Chapter 3: Reproductive Health

Class 12 Biology | NCERT-Based Content | CBSE RBSE Board 2025-26

1. Introduction

Reproductive health refers to a total well-being in all aspects of reproduction, i.e., physical, emotional, behavioral and social. According to the World Health Organization (WHO), reproductive health means a total well-being in all aspects of reproduction. It is not merely the absence of disease or disorders related to the reproductive system.

A reproductively healthy society has people with physically and functionally normal reproductive organs, normal emotional and behavioral interactions in all sex-related aspects. India was among 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. India launched the National Family Planning Programme in 1951 to motivate smaller families through contraception.

2. Reproductive Health - Problems and Strategies

India has one of the largest populations in the world. With approximately 17 percent of the world's population living in just 2.4 percent of the world's land area, our country faces several problems related to reproductive health.

2.1 Major Problems

Population Explosion: Rapid increase in population is creating serious problems including scarcity of resources, unemployment, lack of education, and poverty.

Maternal and Infant Mortality: Despite improvements, maternal and infant mortality rates are still high in many parts of India, particularly in rural areas due to lack of proper medical facilities, malnutrition, and inadequate prenatal and postnatal care.

Sexually Transmitted Infections (STIs): Lack of awareness and education about safe sex practices has led to an increase in STIs, including HIV/AIDS.

Illegal Abortions: Unsafe abortions performed by untrained personnel lead to complications and deaths.

Sex-related Crimes and Misconceptions: Crimes like sexual abuse, rape, and incorrect notions about sex and related aspects need to be addressed through proper sex education.

2.2 Government Programmes and Strategies

Family Planning Programmes: These programmes aim to motivate smaller families through contraception. The Reproductive and Child Health Care (RCH) programme addresses various issues related to reproductive health.

Sex Education: Introduction of sex education in schools to provide correct information about reproductive organs, adolescence and related changes, safe and hygienic sexual practices, STIs, and AIDS.

Awareness Programmes: Creating awareness about reproductive health through media, information and counseling centers, and healthcare personnel.

Medical Facilities: Improving medical facilities for pregnant women and children. Setting up fertility clinics to help couples with conception problems.

Legal Measures: Implementation of laws like the MTP Act and PCPNDT Act.

3. Population Explosion and Birth Control

The rapid increase in human population is termed population explosion. The main reasons include:

• Decline in death rate due to improved medical facilities
• Control of infectious diseases
• Better hygiene and sanitation
• Lack of proper family planning and contraception
• Early marriage and preference for male child

Birth control or contraception refers to the intentional prevention of pregnancy through various methods.

4. Methods of Contraception

4.1 Natural Methods

Periodic Abstinence: Avoiding coitus from day 10 to 17 of the menstrual cycle when ovulation occurs. High failure rate.

Withdrawal or Coitus Interruptus: Male partner withdraws before ejaculation. High failure rate.

Lactational Amenorrhea: During intense lactation, the mother does not ovulate. Effective only for six months after delivery.

4.2 Barrier Methods

Condoms: Thin rubber/latex sheath covering penis or vagina. Protect from STIs including AIDS. Disposable.

Diaphragm, Cervical Cap and Vault: Rubber barriers inserted to cover cervix. Reusable, need expert fitting.

Spermicidal Creams, Jellies and Foams: Chemicals that kill sperms. Used with barrier methods.

4.3 Intrauterine Devices (IUDs)

Non-medicated IUDs: Example: Lippes loop. Increase phagocytosis of sperms.

Copper-releasing IUDs: CuT, Cu7, Multiload 375. Copper ions suppress sperm motility.

Hormone-releasing IUDs: Progestasert, LNG-20. Make uterus unsuitable for implantation. Effective for 5 years.

4.4 Oral Contraceptives

Oral contraceptives are pills containing progestogens alone or with estrogens. They prevent ovulation by inhibiting FSH and LH release.

Pills are taken daily for 21 days, then 7 days gap (for menstruation), then repeated. Very effective but can have side effects like nausea, weight gain.

Injectables and Implants: Progestogens can be used as injectable (Depo-Provera - every 3 months) or implants (Norplant - effective for 5 years).

