Lectures on reproductive health and healthy lifestyle. Reproductive health - what is it? Factors influencing human reproductive health

Lecture

Study questions.

Definition of human reproductive health. Features of the factors that determine and influence it.

At the biological level of human functioning, two tasks are solved - to survive and reproduce. The solution to the first problem is related to human adaptive capabilities, high level individual health. The second problem can only be solved by reproductively healthy people.

According to WHO definitionreproductive health is a state of complete physical, mental and social well-being of the reproductive system, its functions and processes, including the reproduction of offspring and the harmony of psychosexual relationships in the family. In this context, we see that reproductive health is an integral part of human health in a broad sense. But, nevertheless, the specificity of this component is obvious, which makes it possible to isolate and consider reproductive health as if separately.

Like human health in general, reproductive health is determined by a number of indicators and is influenced by various conditions and factors. Ideally, the level of reproductive health is assessed based on the resultsreproductive function – the number of conceptions that have taken place and the number of children born on time in the absence of any artificial restrictions. In modern life, the latter are inevitable, and therefore, in reality, reproductive health is considered as the result of a person’s conscious regulation of his reproductive function.

The level of reproductive health depends on a number of factors that have some specific content and impact:

the reproductive potential of a person, which depends on the genetically inherent capacity of the human reproductive system. For example, this is the number of germ cells that mature in the body of a man or woman during childbearing age;

compatibility of partners, which can be traced at various levels: genetic, for example, compatibilityRh-factor; on the physiological and physical, which is associated with the degree of anatomical similarity of the partners, with the rhythm of their life, for example, with biorhythms; on psychological level, in this case, similarities are considered, for example, the characteristics of the characters and temperaments of the partners;

sexual culture determines the lifestyle and behavior of an individual of a certain gender in society;

regulation of childbirth inevitably affects the level of human reproductive health. The influence of this factor is determined by the appropriateness and correctness of use various methods contraception, family planning.

The concept of an individual’s gender, the main stages of its formation. Primary and secondary sexual characteristics. General characteristics of human sexual function.

Prevention of disorders and the occurrence of causes that reduce reproductive health is largely associated with sex education and sex education, which form the basis of an individual’s sexual culture. Sexual culture is a concept immeasurably greater than the culture of sexual relations. In this regard, it is necessary to determine the content and meaning of the concepts “gender” and “sex”. In some languages these words are synonyms; in Russian their content is different.

Floor - this is a set of anatomical, physiological, psychological and sexual characteristics and characteristics that determine the gender of an individual as a boy-man or a girl-woman.

Sex characterizes intersexual, intimate relationships, sex life.

Highlight:genetic sex – determined by the presence of sex chromosomes. Each human cell contains 23 pairs of chromosomes: 22 pairs of autosomes and one pair of sex chromosomes. Each pair of autosomes in a man is similar to the corresponding pair in a woman. Genetically, a man differs from a woman in the structure and number of sex chromosomes - this is oneY-chromosome and oneX-chromosome, in a woman the sex chromosomes are the same and are represented by X chromosomes. The information contained in these chromosomes determines the development of the sex glands or gonads in the future fetus. Thus, genetic sex determines the formation of the gonad. Gonadal or true sex is identified by the main indicator of gender - the histological structure of the gonad; these can be either the ovaries, in which female reproductive cells mature - eggs, or there may be testes that produce sperm, and also secrete specific female or male sex hormones.

As a result of the functioning of the gonads, an organism develops with a certain external and internal structure, i.e. The individual develops both internal and external genital organs. In this case, we are talking about the morphological or somatic field of the subject. The structure of the external genitalia is defined as the primary sexual characteristics, by which the obstetrician determinescivilian gender newborn During puberty, associated with the activation of the gonads, secondary sexual characteristics appear, manifested in anatomical, physiological and psychological changes in the individual.

Civil gender largely depends on upbringing and other influences that affect an individual throughout his life, for example, the choice of clothing, hairstyle, games, etc.) and at the same time, the formation of sexual consciousness necessarily occurs. In the end, a person chooses a certain type of sexual behavior in society, for example, it is determined in the choice of a sexual partner.

