Reproductive Health

Reproductive health does not mean only having babies. It means your reproductive organs are healthy, your mind is not stressed about it, and you have correct information to make safe choices. Like total health of body plus mind plus social.

India started programme called RCH Reproductive and Child Health Care. It gives information about growing up, safe periods, contraception, care during pregnancy, care after birth, and how to avoid infections. Why? Because if population grows too fast, food, water, house, school, job all become less for everyone. Like too many people in small room.

To control population people need birth control methods called contraceptives. Good contraceptive should be safe, easy to use, cheap, effective, not interfere with love. Also need to know about unsafe sex leading to infections STDs, and about not using tests like amniocentesis to find boy or girl and abort girl, which is banned by law because it is wrong and illegal.

Natural methods work by understanding body, no medicine no device, but need discipline.

Periodic abstinence or rhythm method: egg lives only 1 day after ovulation around day 14, sperm lives 2-3 days. So days 10-17 are risky fertile window. Avoid intercourse in that window, like avoiding market when crowded. But not 100% safe because ovulation can shift with stress.

Withdrawal or coitus interruptus: male pulls out before semen release. It needs strong self control and still some sperm may be in early fluid, so not very effective.

Lactational amenorrhea: after delivery when mother exclusively breastfeeds baby, periods do not come for 6 months because high prolactin stops ovulation. So chance of pregnancy low, but only till 6 months and only if fully breastfeeding day night no other food. Like nature's own gap.

These methods have no side effects but high failure rate if not careful.

Barrier methods stop sperm from meeting egg, like putting a wall.

Condoms: thin rubber sheath worn on penis male condom or inside vagina female condom. It collects semen, stops sperm entering, also protects from STDs like HIV, most effective for infection protection. Example Nirodh most used, disposable use once.

Diaphragm, cervical cap, vaults: rubber cup fitted on cervix inside vagina to block entry. Female needs to learn fitting, used with spermicide cream that kills sperm. Reusable, but not as good for STD protection as condoms.

IUDs Intra Uterine Devices: small T shaped device doctor puts inside uterus, very effective long term 3-10 years, reversible. Three types: non medicated like Lippes loop now not used much, copper releasing CuT Cu7 Multiload copper ions make sperm less motile and toxic to them, hormone releasing LNG 20 Progestasert makes uterus unsuitable for implantation and makes cervix mucus thick. IUD ideal for spacing children. Must be fitted by doctor, may cause bleeding initially.

Oral pills are tablets women take daily to stop egg release. Combined pills have estrogen + progesterone that stop ovulation and make cervix mucus thick and uterus lining thin. Need daily at same time, like taking vitamin.

Saheli is special weekly pill made in India by CDRI, non steroidal centchroman, once a week less side effects because not steroid, works after ovulation prevents implantation, good for long use.

Emergency pills like iPill taken within 72 hours after unprotected sex to avoid pregnancy, not regular method, causes disturbance.

Surgical methods permanent for those who do not want more children. Vasectomy in male small cut in scrotum vas deferens cut and tied sperm cannot come. Tubectomy in female small cut in abdomen fallopian tubes cut and tied egg cannot reach uterus. Very effective but almost irreversible, need counselling, done after completing family.

Medical termination of pregnancy MTP is legal safe abortion by doctor in safe hospitals when pregnancy is unwanted due to failure of contraceptive, rape, or risk to mother or baby defect. Legal in India up to certain weeks, must be by registered doctor with consent. Misuse for sex selective abortion is banned and punishable. Amniocentesis test analyses amniotic fluid for genetic defects should be used only for medical reasons with consent, not for finding boy girl and aborting girl which is banned, prohibited by law.

STDs Sexually Transmitted Diseases now called STIs Infections spread by unsafe sex sharing needles. Common: gonorrhea bacteria pus from genitals, syphilis bacteria sore chancre later rashes, chlamydia bacteria, genital herpes virus blisters painful, hepatitis B virus liver, AIDS HIV virus immunity loss, genital warts HPV virus warts, trichomoniasis protozoa itching. Early symptoms itching fluid discharge burning urine sores swelling. Prevention condom safe sex avoid multiple partners, early detection treat both partners, personal hygiene. Curable if early except viral like herpes HIV hepatitis.

Some couples cannot have baby called infertility due to many reasons male low sperm count motility, female blocked tubes, no ovulation, uterus problem. Today many technologies ART Assisted Reproductive Technologies help.

IVF in vitro fertilization test tube baby: egg taken from ovary sperm from husband kept in dish fertilized outside body makes embryo then put back into uterus. If embryo more than 8 cells placed into uterus ET embryo transfer, if less than 8 cells placed into fallopian tube ZIFT Zygote Intra Fallopian Transfer. GIFT Gamete Intra Fallopian Transfer egg + sperm directly into tube. ICSI Intra Cytoplasmic Sperm Injection one sperm injected into egg with needle for very low count. AI Artificial Insemination sperm collected washed injected into uterus IUI Intra Uterine Insemination when motility low or cervix issue. Surrogacy embryo made from parents but implanted into another woman surrogate who carries pregnancy for them when uterus not able, needs legal contract consent no genetic link if gestational. Adoption legal process to become parent of child no biological connection needs counselling home study court approval permanent rights.

All these need counselling, legal guidance, ethics, medical care, consent always.