NCERT Textbook - Reproductive Health NEET Notes | EduRev

Biology Class 12

Created by: Sushil Kumar

NEET : NCERT Textbook - Reproductive Health NEET Notes | EduRev

 Page 1


You have learnt about human reproductive system and its
functions in Chapter 3. Now, let’s discuss a closely related
topic – reproductive health. What do we understand by
this term?  The term simply refers to healthy reproductive
organs with normal functions. However, it has a broader
perspective and includes the emotional and social aspects
of reproduction also. According to the World Health
Organisation (WHO), reproductive health means a total
well-being in all aspects of reproduction, i.e., physical,
emotional, behavioural and social. Therefore, a society with
people having physically and functionally normal
reproductive organs and normal emotional and behavioural
interactions among them in all sex-related aspects might
be called reproductively healthy. Why is it significant to
maintain reproductive health and what are the methods
taken up to achieve it? Let us examine them.
4.1 REPRODUCTIVE HEALTH – PROBLEMS AND
STRATEGIES
India was amongst the first countries in the world to
initiate action plans and programmes at a national level
to attain total reproductive health as a social goal.
These programmes called ‘family planning’ were
initiated in 1951 and were periodically assessed over
the past decades. Improved programmes covering wider
CHAPTER 4
REPRODUCTIVE HEALTH
4.1 Reproductive Health –
Problems and Strategies
4.2 Population Explosion
and Birth Control
4.3 Medical Termination of
Pregnancy
4.4 Sexually Transmitted
Diseases
4.5 Infertility
2015-16
Page 2


You have learnt about human reproductive system and its
functions in Chapter 3. Now, let’s discuss a closely related
topic – reproductive health. What do we understand by
this term?  The term simply refers to healthy reproductive
organs with normal functions. However, it has a broader
perspective and includes the emotional and social aspects
of reproduction also. According to the World Health
Organisation (WHO), reproductive health means a total
well-being in all aspects of reproduction, i.e., physical,
emotional, behavioural and social. Therefore, a society with
people having physically and functionally normal
reproductive organs and normal emotional and behavioural
interactions among them in all sex-related aspects might
be called reproductively healthy. Why is it significant to
maintain reproductive health and what are the methods
taken up to achieve it? Let us examine them.
4.1 REPRODUCTIVE HEALTH – PROBLEMS AND
STRATEGIES
India was amongst the first countries in the world to
initiate action plans and programmes at a national level
to attain total reproductive health as a social goal.
These programmes called ‘family planning’ were
initiated in 1951 and were periodically assessed over
the past decades. Improved programmes covering wider
CHAPTER 4
REPRODUCTIVE HEALTH
4.1 Reproductive Health –
Problems and Strategies
4.2 Population Explosion
and Birth Control
4.3 Medical Termination of
Pregnancy
4.4 Sexually Transmitted
Diseases
4.5 Infertility
2015-16
58
BIOLOGY
reproduction-related areas are currently in operation under the
popular name ‘Reproductive and Child Health Care (RCH) programmes’.
Creating awareness among people about various reproduction related
aspects and providing facilities and support for building up a
reproductively healthy society are the major tasks under these
programmes.
With the help of audio-visual and the print-media governmental and
non-governmental agencies have taken various steps to create awareness
among the people about reproduction-related aspects. Parents, other
close relatives, teachers and friends, also have a major role in the
dissemination of the above information. Introduction of sex education
in schools should also be encouraged to provide right information to
the young so as to discourage children from believing in myths and
having misconceptions about sex-related aspects. Proper information
about reproductive organs, adolescence and related changes, safe and
hygienic sexual practices, sexually transmitted diseases (STD), AIDS,
etc., would help people, especially those in the adolescent age group to
lead a reproductively healthy life. Educating people, especially fertile
couples and those in marriageable age group, about available birth
control options, care of pregnant mothers, post-natal care of the mother
and child, importance of breast feeding, equal opportunities for the male
and the female child, etc., would address the importance of bringing up
socially conscious healthy families of desired size. Awareness of problems
due to uncontrolled population growth, social evils like sex-abuse and
sex-related crimes, etc., need to be created to enable people to think
and take up necessary steps to prevent them and thereby build up a
socially responsible and healthy society.