As can be seen from the above, the category “gender” is multifaceted. And science considers it taking into account its specifics: biological, medical, psychological, pedagogical, social and others. WITHmedical pointsIn terms of gender, organisms or special cells belong to one of two groups, differing in that the sexual process occurs between representatives of different groups, but not within a given group. Definitionpsychological gender is associated with the feeling and awareness of one’s gender, as well as with psychosexual orientation, for example, attraction to the opposite sex. Also, when considering this aspect of gender, sociosexual orientations are also taken into account, i.e. a realized system of sexual roles, on the basis of which he carries out corresponding activities and achieves a certain social status. WITHpedagogical point of view, gender is considered as a biosocial category. Becausebiological determined by the action of genetic structures, andsocial - as a result of his behavior, formed as a result of upbringing and influence environment. The opinion of biologists, doctors and psychologists boils down to the fact that “sex” is bisexual, i.e. Each sex potentially contains within itself the developmental possibilities of the other sex. The realization of sex depends on the environment and on genetic factors, and the effect of both is quantitative, and therefore the characteristics of the opposite sex are suppressed to varying degrees.

The science that studies the specifics of the psychological and social aspects of interactions between the sexes, the physiology and pathology of sexual life is calledsexology . Sexologists in their work rely on knowledge practical experience in a variety of directions modern science. In this regard, it is customary to highlight several aspects:

1. Biological-medical , which studies the structure and functioning of male and female organisms, the physiology of puberty, and the specifics of sexual function. Sexual function is one of the main biological functions of the body, most clearly manifested from the moment of puberty, determined by the ability to reproduce full-fledged offspring with their subsequent upbringing.

2. Psychological aspect includes the study of issues of sexual behavior. Personal characteristics of sexual life, the sexuality of an individual at different stages of his sexual life, etc.

3. Socio-historical aspect examines the specifics of sexual behavior, established in accordance with moral, religious, civil and other norms accepted in a particular society; it also studies actual sexual behavior, sexual symbolism, issues of the evolution of sexual behavior, etc.

All these links, which determine the methodological basis of sexology, reflect the unity of efforts, goals, and activities on the part of parents, educators, doctors, sociologists and other specialists in the implementation of sex education and enlightenment of the younger generation.

Formation of correct gender relations.

The state of reproductive health largely depends on a person’s lifestyle, as well as on a responsible attitude towards sexual life. Both affect stability family relations, on the general well-being of a person.

A negative factor affecting the state of reproductive function is unwanted pregnancy. Often a woman is faced with a difficult choice: to give birth to a child or have an abortion. This problem is especially difficult to solve in adolescence. An abortion, especially during the first pregnancy, can cause serious mental trauma and in many cases even lead to irreversible disorders in the reproductive sphere. At the same time, the decision to give birth often jeopardizes further studies and other life plans, so each situation must be considered individually and carefully. In order for such situations to occur less frequently, adolescents must have mature understanding of the meaning of reproductive health and the concept of family planning.

Family planning is necessary to achieve the following tasks :

The birth of the desired healthy children;

Preserving women's health;

Achieving harmony in psychosexual relationships in the family;

Implementation of life plans.

For many years, family planning was limited to birth control. However, first of all, this is to ensure the health of a woman who is able to give birth to children exactly when she herself wants it. In other words,family planning - this is the birth of children by choice, and not by chance. The right to family planning is an internationally recognized right of every person.

Family planning helps spouses consciously choose the number of children in the family, approximate dates their birth, plan your life, avoiding unnecessary worries and worries.

The optimal age for having children is 20–35 years. If pregnancy occurs earlier or later, it usually occurs with complications, and the likelihood of health problems for mother and child is higher. The intervals between births should be at least 2 – 2.5 years; this allows a woman to regain strength, maintain her health and the health of her future children. In this regard, it should also be emphasized: abortion is by no means best method birth control, it can be avoided by using modern methods contraception (prevention of unwanted pregnancy).

A teenager should not isolate himself with his problems. He should know that a wise and tactful adult is always ready to help him.

Let's start this section by talking about the importance of family in a person's life. We emphasize that in the system of a healthy lifestyle for young people, the leading place is occupied by the correct relationship between the sexes, the choice of a partner of the opposite sex and the creation of a family.

A young family is the primary unit of society. A family develops a set of habits and behavioral stereotypes that directly affect health.

Family - is a group of people related by marriage, consanguinity or adoption, living together and having common income and expenses.

