Reproductive Health Class 12 Biology Chapter 3 Notes

Reproductive Health Class 12 Biology Chapter 3 Notes

Reproductive and Child Health Care (RCH) Programs

• India initiated family planning programs in 1951.
• These programs aimed to attain total reproductive health as a social goal.
• They were periodically assessed over the decades.
• Improved programs, known as Reproductive and Child Health Care (RCH) programs, are currently in operation.
• Major objectives: Creating awareness about reproduction-related aspects and supporting a reproductively healthy society.
• Awareness campaigns: Utilize audio-visual and print media by governmental and non-governmental agencies.
• Role of parents, relatives, teachers, and friends in disseminating information.
• Importance of introducing sex education in schools to provide accurate information and dispel myths.
• Topics covered in sex education: Reproductive organs, adolescence and related changes, safe and hygienic sexual practices, STDs, AIDS, etc.
• Educating fertile couples and those of marriageable age about birth control options, maternal care, post-natal care, breastfeeding, gender equality.
• Raising awareness about problems linked to uncontrolled population growth and sex-related crimes.
• The need for a socially responsible and healthy society.

Successful Implementation

• Requires strong infrastructural facilities, professional expertise, and material support.
• Providing medical assistance and care for reproduction-related problems like pregnancy, delivery, STDs, abortions, contraception, menstrual issues, infertility, etc.
• Implementation of better techniques and new strategies over time.
• Statutory ban on amniocentesis for sex determination to combat female foeticides.
• Programs like massive child immunization.
• Amniocentesis: Analyzing fetal cells and dissolved substances to test for genetic disorders.
• Support for research on reproduction-related areas by governmental and non-governmental agencies.
• Example: ‘Saheli,’ a new oral contraceptive for females developed at the Central Drug Research Institute (CDRI) in Lucknow, India.
• Positive indicators of improved reproductive health: Better awareness, increased medically assisted deliveries, reduced maternal and infant mortality rates, smaller families, improved detection and treatment of STDs, enhanced medical facilities for sex-related problems.

Population Stabilization and Birth Control

• The 20th century saw significant development in various fields, improving people’s quality of life.
• Increased health facilities and better living conditions led to population growth.
• Worldwide population growth: From around 2 billion in 1900 to about 6 billion by 2000 and 7.2 billion in 2011.
• India’s population growth: From about 350 million at independence to over 1.2 billion in May 2011.
• Factors contributing to rapid growth: Decline in death rate, maternal mortality rate (MMR), and infant mortality rate (IMR), along with an increase in the reproducible-age population.
• Reproductive Child Health (RCH) program had only marginal success in controlling population growth.
• The 2011 census reported a growth rate of less than 2%.
• High population growth rate could lead to scarcity of basic necessities (food, shelter, clothing) despite progress.
• Government measures to control population growth: Motivating smaller families, raising the marriageable age, incentives for small families.
• Commonly used contraceptive methods to prevent unwanted pregnancies.

Contraceptive Methods

• Ideal contraceptive characteristics: User-friendly, easily available, effective, reversible, minimal side effects, no interference with sexual drive or desire.
• Broad categories of contraceptive methods: Natural/Traditional, Barrier, IUDs, Oral contraceptives, Injectables, Implants, Surgical.
• Natural methods: Periodic abstinence (avoiding coitus during fertile period), withdrawal (coitus interruptus), lactational amenorrhea (no menstruation during intense lactation following childbirth).
• Barrier methods: Condoms (male and female), diaphragms, cervical caps, used with spermicidal products.
• Intra Uterine Devices (IUDs): Non-medicated, copper-releasing, hormone-releasing.
• Oral contraceptives (pills): Inhibit ovulation, implantation, and alter cervical mucus quality.
• Saheli: A new oral contraceptive for females containing a non-steroidal preparation.
• Progestogens or progestogen-estrogen combinations available as injections or implants.
• Emergency contraceptives can be used within 72 hours of coitus to prevent pregnancy.
• Surgical methods (sterilization): Vasectomy for males, tubectomy for females; highly effective but poorly reversible.
• Importance of consulting qualified medical professionals for contraceptive method selection.
• Contraceptives are used to prevent, delay, or space pregnancies, but potential side effects should not be ignored.

Medical Termination of Pregnancy (MTP)

• MTP, also known as induced abortion, is the intentional or voluntary termination of pregnancy before full term.
• Approximately 45 to 50 million MTPs are performed worldwide each year, accounting for 1/5th of all conceived pregnancies annually.
• Legalization of MTP is a topic of debate in many countries due to emotional, ethical, religious, and social concerns.
• In 1971, the Government of India legalized MTP with strict conditions to prevent misuse.
• Legal restrictions are important to combat indiscriminate and illegal female foeticides, a significant problem in India.

