Reproductive Health

According to the World Health Organisation, reproductive health means total well-being in all aspects of reproduction: physical, emotional, behavioural and social. In this chapter you will learn why India was among the first countries to launch nationwide programmes for family planning in 1951, now called Reproductive and Child Health Care (RCH) programmes, and how awareness, sex education, medical facilities and statutory measures such as the ban on amniocentesis for sex determination improve reproductive health. You will study the causes and effects of rapid population growth and the methods of birth control: natural methods such as periodic abstinence and lactational amenorrhoea, barrier methods, intrauterine devices like CuT and LNG-20, oral pills including the weekly non-steroidal pill Saheli, injectables, implants and surgical methods such as vasectomy and tubectomy. The chapter also covers medical termination of pregnancy and its legal conditions, sexually transmitted infections like gonorrhoea, syphilis, genital herpes, chlamydiasis, hepatitis B and HIV, and their prevention. Finally, it explains infertility and assisted reproductive technologies such as IVF with embryo transfer, ZIFT, IUT, GIFT, ICSI and artificial insemination.

Detailed Worksheet: Reproductive Health Section A - Definitions (10 marks) 1. Define reproductive health according to WHO. Name the programme launched by India in 1951 to attain it. (2 marks) 2. What is lactational amenorrhoea? Up to how long after parturition is it considered effective? (2 marks) 3. Distinguish between vasectomy and tubectomy. (2 marks) 4. What is medical termination of pregnancy? Why is it considered safe in the first trimester? (2 marks) 5. Expand IVF, ZIFT, IUT and GIFT. (2 marks) Section B - Calculations and Applications (15 marks) 6. India's population was about 350 million at the time of independence and crossed 1 billion in May 2000. Calculate the increase in population and the approximate average annual increase over this period (take 53 years). Give two reasons for this rapid increase. (3 marks) 7. A woman has a regular 28-day menstrual cycle with ovulation on day 14. According to the periodic abstinence method, couples should avoid coitus from day 10 to day 17. If her menstruation begins on 3 August, calculate the dates of the fertile period. Why does this method have a high failure rate? (3 marks) 8. In a clinical study, 1,000 women used a contraceptive for one year and 8 became pregnant. In another group of 1,000 using a different method, 120 became pregnant. Calculate the failure rate per 100 women per year for each method, and suggest which methods these figures might represent. (3 marks) 9. Classify the following contraceptives as natural, barrier, IUD, hormonal or surgical: (i) Multiload 375 (ii) cervical cap (iii) Saheli (iv) coitus interruptus (v) tubectomy (vi) LNG-20. (3 marks) 10. Match each ART with the stage transferred and the site of transfer: (i) ZIFT (ii) IUT (iii) GIFT. Also state when ICSI is used. (3 marks) Section C - Diagrams (10 marks) 11. Draw labelled diagrams of (i) a copper T (CuT) placed in the uterus and (ii) vasectomy and tubectomy showing the cut and tied ducts. (4 marks) 12. Draw a flowchart showing the steps of in vitro fertilisation with embryo transfer (IVF-ET), from collection of gametes to transfer of the embryo. (3 marks) 13. Draw a line graph showing the growth of the world population from 1900 (about 2 billion) to 2000 (about 6 billion), and India's population from 1947 (350 million) to 2000 (1 billion). (3 marks) Section D - Analysis and Higher-order Thinking (15 marks) 14. Explain how copper-releasing IUDs and hormone-releasing IUDs act as contraceptives. Analyse why IUDs are considered ideal for females who want to delay pregnancy or space children, and state two side effects. (5 marks) 15. Sexually transmitted infections are a major health concern among adolescents. Name four STIs with their pathogens or types, explain why early detection is important, list complications such as pelvic inflammatory disease and infertility, and suggest four preventive measures. (5 marks) 16. Amniocentesis is a useful test to detect genetic disorders, but its misuse is banned by law. Explain the procedure, its legitimate use, the reason it is misused, and evaluate the social consequences of female foeticide on the sex ratio. (5 marks) Instructions: Time allowed 2 hours. Attempt all sections. Draw all diagrams neatly in pencil and label every part. Answer sensitively and scientifically.