Reproduction is one of the main functions of the family. An important social demographic group of the population is the young family during the period of its formation and formation. Most demographers consider a young family to be spouses aged no more than 24-25 years and married for no more than 5 years.

According to statistics, in most young families the first child is born in the first 2 years of marriage and a significant part of young families have two children in the first 5 years of marriage.

In the family, basic human needs are satisfied. The family provides to a large extent the social needs of the child. Healthy family functioning is important for each individual, as well as for society as a whole.

Boys and girls, as potential parents, must understand the importance of family in their personal lives and the role of family in society.

Young people are unprepared for family life often causes the breakup of a young family. Family breakdown into early stage Its development leads to the fact that children from an early age are often raised without fathers, and divorced young people do not immediately remarry. It reduces fertility and is main reason unfavorable demographic situation in Russia and a factor negatively affecting the health of young people.

Let us highlight several factors that have an impact bad influence on the strength of a young family. First of all, this is the early age of people getting married. In such families, as a rule, there is a lack of economic independence and sufficient material security. Young spouses are often not ready to overcome all the difficulties of family life in the first years of marriage.

The disintegration of the family is caused by the unpreparedness of young spouses to manage household, rational distribution of the family budget and responsibilities, their incorrect attitude towards the difficulties that always arise in a young family.

Before getting married, young people should know about all the features and difficulties of living together and prepare themselves for it, cultivate the moral and physical qualities necessary to create a strong and happy family. There are no difficulties in life that cannot be overcome for the sake of a loved one, so that these difficulties do not overshadow the great feeling of love, one must be prepared for them. You can only be healthy and happy in your family.

Every young person entering an independent life should have an idea of a healthy lifestyle, correct sexual behavior, information about health risk factors when leading a disordered sex life with frequent changes sexual partners and sexually transmitted diseases.

It should be noted that the best age for marriage is considered to be from 20 to 24 years. By this period, education and general mental development of a person are completed, and work activity creates the necessary material basis for family life. By this time, the young man has a certain correct understanding of the anatomy and functional characteristics of the genital organs - male and female. To a certain extent knows the mechanism of conception and the birth of a new life and is aware of the responsibility of the spouses for the birth healthy child.

A boy and a girl, before getting married, must assess the commonality of their life interests, level of development, seriousness

intentions and depth of respect and love for each other. Only on such a basis can a normal family life be built.

Let us briefly touch upon the issue of morality and hygiene of early, premarital sexual life, as well as sexual life without love, without an understanding of responsibility, without moral and legal obligations.

According to observational data, intense sexual activity in at a young age has the consequence of premature cessation of sexual activity. In addition, early onset of sexual activity does not have a beneficial effect on the offspring. Marriages concluded between boys and girls who have not yet reached full puberty are often infertile, and children born to such parents are weak.

Research shows that healthy children are born, as a rule, to women aged 25-35 years and to men aged 24-40 years.

It must be especially emphasized that the greatest evil for the unborn child is the use of alcohol by one or both parents. Even moderate consumption of alcoholic beverages before conception usually does not go unnoticed. A child born from such parents is excited, restless, sleeps poorly, often shudders in his sleep, and is afraid of everything.

In addition, children of parents who abuse alcohol are often born with various deformities. Scientists from many countries have carried out hundreds of studies confirming an indisputable fact: if conception occurred during a period when one or especially both parents were in a state alcohol intoxication, they give birth to defective children with various pathological abnormalities.

It is important to note that a normal sex life has a beneficial effect on a person’s health, performance and longevity, but at the same time emphasize that the basis of personal happiness is a family created on deep mutual affection and respect between spouses. It is necessary to begin developing the qualities of caring attitude towards each other even before marriage, during the period of acquaintance.

It is especially worth emphasizing once again the health dangers of promiscuous sex life. Such a life leads to premature wear and tear of the body and is fraught with the danger of contracting sexually transmitted diseases.

At the same time, in marriage, spouses experience mutual love, have support, and consolation in difficult situations. life situations. Orthodox Church believes that only in marriage is sexual intimacy possible, because marriage is the source of procreation. In the Orthodox religion, family is highly valued, where the main foundations are love between husband and wife, parents and children. Marriage in Christianity is seen as a vow of mutual love and fidelity that is kept throughout life.