Successful implementation of various action plans to attain
reproductive health requires strong infrastructural facilities, professional
expertise and material support. These are essential to provide medical
assistance and care to people in reproduction-related problems like
pregnancy, delivery, STDs, abortions, contraception, menstrual problems,
infertility, etc. Implementation of better techniques and new strategies
from time to time are also required to provide more efficient care and
assistance to people. Statutory ban on amniocentesis (a foetal sex
determination test based on the chromosomal pattern in the amniotic
fluid surrounding the developing embryo) for sex-determination to legally
check increasing female foeticides, massive child immunisation, etc., are
some programmes that merit mention in this connection.
Research on various reproduction-related areas are encouraged and
supported by governmental and non-governmental agencies to find out
new methods and/or to improve upon the existing ones. Do you know
that ‘Saheli’–a new oral contraceptive for the females–was developed
by scientists at Central Drug Research Institute (CDRI) in Lucknow, India?
Better awareness about sex related matters, increased number of medically
assisted deliveries and better post-natal care leading to decreased maternal
2015-16
Page 3


You have learnt about human reproductive system and its
functions in Chapter 3. Now, let’s discuss a closely related
topic – reproductive health. What do we understand by
this term?  The term simply refers to healthy reproductive
organs with normal functions. However, it has a broader
perspective and includes the emotional and social aspects
of reproduction also. According to the World Health
Organisation (WHO), reproductive health means a total
well-being in all aspects of reproduction, i.e., physical,
emotional, behavioural and social. Therefore, a society with
people having physically and functionally normal
reproductive organs and normal emotional and behavioural
interactions among them in all sex-related aspects might
be called reproductively healthy. Why is it significant to
maintain reproductive health and what are the methods
taken up to achieve it? Let us examine them.
4.1 REPRODUCTIVE HEALTH – PROBLEMS AND
STRATEGIES
India was amongst the first countries in the world to
initiate action plans and programmes at a national level
to attain total reproductive health as a social goal.
These programmes called ‘family planning’ were
initiated in 1951 and were periodically assessed over
the past decades. Improved programmes covering wider
CHAPTER 4
REPRODUCTIVE HEALTH
4.1 Reproductive Health –
Problems and Strategies
4.2 Population Explosion
and Birth Control
4.3 Medical Termination of
Pregnancy
4.4 Sexually Transmitted
Diseases
4.5 Infertility
2015-16
58
BIOLOGY
reproduction-related areas are currently in operation under the
popular name ‘Reproductive and Child Health Care (RCH) programmes’.
Creating awareness among people about various reproduction related
aspects and providing facilities and support for building up a
reproductively healthy society are the major tasks under these
programmes.
With the help of audio-visual and the print-media governmental and
non-governmental agencies have taken various steps to create awareness
among the people about reproduction-related aspects. Parents, other
close relatives, teachers and friends, also have a major role in the
dissemination of the above information. Introduction of sex education
in schools should also be encouraged to provide right information to
the young so as to discourage children from believing in myths and
having misconceptions about sex-related aspects. Proper information
about reproductive organs, adolescence and related changes, safe and
hygienic sexual practices, sexually transmitted diseases (STD), AIDS,
etc., would help people, especially those in the adolescent age group to
lead a reproductively healthy life. Educating people, especially fertile
couples and those in marriageable age group, about available birth
control options, care of pregnant mothers, post-natal care of the mother
and child, importance of breast feeding, equal opportunities for the male
and the female child, etc., would address the importance of bringing up
socially conscious healthy families of desired size. Awareness of problems
due to uncontrolled population growth, social evils like sex-abuse and
sex-related crimes, etc., need to be created to enable people to think
and take up necessary steps to prevent them and thereby build up a
socially responsible and healthy society.
Successful implementation of various action plans to attain
reproductive health requires strong infrastructural facilities, professional
expertise and material support. These are essential to provide medical
assistance and care to people in reproduction-related problems like
pregnancy, delivery, STDs, abortions, contraception, menstrual problems,
infertility, etc. Implementation of better techniques and new strategies
from time to time are also required to provide more efficient care and
assistance to people. Statutory ban on amniocentesis (a foetal sex
determination test based on the chromosomal pattern in the amniotic
fluid surrounding the developing embryo) for sex-determination to legally
check increasing female foeticides, massive child immunisation, etc., are
some programmes that merit mention in this connection.
Research on various reproduction-related areas are encouraged and
supported by governmental and non-governmental agencies to find out
new methods and/or to improve upon the existing ones. Do you know
that ‘Saheli’–a new oral contraceptive for the females–was developed
by scientists at Central Drug Research Institute (CDRI) in Lucknow, India?
