Exercises
What do you think is the significance of reproductive health in a society?
Answer
Reproductive health means total well-being in the physical, emotional, behavioural and social aspects of reproduction. A reproductively healthy society has people with normal, functional reproductive organs and correct knowledge about them. Its significance:
(i) Awareness about reproductive organs, adolescence, safe and hygienic sexual practices and STIs helps people, especially adolescents, avoid infections, myths and risky behaviour.
(ii) Knowledge of birth control helps couples plan small families and space children, which checks population growth.
(iii) Proper care during pregnancy, safe delivery and post-natal care of mother and child lower maternal and infant mortality rates.
(iv) Awareness about equal value of male and female children, and about sex abuse and sex-related crimes, helps build a socially responsible and healthy society.
Suggest the aspects of reproductive health which need to be given special attention in the present scenario.
Answer
(i) Creating awareness, including sex education in schools, about reproductive organs, adolescence, safe sexual practices, STIs and AIDS. (ii) Promoting birth control methods and small families to check population growth. (iii) Care of pregnant mothers, medically assisted deliveries, post-natal care of mother and child, and encouraging breast feeding. (iv) Early detection and treatment of STIs and of reproductive problems such as menstrual irregularities and infertility. (v) Preventing illegal abortions and female foeticide, by enforcing the ban on sex determination by amniocentesis. (vi) Equal opportunities for male and female children and prevention of sex abuse and sex-related crimes. (vii) Building strong infrastructure and supporting research on reproduction-related problems.
Is sex education necessary in schools? Why?
Answer
Yes. Sex education in schools gives young people correct information and discourages them from believing myths and misconceptions about sex-related aspects. It teaches them about reproductive organs, changes during adolescence, safe and hygienic sexual practices, STIs and AIDS, and the dangers of early pregnancy and illegal abortion. Adolescents (age group 15–24 has very high STI incidence) can thus make responsible decisions and lead a reproductively healthy life.
Do you think that reproductive health in our country has improved in the past 50 years? If yes, mention some such areas of improvement.
Answer
Yes. Areas of improvement: (i) better awareness about sex-related matters; (ii) more medically assisted deliveries and better post-natal care, leading to lower maternal mortality rate (MMR) and infant mortality rate (IMR); (iii) more couples choosing small families, with wide availability of contraceptives; (iv) better detection and cure of STIs; (v) overall better medical facilities for sex-related problems, including help for infertile couples through ART; (vi) programmes like RCH, massive child immunisation and the statutory ban on amniocentesis for sex determination.
What are the suggested reasons for population explosion?
Answer
Improved health facilities and better living conditions have led to: (i) a rapid decline in death rate; (ii) a decline in maternal mortality rate (MMR); (iii) a decline in infant mortality rate (IMR); and (iv) an increase in the number of people in the reproducible age group. With the birth rate not falling as fast, the population has grown explosively (India: about 350 million at independence to over 1.2 billion by 2011).
Is the use of contraceptives justified? Give reasons.
Answer
Yes. Our population growth rate is still high enough to cause scarcity of basic needs such as food, shelter and clothing. Contraceptives help couples prevent unwanted pregnancies, delay the first child, space children and keep families small, thereby checking population growth. They also protect the health of mothers by avoiding frequent pregnancies, and barrier methods like condoms also protect against STIs and AIDS. However, they should be chosen in consultation with a doctor, as they may have side effects such as nausea, abdominal pain, irregular bleeding or, rarely, breast cancer.
Removal of gonads cannot be considered as a contraceptive option. Why?
Answer
An ideal contraceptive should be reversible, have least side effects and must not interfere with sexual drive or the sexual act. Gonads (testes and ovaries) not only produce gametes but also secrete sex hormones (testosterone, estrogen, progesterone) needed for secondary sexual characters, sexual drive and general health. Their removal is irreversible and causes serious hormonal imbalance. Hence it is not a contraceptive option; sterilisation (vasectomy/tubectomy) instead only blocks gamete transport.
Amniocentesis for sex determination is banned in our country. Is this ban necessary? Comment.
Answer
Amniocentesis is a technique in which some amniotic fluid around the developing foetus is taken and the foetal cells and dissolved substances are analysed to detect genetic disorders such as Down syndrome, haemophilia and sickle-cell anaemia. It is meant to check foetal health. However, it is misused to find out the sex of the foetus, and if it is female, the pregnancy is often terminated, leading to female foeticide and a falling female sex ratio. So the statutory ban on its use for sex determination is necessary to protect the girl child, while its use for detecting genetic disorders continues.
