Reproductive health implies that men and women are able to have a responsible, satisfying and safe sex, and the ability to reproduce and freedom to decide if, when and how often to do so. Implicit in this is access to safe, effective, affordable and acceptable methods of birth control as well as access to sexual and reproductive medicine that will enable women to go through pregnancy and childbirth safely.
According to the World Health Organisation (WHO), “Reproductive and sexual ill-health account for 20 per cent of women’s medical problems, and 14 per cent in men.
The WHO estimates that every year, 358 000 women die due to complications during pregnancy and childbirth. Access to reproductive and sexual health services including family planning services, pre-natal care, safe delivery and post-natal care, prevention and treatment of infertility, prevention of spontaneous abortion and the management of the consequences of induced abortion, and treatment of reproductive tract infections, sexually transmitted diseases and other reproductive health conditions. In addition, it includes services regarding HIV/AIDS, breast cancer, infertility, delivery, hormone therapy, sex reassignment therapy, and abortion.
The case with India
India is nowhere close to achieving these goals. It is estimated that one in every five pregnancies in India are unwanted or unplanned, and every 5 seconds (seems improbable), a woman dies after childbirth. The majority of women in India have very limited access to reproductive rights and proper health care thanks to social, economic and cultural factors, like male dominance, that rob women of a voice when it comes to decisions regarding marriage, sexual life, getting pregnant and the use of contraceptives.
The health of the girl child, especially adolescents and women over the reproductive age, makes for a disturbing scenario. When it comes to reproductive health, pregnancy care is very crucial. During pregnancy, nutritional deficiency has a negative impact on both mother and baby. During this period, women are vulnerable to anaemia, post-delivery bleeding, low birth weight babies, etc. These problems are greatest among the rural population, where illiteracy is a major contributor. But the middle class and the affluent are not immune to lack of proper nutrition.
An overdose of junk food and processed food has a profound effect on the health of the woman as she advances into motherhood. Another concern regarding reproductive and sexual health is the growing incidence of sexually transmitted diseases among women. Women should have the right to have safe sex, to decide on when she wants to get pregnant or opt for a legal abortion.
Women’s empowerment can be successful only when societal norms enable a woman to take their own decisions. What we need is an advanced health system to deal with pregnancy-related complications. It is a matter of shame that in the 21st century, we still have women dying due to pregnancy- and abortion-related causes.
Reproductive Health Needs of Adolescents:
- Information on their bodies and the changes in their bodies during adolescence Information on sexuality and reproductive health Sexually transmitted diseases and HIV
- Access to information on making safe sex choices
- Increasing responsibilities in society as they grow up
- Access to family planning services
- Prenatal and post-abortion care
- Safe delivery
- Treatment of unsafe abortions
- Diagnosis and treatment of sexually transmitted diseases
- Protection from sexual abuse
- Culturally appropriate psychosocial counselling and/or mental health services
- Negotiating skills
Dr Shah is an obstetrics and gynaecologist at Columbia Asia Hospital, Gurgaon.