Better awareness about sex related matters, increased number of medically
assisted deliveries and better post-natal care leading to decreased maternal
2015-16
59
REPRODUCTIVE HEALTH
and infant mortality rates, increased number of couples with small
families, better detection and cure of STDs and overall increased medical
facilities for all sex-related problems, etc. all indicate improved reproductive
health of the society.
4.2 POPULATION EXPLOSION AND BIRTH CONTROL
In the last century an all-round development in various fields significantly
improved the quality of life of the people. However, increased health facilities
along with better living conditions had an explosive impact on the growth
of population. The world population which was around 2 billion
(2000 million) in 1900 rocketed to about 6 billions  by 2000. A similar
trend was observed in India too. Our population which was approximately
350 million at the time of our independence reached close to the billion
mark by 2000 and crossed 1 billion in May 2000. That means, every
sixth person in the world is an Indian. A rapid decline in death rate,
maternal mortality rate (MMR) and infant mortality rate (IMR) as
well as an increase in number of people in reproducible age are probable
reasons for this. Through our RCH programmes, though we could bring
down the population growth rate, it was only marginal. According to the
2001 census report, the population growth rate was still around  1.7 per
cent, i.e., 17/1000/year, a rate at which our population could double in
33 years. Such an alarming growth rate could lead to an absolute scarcity
of even the basic requirements, i.e., food, shelter and clothing, in spite of
significant progress made in those areas. Therefore, the government was
forced to take up serious measures to check this population growth rate.
The most important step to overcome this problem is to motivate smaller
families by using various contraceptive methods. You might have seen
advertisements in the media as well as posters/bills, etc., showing a happy
couple with two children with a slogan Hum Do Hamare Do (we two, our
two). Many couples, mostly the young, urban, working ones have even
adopted an ‘one child norm’. Statutory raising of marriageable age of the
female to 18 years and that of males to 21 years, and incentives given to
couples with small families are two of the other measures taken to tackle
this problem. Let us describe some of the commonly used contraceptive
methods, which help prevent unwanted pregnancies.
An ideal contraceptive should be user-friendly, easily available,
effective and reversible with no or least side-effects. It also should in no
way interfere with the sexual drive, desire and/or the sexual act of the
user. A wide range of contraceptive methods are presently available which
could be broadly grouped into the following categories, namely
Natural/Traditional, Barrier, IUDs, Oral contraceptives, Injectables,
Implants and Surgical methods.
Natural methods work on the principle of avoiding chances of ovum
and sperms meeting. Periodic abstinence is one such method in which
the couples avoid or abstain from coitus from day 10 to 17 of the menstrual
cycle when ovulation could be expected. As chances of fertilisation are
2015-16
Page 4


You have learnt about human reproductive system and its
functions in Chapter 3. Now, let’s discuss a closely related
topic – reproductive health. What do we understand by
this term?  The term simply refers to healthy reproductive
organs with normal functions. However, it has a broader
perspective and includes the emotional and social aspects
of reproduction also. According to the World Health
Organisation (WHO), reproductive health means a total
well-being in all aspects of reproduction, i.e., physical,
emotional, behavioural and social. Therefore, a society with
people having physically and functionally normal
reproductive organs and normal emotional and behavioural
interactions among them in all sex-related aspects might
be called reproductively healthy. Why is it significant to
maintain reproductive health and what are the methods
taken up to achieve it? Let us examine them.
4.1 REPRODUCTIVE HEALTH – PROBLEMS AND
STRATEGIES
India was amongst the first countries in the world to
initiate action plans and programmes at a national level
to attain total reproductive health as a social goal.
These programmes called ‘family planning’ were
initiated in 1951 and were periodically assessed over
the past decades. Improved programmes covering wider
CHAPTER 4
REPRODUCTIVE HEALTH
4.1 Reproductive Health –
Problems and Strategies
4.2 Population Explosion
and Birth Control
4.3 Medical Termination of
Pregnancy
4.4 Sexually Transmitted
Diseases
4.5 Infertility
2015-16
58
BIOLOGY
reproduction-related areas are currently in operation under the
popular name ‘Reproductive and Child Health Care (RCH) programmes’.
Creating awareness among people about various reproduction related
aspects and providing facilities and support for building up a
reproductively healthy society are the major tasks under these
programmes.