Most world religions place a high value on family. For example, in Islam, marriage is viewed as the will of Allah, and marital relations are not only a source of procreation, but also a source of sexual pleasure. Spouses are assigned certain social roles: the husband provides material well-being, the wife raises children. Sexual relations outside marriage are not welcome, as they do not make married life stable.

IN modern society the family remains the main structure. A family based on consanguinity is a small social group whose members are bound by a common life, mutual assistance, and moral and legal responsibility. In most cultures, marriage is sanctified by tradition and is associated with pleasure and joyful elation, happy expectations and plans for the future.

At the same time, it should be noted that a couple entering into marriage will face many problems. In any case, if two people come together to spend 24 hours a day together, they will face many problems. Each spouse has his own formed system of behavior, his own views on relationships in the family, his own understanding of the social roles of the spouses. On this basis, conflicts may arise when expectations conflict with reality. From a certain point, the process of negotiations begins to achieve balance and harmony in the relationship. There needs to be an element of compromise on both sides. It is important to remember well that in nature there are no completely compatible people, but at the same time, each person is trainable to a certain extent, that is, he can change his views on life and his behavior. It is these opportunities that you need to be able to use, moving towards each other, creating an atmosphere of harmony and love in the family.

Much can be achieved by developing the ability to listen to your interlocutor and understand his point of view. Therefore, it is very important before marriage during the courtship period to get to know each other in more detail and find out your attitude to the main points of life together. A future marriage should be considered as a union necessary not only for the birth of children, but also for the development of the personality of each spouse. During the period of premarital acquaintance, boys and girls themselves must determine whether they are suitable for each other.

For a successful marriage, a number of factors can be identified that influence the harmony of life together: psychological, cultural, material.

The psychological factor determines the degree of correspondence between partners’ views on the elements of life together (character traits, strong-willed qualities, intelligence, leadership in the family).

Cultural factor determines the intellectual and cultural needs of spouses and depends on their educational level, profession, and leisure interests. It's good when a man and a woman unite common interests, Related physical culture(hiking, skiing, sports games, etc.). Active recreation relieves many problems. Rest in itself implies the absence of reasons for irritation and quarrels.

Material factor determines the contribution of each spouse to the creation of the family’s material base. In living together, the main thing can be considered the ability to understand and forgive your life partner, to see all his advantages and forgive his shortcomings.

The union of a man and a woman must satisfy not only biological needs, but also emotional, oral and intellectual needs. This creates the basis for a strong life together, helps to preserve and carry through life the feelings of first love, and ensure a happy life.

Questions for self-control:

What is reproductive health?

What is gender? Types of floor.

How are correct gender relationships formed?

What is family?

Sex education. A.G. Trushkin, V.V. Batashev. L.Yu. Trushkina and others. Rostov-on-Don. "Phoenix" 2001 S.310

Abramenkova V.V. Sexual differentiation and interpersonal relationships in a children's group. "Questions of Psychology" No. 5, 1987

Ageev V.S. Psychological and social functions of gender role stereotypes. “Questions of Psychology” No. 2, 1987

Aleshina Yu.E., Volovich A.S. Problems of mastering the roles of men and women. “Questions of Psychology” No. 4, 1991

Belkin A.I. Biological and social factors, forming sexual identification (according to a study of persons who have undergone gender reassignment. “The relationship between the biological and the social in a person.” Edited by Banshchikov V.M., Lomov B.F., M. 1975)

Human reproductive health is an indicator of the national security of the state.

In Russia, this problem is quite acute: birth rates are low. This indicates a decrease in the reproductive function of the population and lead to a demographic catastrophe.

What is reproductive health?

The definition of the international expert organization World Health Organization (WHO) states that reproductive health is complete well-being, social, physical and psychological in all matters related to reproductive function. WHO experts also believe that citizens who engage in sexual relations for the purpose of procreation must be guaranteed safety from infections that can be transmitted during intimate relations. The safety of pregnancy, childbirth, the well-being of the mother and the health of the baby, the ability to plan a pregnancy and prevent an unwanted one must be guaranteed.<./p>

What factors influence the reproductive health of the population?

The following factors influence the reproductive health of the population:

mental and somatic health of the population,
working conditions,
growth in number infectious diseases and HIV infection (AIDS),
increase in the incidence of tuberculosis,
alcoholism,
drug addiction and substance abuse.