Emergency Contraceptives: Progestogens given within 72 hours of unprotected coitus. Should not be used repeatedly.

4.5 Surgical Methods

Vasectomy: In males, vas deferens is cut/tied. Prevents sperms in ejaculate.

Tubectomy: In females, fallopian tubes are cut/tied. Prevents ovum from reaching uterus.

Highly effective but irreversible. Advised only for couples not wanting more children.

5. Medical Termination of Pregnancy (MTP)

MTP or induced abortion is the voluntary termination of pregnancy before full term. Used to avoid unwanted pregnancies from unprotected coitus, contraceptive failure, or rape.

Every year about 45-50 million MTPs are performed worldwide (1/5th of conceived pregnancies). Safe during first trimester (up to 12 weeks). Government legalized MTP in 1971, amended in 2017 (MTP Amendment Act 2017).

5.1 Methods of MTP

MTPs performed by registered medical practitioners in approved hospitals. Methods: drugs (mifepristone + prostaglandins) or surgical removal.

5.2 Legal and Ethical Aspects

MTP Act permits abortion when:

• Continuation risks life or health of pregnant woman
• Substantial risk of serious abnormalities in child
• Pregnancy from rape or contraceptive failure in married woman

Requires opinion of one doctor (up to 12 weeks) or two doctors (12-20 weeks).

MTP misused for sex determination and female feticide. PCPNDT Act prohibits sex determination and bans prenatal techniques for this purpose.

6. Sexually Transmitted Infections (STIs)

STIs are diseases transmitted through sexual intercourse, also called venereal diseases (VD) or reproductive tract infections (RTI).

6.1 Common STIs

Bacterial Infections:

• Gonorrhea: Caused by Neisseria gonorrhoeae. Burning during urination, pus discharge.
• Syphilis: Caused by Treponema pallidum. Primary lesion (chancre), skin rash, can damage cardiovascular and nervous systems.

Viral Infections:

• Genital Herpes: Herpes simplex virus. Fluid-filled blisters on genitals.
• Genital Warts: Human Papillomavirus (HPV). Warts on genitals, some types cause cervical cancer.
• HIV/AIDS: Human Immunodeficiency Virus attacks immune system, leads to AIDS.

Protozoan: Trichomoniasis (Trichomonas vaginalis). Frothy discharge.

Fungal: Candidiasis (Candida albicans). Itching, thick white discharge.

6.2 Transmission and Prevention

STIs transmitted through sexual contact, contaminated blood transfusion, sharing needles/syringes, and from infected mother to child.

Prevention:

• Avoid sex with unknown/multiple partners
• Use condoms (protect from STIs including HIV)
• Early detection and complete treatment
• Avoid sharing needles, syringes, razor blades
• Screen blood before transfusion

7. Infertility

Infertility is inability to conceive even after unprotected cohabitation for more than a year. Affects 10-15% of couples worldwide.

7.1 Causes

In Males: Low sperm count/motility, abnormal morphology, obstruction in ducts, hormonal imbalances.

In Females: Failure of ovulation, blocked tubes, hormonal imbalances, endometriosis, uterine abnormalities.

7.2 Assisted Reproductive Technologies (ART)

IVF and ET: Fertilization outside body in lab. Embryos transferred to uterus/fallopian tube. Babies are test-tube babies. First: Louise Joy Brown (1978).

ET variations:

• ZIFT: Embryo with up to 8 blastomeres transferred to fallopian tube.
• IUT: Embryo with more than 8 blastomeres transferred to uterus.

GIFT: Ovum and sperms transferred to fallopian tube. Fertilization occurs naturally in tube.

ICSI: Single sperm directly injected into ovum in lab. Used when male has very low sperm count/motility.

AI: Semen artificially introduced into vagina/uterus.

• IUI: Introduced into uterus.
• ICI: Introduced into cervix.

Donor gametes or surrogate mothers can be used if needed.

8. Practice Questions

Multiple Choice Questions

Very Short Answer (1 mark)

Short Answer (2-3 marks)

Long Answer (5 marks)