With the help of audio-visual and the print-media governmental and
non-governmental agencies have taken various steps to create awareness
among the people about reproduction-related aspects. Parents, other
close relatives, teachers and friends, also have a major role in the
dissemination of the above information. Introduction of sex education
in schools should also be encouraged to provide right information to
the young so as to discourage children from believing in myths and
having misconceptions about sex-related aspects. Proper information
about reproductive organs, adolescence and related changes, safe and
hygienic sexual practices, sexually transmitted diseases (STD), AIDS,
etc., would help people, especially those in the adolescent age group to
lead a reproductively healthy life. Educating people, especially fertile
couples and those in marriageable age group, about available birth
control options, care of pregnant mothers, post-natal care of the mother
and child, importance of breast feeding, equal opportunities for the male
and the female child, etc., would address the importance of bringing up
socially conscious healthy families of desired size. Awareness of problems
due to uncontrolled population growth, social evils like sex-abuse and
sex-related crimes, etc., need to be created to enable people to think
and take up necessary steps to prevent them and thereby build up a
socially responsible and healthy society.
Successful implementation of various action plans to attain
reproductive health requires strong infrastructural facilities, professional
expertise and material support. These are essential to provide medical
assistance and care to people in reproduction-related problems like
pregnancy, delivery, STDs, abortions, contraception, menstrual problems,
infertility, etc. Implementation of better techniques and new strategies
from time to time are also required to provide more efficient care and
assistance to people. Statutory ban on amniocentesis (a foetal sex
determination test based on the chromosomal pattern in the amniotic
fluid surrounding the developing embryo) for sex-determination to legally
check increasing female foeticides, massive child immunisation, etc., are
some programmes that merit mention in this connection.
Research on various reproduction-related areas are encouraged and
supported by governmental and non-governmental agencies to find out
new methods and/or to improve upon the existing ones. Do you know
that ‘Saheli’–a new oral contraceptive for the females–was developed
by scientists at Central Drug Research Institute (CDRI) in Lucknow, India?
Better awareness about sex related matters, increased number of medically
assisted deliveries and better post-natal care leading to decreased maternal
2015-16
59
REPRODUCTIVE HEALTH
and infant mortality rates, increased number of couples with small
families, better detection and cure of STDs and overall increased medical
facilities for all sex-related problems, etc. all indicate improved reproductive
health of the society.
4.2 POPULATION EXPLOSION AND BIRTH CONTROL
In the last century an all-round development in various fields significantly
improved the quality of life of the people. However, increased health facilities
along with better living conditions had an explosive impact on the growth
of population. The world population which was around 2 billion
(2000 million) in 1900 rocketed to about 6 billions  by 2000. A similar
trend was observed in India too. Our population which was approximately
350 million at the time of our independence reached close to the billion
mark by 2000 and crossed 1 billion in May 2000. That means, every
sixth person in the world is an Indian. A rapid decline in death rate,
maternal mortality rate (MMR) and infant mortality rate (IMR) as
well as an increase in number of people in reproducible age are probable
reasons for this. Through our RCH programmes, though we could bring
down the population growth rate, it was only marginal. According to the
2001 census report, the population growth rate was still around  1.7 per
cent, i.e., 17/1000/year, a rate at which our population could double in
33 years. Such an alarming growth rate could lead to an absolute scarcity
of even the basic requirements, i.e., food, shelter and clothing, in spite of
significant progress made in those areas. Therefore, the government was
forced to take up serious measures to check this population growth rate.
The most important step to overcome this problem is to motivate smaller
families by using various contraceptive methods. You might have seen
advertisements in the media as well as posters/bills, etc., showing a happy
couple with two children with a slogan Hum Do Hamare Do (we two, our
two). Many couples, mostly the young, urban, working ones have even
adopted an ‘one child norm’. Statutory raising of marriageable age of the
female to 18 years and that of males to 21 years, and incentives given to
couples with small families are two of the other measures taken to tackle
this problem. Let us describe some of the commonly used contraceptive
methods, which help prevent unwanted pregnancies.
An ideal contraceptive should be user-friendly, easily available,
effective and reversible with no or least side-effects. It also should in no
way interfere with the sexual drive, desire and/or the sexual act of the
user. A wide range of contraceptive methods are presently available which
could be broadly grouped into the following categories, namely
Natural/Traditional, Barrier, IUDs, Oral contraceptives, Injectables,
Implants and Surgical methods.