What is the state of reproductive health of the Russian population?

Unfortunately, we have to admit that in Russia there are emerging negative trends in the state of reproductive health of the population in all regions.

Over the past ten years, the incidence has increased by only ten percent, but the number of chronic diseases has increased. The structure of morbidity has changed: there is a tendency towards an increase in the incidence of tuberculosis, sexually transmitted diseases, HIV infection(AIDS).

One and a half million Russian women work in unsatisfactory conditions, in difficult, dirty industries. Yes, and men are not in better conditions. And hence - infertility, miscarriages and spontaneous abortions, male infertility and the birth of children with congenital malformations, mentally handicapped.

What about alcoholism, drug addiction and substance abuse in adolescence? As a reproductologist from Nizhny Novgorod, Tver and the Far East states, the problems of adolescents develop into problems of pregnant women and those wishing to become pregnant.

Let's analyze the health status of pregnant women. Over ten years, the number of anemia in pregnant women has increased by 10%, and the number of late toxicoses of pregnancy has increased by 40%. Normal births are becoming rare; as one of the reproductive specialists in Nizhny Novgorod testifies, there are only a third of them. The level of births of immature and premature children is high.

Reproductologists in Nizhny Novgorod, Moscow, Khabarovsk and other cities note that there are a number of factors that prevent reproductive health from being maintained. This:

excessively early onset of active sexual activity,
sexually transmitted diseases and infections that are transmitted sexually,
violations hormonal balance
genetic diseases,
poor quality poor nutrition,
environmental pollution,
harmful addictions, both men and women,
low level educational work with the population,
inability to plan pregnancy and inability to use hormonal contraceptives.

How to preserve the reproductive health of the nation?

The regulations adopted by the state declare a person’s right to continue their kind. The following measures have been taken in this area;

free health care,
prevention of pathology of the reproductive system,
mandatory medical preventive examinations,
improving the well-being of the population,
improving people's awareness.

A whole system of criteria has been created with which you can assess whether a person is capable of performing childbearing functions:

deterioration of somatic health,
changes in the study of biological materials and clinical trials,
disruption of organs and systems,
processing of statistical data on mortality and birth rates,
assessment of the condition of the reproductive organs.

How to plan a future family?

Reproductologists who work in rehabilitation centers for family reproductive function help plan the birth of a child. Reproductologists provide consultations in all major cities of Russia: Moscow, St. Petersburg, Nizhny Novgorod. What advice can you get for a family wanting to have a child?

To conceive, the following conditions are needed:

the optimal age for pregnancy and childbirth is from 19 to 35 years,
It is advisable to maintain an interval of about two and a half years between births,
if the future parents were sick infectious diseases, then you need to abstain from pregnancy for at least two months,
in spring and autumn, the likelihood of immune conflict and spontaneous mutations decreases, so it is advisable to plan the process of conception for this period,
if a woman works with harmful chemicals, two months before planned conception, contact with such substances should be avoided if possible,
future parents should stop drinking alcohol and smoking,
in the presence of chronic pathology, pregnancy is possible with stable remission for five years.

There are also contraindications to conceiving a child:

recurrent miscarriage, stillbirth, birth of children with congenital defects or hereditary pathology,
hereditary diseases spouses or immediate relatives,
availability of information about the possible impact mutagenic factors,
incurable pathology of the reproductive organs in the expectant mother,
woman's age over 35 years.

How to form adequate reproductive behavior of adolescents?

It is worth emphasizing that WHO experts consider adolescence to be from 10 to 19 years. In older adolescence, there are all the physiological prerequisites for the implementation of childbearing or reproductive function. Modern young people are characterized by pronounced sexual hyperactivity with all the consequences: sexually transmitted infections, unplanned pregnancy. They have every right to their intimate life However, they must be informed both about the consequences of their behavior and about the responsibility in the event of pregnancy or a partner becoming infected with infectious diseases that can be sexually transmitted.

Throughout the country, reproductive specialists provide effective support to people who wish to become parents. With their influence on society, reproductive health indicators can be significantly improved.

Start your path to happiness - right now!