Reasons for MTP

• MTP is sought to terminate unwanted pregnancies, resulting from casual unprotected intercourse, contraceptive failure, or cases of rape.
• It is necessary in situations where continuing the pregnancy could be harmful or fatal to the mother, the foetus, or both.

Safety and Timing

• MTPs are generally considered safe during the first trimester, up to 12 weeks of pregnancy.
• Second trimester abortions are riskier and more complicated.

Concerns and Trends

• Many MTPs are performed illegally by unqualified individuals (quacks), posing significant safety risks.
• The misuse of amniocentesis to determine the sex of the unborn child, followed by illegal MTP if the foetus is female, is a dangerous and illegal practice.
• Such practices are detrimental to both the young mother and the foetus.
• Effective counseling is needed to promote safe sex practices, educate about the risks of illegal abortions, and provide increased access to healthcare facilities.
• These measures can help address the unhealthy trends related to MTP.

Sexually Transmitted Infections (STIs)

• STIs are infections or diseases transmitted through sexual intercourse.
• Also known as venereal diseases (VD) or reproductive tract infections (RTI).
• Common STIs include gonorrhoea, syphilis, genital herpes, chlamydiasis, genital warts, trichomoniasis, hepatitis-B, and HIV leading to AIDS.
• HIV infection is particularly dangerous and discussed in detail in Chapter 7.

Modes of Transmission

• Some STIs like hepatitis-B and HIV can also be transmitted through sharing of injection needles, surgical instruments, blood transfusion, and from an infected mother to the foetus.
• Except for hepatitis-B, genital herpes, and HIV, most other STIs are completely curable if detected early and treated properly.

Challenges in Detection

• Early symptoms of STIs are often minor and include itching, fluid discharge, slight pain, and genital swellings.
• Infected females may be asymptomatic, leading to delayed detection.
• Social stigma associated with STIs discourages timely detection and treatment.
• Delayed treatment can lead to complications like pelvic inflammatory diseases (PID), abortions, stillbirths, ectopic pregnancies, infertility, or reproductive tract cancer.

Importance of Prevention and Early Detection

• STIs pose a significant threat to a healthy society.
• Prevention and early detection are prioritized under reproductive health-care programs.
• Incidences of STIs are high among individuals aged 15-24 years.
• Prevention is possible by following these principles:

1. Avoiding sex with unknown or multiple partners.
2. Using condoms consistently and correctly during sexual activity.
3. Seeking consultation with a qualified doctor for early detection and complete treatment if an infection is suspected.

Infertility

Infertility and Its Causes

• Infertility is the inability of a couple to produce children despite unprotected sexual co-habitation.
• Causes of infertility can be physical, congenital, due to diseases, drugs, immunological factors, or psychological issues.
• In India, infertility is often wrongly attributed to females, but male partners can also be the cause.

Diagnosis and Treatment

• Specialized healthcare units like infertility clinics can help diagnose and treat some infertility disorders.
• Corrective treatments may enable couples to conceive.
• In cases where correction is not possible, assisted reproductive technologies (ART) can assist in achieving pregnancy.

In Vitro Fertilization (IVF)

• IVF, known as the test tube baby program, involves collecting eggs from the female and sperm from the male.
• These are induced to form a zygote in a laboratory setting.
• The zygote or early embryos can be transferred into the fallopian tube (ZIFT) or uterus (IUT) for further development.
• Embryos formed in vivo (naturally within the female) can also be used for transfer.

Other ART Techniques

• Gamete Intra Fallopian Transfer (GIFT) involves transferring an egg collected from a donor into another female’s fallopian tube for fertilization and development.
• Intra Cytoplasmic Sperm Injection (ICSI) involves directly injecting a sperm into an egg to form an embryo.

Artificial Insemination (AI)

• AI is used to correct infertility cases due to the male partner’s inability to inseminate the female or low sperm counts.
• Semen collected from the husband or a healthy donor is artificially introduced into the female’s vagina or uterus (IUI).

Challenges and Limitations

• These techniques require precision handling by specialized professionals and expensive equipment.
• Availability is limited to very few centers in the country, making them affordable to only a limited number of people.
• Emotional, religious, and social factors can deter couples from adopting these methods.
• Adoption is a legal and viable option for couples seeking parenthood, and it can provide homes for orphaned and destitute children.