Natural methods work on the principle of avoiding chances of ovum
and sperms meeting. Periodic abstinence is one such method in which
the couples avoid or abstain from coitus from day 10 to 17 of the menstrual
cycle when ovulation could be expected. As chances of fertilisation are
2015-16
60
BIOLOGY
Figure 4.2. Copper T (CuT)
very high during this period, it is called the fertile period. Therefore, by
abstaining from coitus during this period, conception could be prevented.
Withdrawal or coitus interruptus is another method in which the male
partner withdraws his penis from the vagina just before ejaculation so as
to avoid insemination. Lactational amenorrhea (absence of
menstruation) method is based on the fact that ovulation
and therefore the cycle do not occur during the period of
intense lactation following parturition. Therefore, as long
as the mother breast-feeds the child fully, chances of
conception are almost nil. However, this method has been
reported to be effective only upto a maximum period of six
months following parturition. As no medicines or devices
are used in these methods, side effects are almost nil.
Chances of failure, though, of this method are also high.
In barrier methods, ovum and sperms are prevented
from physically meeting with the help of barriers. Such
methods  are available for both males and females.
Condoms (Figure 4.1 a, b) are barriers made of thin rubber/
latex sheath that are used to cover the penis in the male or
vagina and cervix in the female, just before coitus so that
the ejaculated semen would not enter into the female
reproductive tract. This can prevent conception. ‘Nirodh’ is
a popular brand of condom for the male. Use of condoms
has increased in recent years due to its additional benefit of
protecting the user from contracting STDs and AIDS. Both
the male and the female condoms are disposable, can be
self-inserted and thereby gives privacy to the user.
Diaphragms, cervical caps and vaults are also barriers
made of rubber that are inserted into the female reproductive
tract to cover the cervix during coitus. They prevent
conception by blocking the entry of sperms through the
cervix. They are reusable. Spermicidal creams, jellies and
foams are usually used alongwith these barriers to increase
their contraceptive efficiency.
Another effective and popular method is the use of Intra
Uterine Devices (IUDs). These devices are inserted by
doctors or expert nurses in the uterus through vagina.
These Intra Uterine Devices are presently available as the
non-medicated IUDs (e.g., Lippes loop), copper releasing
IUDs (CuT, Cu7, Multiload 375) and the hormone releasing IUDs
(Progestasert, LNG-20) (Figure 4.2). IUDs increase phagocytosis of sperms
within the uterus and the Cu ions released suppress sperm motility
and the fertilising capacity of sperms. The hormone releasing IUDs,
in addition, make the uterus unsuitable for implantation and the
cervix hostile to the sperms. IUDs are ideal contraceptives for the females
Figure 4.1(b) Condom for female
Figure 4.1(a) Condom for male
2015-16
Page 5


You have learnt about human reproductive system and its
functions in Chapter 3. Now, let’s discuss a closely related
topic – reproductive health. What do we understand by
this term?  The term simply refers to healthy reproductive
organs with normal functions. However, it has a broader
perspective and includes the emotional and social aspects
of reproduction also. According to the World Health
Organisation (WHO), reproductive health means a total
well-being in all aspects of reproduction, i.e., physical,
emotional, behavioural and social. Therefore, a society with
people having physically and functionally normal
reproductive organs and normal emotional and behavioural
interactions among them in all sex-related aspects might
be called reproductively healthy. Why is it significant to
maintain reproductive health and what are the methods
taken up to achieve it? Let us examine them.
4.1 REPRODUCTIVE HEALTH – PROBLEMS AND
STRATEGIES
India was amongst the first countries in the world to
initiate action plans and programmes at a national level
to attain total reproductive health as a social goal.
These programmes called ‘family planning’ were
initiated in 1951 and were periodically assessed over
the past decades. Improved programmes covering wider
CHAPTER 4
REPRODUCTIVE HEALTH
4.1 Reproductive Health –
Problems and Strategies
4.2 Population Explosion
and Birth Control
4.3 Medical Termination of
Pregnancy
4.4 Sexually Transmitted
Diseases
4.5 Infertility
2015-16
58
BIOLOGY
reproduction-related areas are currently in operation under the
popular name ‘Reproductive and Child Health Care (RCH) programmes’.
Creating awareness among people about various reproduction related
aspects and providing facilities and support for building up a
reproductively healthy society are the major tasks under these
programmes.