Traditionally, population problems were studied within the framework of demographic science, but as a result of their long-term understanding by the international scientific and political community, this problem began to be interpreted more broadly, including medical and socio-psychological aspects. Health, as defined by the World Health Organization (WHO), is a state of complete physical, mental and social well-being, and not just the absence of disease or infirmity. At the same time, the concept of “health” is relatively conditional and is objectively established by a set of anthropometric, clinical, physiological and biochemical indicators, determined taking into account gender and age factors, as well as climatic and geographical conditions.

The most important component of this concept is reproductive health. According to the recommendations of the Program of Action of the International Conference on Population and Development (Cairo, 1994), reproductive health means not only the absence of diseases of the reproductive system, disorders of its functions and/or processes in it, but also a state of complete physical and social well-being. This means the possibility of a satisfied and safe sexual life, the ability to reproduce (have children) and independently decide on family planning issues. Provides the right of men and women to information about and access to safe, effective, affordable and acceptable methods of birth control that are consistent with the law. The possibility of access to appropriate health care services is affirmed, allowing a woman to safely undergo pregnancy and childbirth, creating optimal conditions for the birth of a healthy child. The concept of “reproductive health” also includes sexual health - a condition that allows a person to fully experience sexual desire and realize it, while receiving satisfaction.

This phenomenon is of particular interest to sociologists and social psychologists, since reproductive health is almost entirely determined by behavior - a long-standing object of both empirical and theoretical sociological and socio-psychological research. To specify the area of study, sexual and reproductive behavior is distinguished from the entire behavioral field. Of particular interest in this regard is the sexual and reproductive behavior of adolescents and young people, since behavioral patterns are formed during adolescence, many of which have an impact on health and life expectancy in the future.

The second interesting aspect of the problem is related to the concepts of “sexuality” and “reproduction” and the processes behind them.

Thus, today the issue of reproductive health of the population is of interest not only to doctors and psychologists, but also to sociologists. Adolescent sexuality, which has strong social determinants, deserves special attention. The importance of the problem of teenage sexuality cannot be underestimated, because this leads to serious and sometimes tragic consequences. Being extremely sensitive and long banned for discussion at any level, issues related to this problem have always worried teenagers, giving rise to myths, shame, and sometimes fear.

Based on the type of impact on reproductive health, two types of reproductive toxicity effects can be distinguished, which are the result of influence directly on male and female sexual function(fertility) and offspring development.

The first type of effects manifests itself in the form of such changes in male and female reproductive health as delayed sexual development, decreased fertility and libido, persistent disorders of the menstrual cycle and spermatogenesis, gynecological diseases, disruption of pregnancy (threatened abortion, spontaneous abortion, threat of premature birth, complications of the second half of pregnancy), childbirth and lactation, premature reproductive aging, etc.

The second type of effects includes disturbances in the normal development of the fetus, both before and after birth, due to adverse effects on either parent before conception or effects on the development of the offspring in the prenatal and postnatal period. These may be stillbirths, congenital malformations, morphogenetic malformations, low or high birth weight of the newborn, abnormal proportions of newborns, etc.

We will consider changes in individual indicators of the state of reproductive health under the influence of a polluted environment according to the physiological cycle - starting from the inability to conceive a child and ending with violations of the health of newborn children. Adverse changes in the reproductive health of children when parents and offspring are exposed to a polluted environment can appear quite early. The reproductive system in childhood and adolescence has high sensitivity to the influence of various environmental factors. The risk of reproductive health disorders in children and adolescents increases during critical periods of growth and development of the body and largely determines the usefulness of reproductive function. The pathogenesis of emerging disorders of this function is very complex.

Reproductive health

Reproductive health concept

According to WHO definition, reproductive health is a state of complete physical, mental and social well-being of the reproductive system, its functions and processes, including the reproduction of offspring and the harmony of psychosexual relationships in the family.

Reproductive health is influenced by many factors - medical, socio-economic, environmental, etc. The most important of them are:

Somatic and mental health;

Not healthy image the life of the child's parents;

Lack of hormonal contraception industry in Russia;

Deterioration in the health of newborn children;

Heavy physical exercise women in production;

Exposure to adverse chemical and physical factors environment;

Shrinking reality social guarantees;

Declining standard of living

Reproductive health – a system of measures to ensure the appearance of healthy offspring, prevention and treatment reproductive organs, protection against sexually transmitted diseases, family planning, prevention of maternal and infant mortality.

Protecting reproductive health is all the more important because the deterioration of reproductive health is reflected in medical and demographic indicators: fertility, infant mortality, morbidity in pregnant women, infertility in marriages, etc.

