejaculated semen would not enter into the female reproductive tract. This can prevent conception. Use of condoms has increased in recent years due to its additional benefit of protecting the user from contracting STDs and AIDS. Both the male and female condoms are disposable.
- image source : 123RF
ii) Diaphragm :
It is a tubular rubber sheath with a flexible metal or spring ring at the margin which is fitted inside the vagina.
iii) Cervical cap :
It is a rubber nipple which is fitted over the cervix and it is designed to remain there by suction. The device prevents the entry of sperms into uterus.
iv) Vault cap :
It is a hemispherical dome-shaped rubber or plastic cap with a thick rim which is meant for fitting over the vaginal vault over the cervix.
Spermicidal creams, jellies and foams are usually used along with these barriers to increase their contraceptive efficiency.
- image source : Shutterstock
3. Intra Uterine Devices (IUDs) :
Another effective and popular method of contraception is the use of Intra Uterine Devices (IUDs).These are devices which are inserted in the uterus through vagina to prevent contraception.These intra Uterine Devices are presently available as the non-medicated IUDs e.g. Lippes loop, copper releasing IUDs e.g. CuT, Cu7, Multiload 375 and the hormone releasing IUDs e.g. progestasert, LNG-20. IUDs increases phagocytosis of sperms within the uterus and the Cu ions released suppress sperm motility and the fertilizing capacity of sperms. The hormone releasing IUDs in addition make the uterus unsuitable for implantation and the cervix hostile to the sperms.
Understanding Intrauterine Devices
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4. Oral Contraceptives (Oral pills) :
These are preparations containing either progestin (progestogen or synthetic progestorone) alone or a combination of progestogen and ostrogen (estrogen).
The pills are taken daily orally for 21 days in a menstrual cycle starting from 5th day and ending on 25th day. However it is advisable to restart the course after a gap of 7 days, irrespective of the onset or nonset of menstruation during the pill free days. They inhibit ovulations and implantation as well as alter the quality of cervical mucus to prevent entry of sperms.
5. Surgical Methods :
Surgical methods also called sterilization, are generally advised for the male or female partner as terminal method to prevent any more pregnancies. Surgical methods block gamete transport and thereby prevent conception. Sterilization procedure in mle is called 'vasectomy' and that in the female is called 'tubectomy'. In vasectomy a small part of the vas deferens is removed or tied up through a small incision on the scrotum whereas in tubectomy, a small part of the fallopian tube is or tied up through a small incision in the abdomen or through vagina.
these techniques are highly effective but their reversibility is very poor.
- image source :Shutterstock
It needs to be emphasised that the selection of a suitable contraceptive method and its use should always be undertaken in consultation with qualified medical professionals. One must also remember that contraceptives are not regular requirements for the maintenance of reproductive health. In fact, they re practised against a natural reproductive event i.e., pregnancy. However their possible ill effects like nausea, abdominal pain, breakthrough bleeding, irregular menstrual bleeding or even breast cancer, though not very significant, should not be totally ignored.
Allow me to end my blog for now. Although I have left to cover the Sexually Transmitted Disease (STDs) in the next blog, feel free to go through my blog. Feedbacks and corrections are always welcome. I'll try to contribute as much as I could to this community. Hope to catch you in the next blog. Peace out!
Reference:
1)Wikipedia
2)National Institute of Environmental Health Sciences