With the help of audio-visual and the print-media governmental and
non-governmental agencies have taken various steps to create awareness
among the people about reproduction-related aspects. Parents, other
close relatives, teachers and friends, also have a major role in the
dissemination of the above information. Introduction of sex education
in schools should also be encouraged to provide right information to
the young so as to discourage children from believing in myths and
having misconceptions about sex-related aspects. Proper information
about reproductive organs, adolescence and related changes, safe and
hygienic sexual practices, sexually transmitted diseases (STD), AIDS,
etc., would help people, especially those in the adolescent age group to
lead a reproductively healthy life. Educating people, especially fertile
couples and those in marriageable age group, about available birth
control options, care of pregnant mothers, post-natal care of the mother
and child, importance of breast feeding, equal opportunities for the male
and the female child, etc., would address the importance of bringing up
socially conscious healthy families of desired size. Awareness of problems
due to uncontrolled population growth, social evils like sex-abuse and
sex-related crimes, etc., need to be created to enable people to think
and take up necessary steps to prevent them and thereby build up a
socially responsible and healthy society.
Successful implementation of various action plans to attain
reproductive health requires strong infrastructural facilities, professional
expertise and material support. These are essential to provide medical
assistance and care to people in reproduction-related problems like
pregnancy, delivery, STDs, abortions, contraception, menstrual problems,
infertility, etc. Implementation of better techniques and new strategies
from time to time are also required to provide more efficient care and
assistance to people. Statutory ban on amniocentesis (a foetal sex
determination test based on the chromosomal pattern in the amniotic
fluid surrounding the developing embryo) for sex-determination to legally
check increasing female foeticides, massive child immunisation, etc., are
some programmes that merit mention in this connection.
Research on various reproduction-related areas are encouraged and
supported by governmental and non-governmental agencies to find out
new methods and/or to improve upon the existing ones. Do you know
that ‘Saheli’–a new oral contraceptive for the females–was developed
by scientists at Central Drug Research Institute (CDRI) in Lucknow, India?
Better awareness about sex related matters, increased number of medically
assisted deliveries and better post-natal care leading to decreased maternal
2015-16
59
REPRODUCTIVE HEALTH
and infant mortality rates, increased number of couples with small
families, better detection and cure of STDs and overall increased medical
facilities for all sex-related problems, etc. all indicate improved reproductive
health of the society.
4.2 POPULATION EXPLOSION AND BIRTH CONTROL
In the last century an all-round development in various fields significantly
improved the quality of life of the people. However, increased health facilities
along with better living conditions had an explosive impact on the growth
of population. The world population which was around 2 billion
(2000 million) in 1900 rocketed to about 6 billions  by 2000. A similar
trend was observed in India too. Our population which was approximately
350 million at the time of our independence reached close to the billion
mark by 2000 and crossed 1 billion in May 2000. That means, every
sixth person in the world is an Indian. A rapid decline in death rate,
maternal mortality rate (MMR) and infant mortality rate (IMR) as
well as an increase in number of people in reproducible age are probable
reasons for this. Through our RCH programmes, though we could bring
down the population growth rate, it was only marginal. According to the
2001 census report, the population growth rate was still around  1.7 per
cent, i.e., 17/1000/year, a rate at which our population could double in
33 years. Such an alarming growth rate could lead to an absolute scarcity
of even the basic requirements, i.e., food, shelter and clothing, in spite of
significant progress made in those areas. Therefore, the government was
forced to take up serious measures to check this population growth rate.
The most important step to overcome this problem is to motivate smaller
families by using various contraceptive methods. You might have seen
advertisements in the media as well as posters/bills, etc., showing a happy
couple with two children with a slogan Hum Do Hamare Do (we two, our
two). Many couples, mostly the young, urban, working ones have even
adopted an ‘one child norm’. Statutory raising of marriageable age of the
female to 18 years and that of males to 21 years, and incentives given to
couples with small families are two of the other measures taken to tackle
this problem. Let us describe some of the commonly used contraceptive
methods, which help prevent unwanted pregnancies.
An ideal contraceptive should be user-friendly, easily available,
effective and reversible with no or least side-effects. It also should in no
way interfere with the sexual drive, desire and/or the sexual act of the
user. A wide range of contraceptive methods are presently available which
could be broadly grouped into the following categories, namely
Natural/Traditional, Barrier, IUDs, Oral contraceptives, Injectables,
Implants and Surgical methods.
