Chapter 3: Reproductive Health (Reproduction)

Reproductive health means total well-being in all aspects of reproduction: physical, emotional, behavioural and social. It matters to society because:

• healthy mothers and babies lower maternal and infant mortality;
• awareness of contraception helps control population growth and allows families to plan;
• prevention of sexually transmitted infections (STIs) protects the whole community;
• it supports gender equality and better care for women and children, and so a healthier, more productive society.

It lowers maternal and infant deaths, controls population growth, prevents STIs and builds a healthier society.

• Awareness of reproductive organs, adolescence and related changes, and safe and hygienic sexual practices.
• Prevention of sexually transmitted infections, including HIV/AIDS.
• Family planning and the use of contraceptives.
• Proper care of mothers before, during and after childbirth, and promotion of breastfeeding.
• Stopping sex-selective abortion (female foeticide) and protecting the girl child.
• Help for infertile couples.

Sex education, STI/AIDS prevention, family planning, maternal and child care, stopping female foeticide, and infertility care.

Yes. Sex education in schools gives young people correct information about reproductive organs, adolescence, safe and hygienic sexual practices and STIs. It protects them from myths and misconceptions, helps them avoid early pregnancy and infections, and prepares them to lead a healthy, responsible reproductive life.

Yes; it gives correct information, removes myths, and helps prevent STIs and early pregnancies.

Yes. Areas of improvement:

• Better awareness about sex, reproduction and family planning.
• More medically assisted deliveries and better post-natal care, so maternal and infant mortality rates have fallen.
• Wider use of contraceptives and smaller families.
• Better detection and treatment of STIs.
• Availability of assisted reproductive technologies for infertile couples.

Yes: lower maternal and infant mortality, more institutional deliveries, better family planning and STI care.

The main reason is a sharp fall in the death rate without a matching fall in the birth rate:

• decline in maternal mortality rate (MMR) and infant mortality rate (IMR);
• control of diseases and better health care, so more people live longer;
• increase in the number of people of reproductive age.

A falling death rate (lower MMR and IMR, better health care) while birth rates stay high.

Yes. Contraceptives help control the population explosion and let couples plan the size and spacing of their family. They prevent unwanted pregnancies (and so unsafe abortions), and barrier methods like condoms also protect against STIs, including HIV. An ideal contraceptive is safe and reversible and does not interfere with sexual desire.

Yes; they help control population, prevent unwanted pregnancies and (barrier methods) STIs.

Contraceptives should be safe and, ideally, reversible. The gonads (testes and ovaries) also produce hormones needed for secondary sexual characters and normal body functions. Removing them would cause serious hormonal imbalance and permanent sterility, so it is not a contraceptive option. (Sterilisation methods like vasectomy and tubectomy only block the ducts.)

The gonads produce essential hormones, and removing them is irreversible and harmful.

Yes, the ban is necessary. Amniocentesis is a test of the amniotic fluid meant to detect genetic disorders in the foetus. It was being misused to find the sex of the foetus, followed by abortion of female foetuses (female foeticide). This lowered the female-to-male sex ratio. The legal ban helps stop sex-selective abortions and protects the girl child.

Yes; it was misused for sex determination and female foeticide.

Assisted reproductive technologies (ART):

• IVF–ET (in vitro fertilisation and embryo transfer, "test tube baby"): ZIFT (zygote transferred into the fallopian tube) or IUT (embryo with more than 8 blastomeres transferred into the uterus).
• GIFT (gamete intrafallopian transfer): an ovum from a donor is transferred into the fallopian tube of a female who cannot produce ova.
• ICSI (intracytoplasmic sperm injection): a sperm is injected directly into the ovum.
• Artificial insemination (AI/IUI): semen from the husband or a donor is introduced into the vagina or uterus.

(Adoption is another option.)

IVF–ET (ZIFT, IUT), GIFT, ICSI and artificial insemination (IUI).

• Avoid sex with unknown partners or multiple partners.
• Always use condoms during intercourse.
• Do not share injection needles or syringes; use sterilised instruments.
• In case of doubt, consult a qualified doctor early for diagnosis and complete treatment.

Avoid unknown/multiple partners, use condoms, never share needles, and get early medical help.

• (a) True. Pregnancy can end naturally (miscarriage) because of genetic or other problems.
• (b) False. Infertility can be due to defects in either partner, or both (male, female or unknown causes).
• (c) True. Lactational amenorrhoea: ovulation usually does not occur while the mother breastfeeds fully, up to about six months after childbirth.
• (d) True. Awareness helps people avoid STIs and unwanted pregnancies and take better care of reproductive health.

(a) True; (b) False (either partner can be the cause); (c) True (up to about 6 months); (d) True.

• (a) Surgical methods of contraception prevent gamete transport (they block the vas deferens or fallopian tube), not gamete formation.
• (b) Not all STDs are curable: hepatitis B, genital herpes and HIV infection are not completely curable; others are curable if detected early and treated fully.
• (c) Oral pills are popular mainly among urban women (less so among rural women).
• (d) In ET techniques, embryos are transferred into the fallopian tube (ZIFT, up to 8 blastomeres) or into the uterus (IUT, more than 8 blastomeres).

(a) They prevent gamete transport; (b) HIV, hepatitis B and herpes are not fully curable; (c) popular among urban women; (d) into the fallopian tube or the uterus depending on the stage.