Family planning

According to the WHO definition, family planning is ensuring control of reproductive function for the birth of healthy and desired children.

Family planning – a set of medical, social and legal measures carried out with the aim of giving birth to desired children, regulating the intervals between pregnancies, controlling the timing of childbearing, and preventing unwanted pregnancies.

Family planning includes:

ü preparation for the desired pregnancy;

ü examination and treatment of infertile couples;

ü contraception.

Birth control - one of the most important tasks of the state, because Fertility ensures normal conditions for the existence of future generations.

The demographic situation in the Russian Federation in recent years has been characterized by a decline in the birth rate, the level of which over the past 10 years was the lowest in 1995 and amounted to 9.6 children per 1000 people. population. Remain high performance infant and perinatal mortality, maternal mortality. Unfavorable indicators of population reproduction are observed against the backdrop of deteriorating health status of pregnant women. Over the past 10 years, the incidence of anemia in pregnant women has increased more than 6 times, and the incidence of organ anemia has increased 4 times genitourinary system, 2 times – circulatory system and gestosis.

A consequence of the deteriorating health status of pregnant women is an increase in the number of births with various complications. The situation with HIV infection has sharply worsened, infertility is widespread, the level of reproductive culture of the population is low, and there is insufficient awareness of the population on family planning issues.

In order to improve the reproductive health of the population, the Decree of the Government of the Russian Federation of August 28, 1996 developed and approved a National Action Plan to improve the situation of women and increase their role in society. Order No. 355 of the Ministry of Health of the Russian Federation dated October 7, 1996 was issued, defining the measures, procedure and timing for the implementation of the National Action Plan.

In recent years, Russia has also adopted important legislative documents protecting the rights of women, families and defining the legal status of motherhood and childhood. For example, in order to reduce maternal mortality and the number of serious complications associated with late abortions, The Government of the Russian Federation adopted Resolution No. 567 dated May 8, 1996, which defined a list of social indications for late termination of pregnancy. The adoption of the above order is aimed at reducing the number of criminal interventions, preserving the health and saving the lives of women.

Family planning is one of the most important health problems for the entire state as a whole. The solution to this problem is aimed at creating conditions for the birth of healthy and desired children, protecting the reproductive health of the population and thereby preserving the gene pool of the nation. Family planning concerns every person, but is essentially a problem of the country's national security, since it is directly related to the health of future generations. Therefore, by the Decree of the President of the Russian Federation dated August 18, 1994, the federal target programs “Family Planning” and “Safe Motherhood” were approved as part of the “Children of Russia” program, which is aimed at ensuring the birth of desired and healthy children, preventing child and maternal morbidity, and reducing mortality .

As part of the implementation of the federal Family Planning program, a family planning service has been created in the country. Currently, there are approximately 200 regional centers for family planning and reproduction in Russia. They are faced with the task of changing the current practice of achieving the desired number of children in a family, using contraception, rather than abortion, which harms the reproductive health of women. In addition, the tasks of the centers include explanatory work regarding the optimal age for having children.

Public organizations play an important role in the implementation of the Family Planning program: Russian Association“family planning”, which has 50 branches in the regions of the country; International Association "Family and Health"; Russian Society for Contraception.

The work of family planning services allows:

· reduce the frequency of unplanned pregnancies;

· achieve a reduction in many types of obstetric and gynecological pathology;

· reduce maternal and perinatal mortality.

But in the activities of family planning centers, many issues remain controversial, for example, the promotion of contraceptives among adolescents. In many cases, unfortunately, this activity, not to mention the moral side, leads to such undesirable consequences as growth venereal diseases among teenagers and an increase in teenage pregnancies.

Order of the Ministry of Health of the RSFSR dated November 15, 1991 No. 186 “On measures for the further development of gynecological care to the population” provides for the inclusion of workers social sphere to the family planning service, assigning them the functions of active patronage of women at risk, working with displaced persons, refugees, women on maternity leave, and women with antisocial behavior.

8.2.1. Preparing for the desired pregnancy

Preparing for the desired pregnancy is the main point in family planning. Spouses 2 months before the planned pregnancy should completely abandon bad habits(alcohol, smoking, drugs). The favorable age of the mother is 19-35 years. The interval between births should be at least 2-2.5 years and preferably no more than 5 years.