Natural methods work on the principle of avoiding chances of ovum
and sperms meeting. Periodic abstinence is one such method in which
the couples avoid or abstain from coitus from day 10 to 17 of the menstrual
cycle when ovulation could be expected. As chances of fertilisation are
2015-16
60
BIOLOGY
Figure 4.2. Copper T (CuT)
very high during this period, it is called the fertile period. Therefore, by
abstaining from coitus during this period, conception could be prevented.
Withdrawal or coitus interruptus is another method in which the male
partner withdraws his penis from the vagina just before ejaculation so as
to avoid insemination. Lactational amenorrhea (absence of
menstruation) method is based on the fact that ovulation
and therefore the cycle do not occur during the period of
intense lactation following parturition. Therefore, as long
as the mother breast-feeds the child fully, chances of
conception are almost nil. However, this method has been
reported to be effective only upto a maximum period of six
months following parturition. As no medicines or devices
are used in these methods, side effects are almost nil.
Chances of failure, though, of this method are also high.
In barrier methods, ovum and sperms are prevented
from physically meeting with the help of barriers. Such
methods  are available for both males and females.
Condoms (Figure 4.1 a, b) are barriers made of thin rubber/
latex sheath that are used to cover the penis in the male or
vagina and cervix in the female, just before coitus so that
the ejaculated semen would not enter into the female
reproductive tract. This can prevent conception. ‘Nirodh’ is
a popular brand of condom for the male. Use of condoms
has increased in recent years due to its additional benefit of
protecting the user from contracting STDs and AIDS. Both
the male and the female condoms are disposable, can be
self-inserted and thereby gives privacy to the user.
Diaphragms, cervical caps and vaults are also barriers
made of rubber that are inserted into the female reproductive
tract to cover the cervix during coitus. They prevent
conception by blocking the entry of sperms through the
cervix. They are reusable. Spermicidal creams, jellies and
foams are usually used alongwith these barriers to increase
their contraceptive efficiency.
Another effective and popular method is the use of Intra
Uterine Devices (IUDs). These devices are inserted by
doctors or expert nurses in the uterus through vagina.
These Intra Uterine Devices are presently available as the
non-medicated IUDs (e.g., Lippes loop), copper releasing
IUDs (CuT, Cu7, Multiload 375) and the hormone releasing IUDs
(Progestasert, LNG-20) (Figure 4.2). IUDs increase phagocytosis of sperms
within the uterus and the Cu ions released suppress sperm motility
and the fertilising capacity of sperms. The hormone releasing IUDs,
in addition, make the uterus unsuitable for implantation and the
cervix hostile to the sperms. IUDs are ideal contraceptives for the females
Figure 4.1(b) Condom for female
Figure 4.1(a) Condom for male
2015-16
61
REPRODUCTIVE HEALTH
who want to delay pregnancy and/or space children. It is
one of most widely accepted methods of contraception in
India.
Oral administration of small doses of either progestogens
or progestogen–estrogen combinations is another
contraceptive method used by the females. They are used
in the form of tablets and hence are popularly called the
pills. Pills have to be taken daily for a period of 21 days
starting preferably within the first five days of menstrual
cycle. After a gap of 7 days (during which menstruation
occurs) it has to be repeated in the same pattern till the
female desires to prevent conception. They inhibit ovulation
and implantation as well as alter the quality of cervical mucus to prevent/
retard entry of sperms. Pills are very effective with lesser side effects and
are well accepted by the females. Saheli –the new oral contraceptive for
the females contains a non-steroidal preparation. It is a ‘once a week’ pill
with very few side effects and high contraceptive value.
Progestogens alone or in combination with estrogen can also be used
by females as injections or implants under the skin (Figure 4.3). Their
mode of action is similar to that of pills and their effective periods are
much longer. Administration of progestogens or progestogen-estrogen
combinations or IUDs within 72 hours of coitus have been found to be
very effective as emergency contraceptives as they could be used to avoid
possible pregnancy due to rape or casual unprotected intercourse.
Surgical methods, also called sterilisation, are generally advised for
the male/female partner as a terminal method to prevent any more
pregnancies. Surgical intervention blocks gamete transport and thereby
prevent conception. Sterilisation procedure in the male is called ‘vasectomy’
Figure 4.3 Implants
Figure 4.4a Vasectomy
Figure 4.4 (b) Tubectomy
2015-16
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