Suggest some methods to assist infertile couples to have children.
Answer
Where the disorder cannot be corrected by treatment, assisted reproductive technologies (ART) can help:
(i) In vitro fertilisation followed by embryo transfer (IVF–ET, test tube baby): ova and sperms from the couple/donors are fused in the laboratory; the zygote or early embryo (up to 8 blastomeres) is transferred into the fallopian tube (ZIFT), and embryos with more than 8 blastomeres into the uterus (IUT).
(ii) GIFT (gamete intra fallopian transfer): transfer of an ovum from a donor into the fallopian tube of a female who cannot produce ova but can support fertilisation and development.
(iii) ICSI (intra cytoplasmic sperm injection): a sperm is injected directly into the ovum in the laboratory to form an embryo.
(iv) Artificial insemination (AI) / IUI: semen from the husband or a healthy donor is introduced into the vagina or uterus, useful when the male cannot inseminate or has a low sperm count.
(v) Legal adoption of orphaned and destitute children is also one of the best options for parenthood.
What are the measures one has to take to prevent from contracting STDs?
Answer
(i) Avoid sex with unknown or multiple partners. (ii) Always use condoms during coitus. (iii) In case of doubt, consult a qualified doctor for early detection and complete treatment. Also, avoid sharing injection needles and surgical instruments, and use only screened blood for transfusion (hepatitis-B and HIV spread this way too).
State True/False with explanation: (a) Abortions could happen spontaneously too. (b) Infertility is defined as the inability to produce a viable offspring and is always due to abnormalities/defects in the female partner. (c) Complete lactation could help as a natural method of contraception. (d) Creating awareness about sex related aspects is an effective method to improve reproductive health of the people.
Answer
(a) True – a pregnancy may end naturally (miscarriage) due to causes such as foetal abnormality or maternal illness, without any intentional intervention.
(b) False – infertility can be due to defects in either partner, and quite often the problem lies in the male partner (for example a low sperm count). Causes may be physical, congenital, disease, drugs, immunological or psychological.
(c) True – during intense (full) breast-feeding after parturition, ovulation and the menstrual cycle do not occur (lactational amenorrhea), so chances of conception are almost nil; but it is effective only up to about six months after delivery.
(d) True – awareness about reproductive organs, safe sexual practices, STIs, contraception and care of mother and child helps people lead reproductively healthy lives.
Correct the following statements: (a) Surgical methods of contraception prevent gamete formation. (b) All sexually transmitted diseases are completely curable. (c) Oral pills are very popular contraceptives among the rural women. (d) In E. T. techniques, embryos are always transferred into the uterus.
Answer
(a) Surgical methods of contraception prevent gamete transport (not gamete formation), by cutting/tying the vas deferens or fallopian tube.
(b) Most STIs are completely curable if detected early and treated properly, but hepatitis-B, genital herpes and HIV infections are not completely curable.
(c) Oral pills are more popular among urban women; rural women depend more on other methods, and IUDs are among the most widely accepted methods in India.
(d) In ET techniques, the zygote or embryos with up to 8 blastomeres are transferred into the fallopian tube (ZIFT), and only embryos with more than 8 blastomeres are transferred into the uterus (IUT).
Important Extra Questions
How do copper-releasing IUDs prevent conception?
Answer
IUDs increase phagocytosis of sperms in the uterus, and the Cu ions released suppress sperm motility and their fertilising capacity.
What is Saheli?
Answer
A non-steroidal, once-a-week oral contraceptive pill for females, developed at the Central Drug Research Institute (CDRI), Lucknow; it has few side effects and high contraceptive value.
Why is MTP considered relatively safe only in the first trimester?
Answer
Up to 12 weeks the foetus is small and termination carries less risk to the mother; second-trimester abortions are much riskier.
What are emergency contraceptives?
Answer
Progestogens or progestogen–estrogen combinations, or IUDs, used within 72 hours of coitus to avoid possible pregnancy after rape or unprotected intercourse.
Name two complications of untreated STIs.
Answer
Pelvic inflammatory disease (PID), abortions, still births, ectopic pregnancy, infertility or even cancer of the reproductive tract (any two).