Conception is permissible no less than 2 months after the spouses have suffered an infectious disease. It is advisable to conceive in autumn and winter (the percentage of spontaneous mutations and the risk of immune conflict are reduced). In women suffering from chronic diseases, pregnancy is permissible, depending on the disease, only if there are no exacerbations for 1-5 years.

Pregnancy for workers exposed to adverse factors can be recommended only after 1-3 years of work in production, i.e. after the development of persistent adaptation.

Prevention of the onset of unwanted (unplanned) events

Pregnancy.

In preventing unplanned pregnancy, the use of various methods of contraception by partners is of great importance, which allows avoiding induced abortion. The contraceptive method is selected taking into account medical indications and contraindications, as well as taking into account the living conditions of the family.

There are several methods of contraception:

1. mechanical contraceptives - the most common are condoms, or male condoms. Women use vaginal diaphragms and cervical caps, which are inserted before sexual intercourse. Proved them preventive role regarding sexually transmitted diseases, including HIV infection;

2. chemical , or spermicidal contraceptives - creams, pastes, powders, suppositories, aerosols, etc. The mechanism of action of these contraceptives is based on the spermotoxic effect;

3. physiological method , or rhythm method - is based on the physiological sterility of women at the beginning and end of the menstrual cycle. But this method is not recommended in case of emotional or physical overload, climate change, irregular cycle and after abortions;

4. intrauterine contraception- most common in our country (VMK). Intrauterine contraceptives are highly effective (97%), do not affect the body, are easy to use, and are available to anyone. social groups, they can be used long-term and continuously. There are two types of VMC: 1) inert (not containing chemicals) and 2) medicinal. Among the inert ones, an intrauterine contraceptive made of polyethylene, shaped like a double letter S, has become widespread. The size is selected by the doctor, the duration of use is 2 years. Spirals made of copper wire are known among medications. Sometimes the spiral material contains silver in addition to copper. Duration of use is 3-5 years.

5. oral hormonal contraception– is currently considered the most effective, but it is contraindicated in diseases of the s.s.s., liver, diabetes mellitus etc. The most widely used are Logest, Novinet, Regulon, Mercilon, Marvelon, Trimercy, etc.

6. interrupted sexual intercourse- a common method of contraception. Unfortunately, this method disrupts the physiology of sexual intercourse and negatively affects female and male organisms;

7. surgical methods– sterilization of men and women, maintenance of subcutaneous implants providing contraception for up to 5 years.

The selection of contraceptives should be individual, and this should be done by a doctor.

It should be noted that the Church has a negative attitude towards contraception, considering interference in God’s Providence unacceptable, especially since contraceptives are essentially abortifacients, i.e. the use of contraceptives is tantamount to abortion, “since it destroys a life that has already begun.” The Church considers abstinence from sexual intercourse to be the only acceptable way to avoid pregnancy.

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An important point in such a concept as “human health” is precisely its reproductive health. It represents the absence of diseases of the reproductive system, as well as a state of both social and physical harmony of a person. In other words, human reproductive health is a full sexual life and the ability to reproduce offspring. Each person decides for himself when and how many children to have. However, having made this important life decision, many are faced with quite complex problems regarding lack of awareness of the most important factors own reproductive functions and ways to maintain them normal operation. Reproductive health also refers to sexual health, namely, the state that allows you to fully feel and realize your attraction to the opposite sex and receive satisfaction.

Malfunctions of the reproductive system:

Infertility is the inability of a man or woman to conceive a child even with regular unprotected sexual intercourse for about one year. The reasons for this disorder may be different for both female and male representatives.

Let's consider the main reasons for malfunctions of the male reproductive system.

Excretory failure of reproductive health or obstruction of the vas deferens. With this deviation, there is a failure in the release of sperm components into urethra through the genital canals. The disorder can be either permanent or intermittent.

A secretory failure of reproductive health, during which the production of seminal cells does not occur in the testicular canals, is often expressed in aspermia, when there are no spermatogenesis cells in the ejaculate; azoospermia, when sperm are absent, but spermatogenesis cells are present, and oligozoospermia, a deviation in which the structure and dynamics of sperm change.

The main causes of secretory failure of reproductive health in men:

testicular failure;

hormone disruptions. There is a lack of pituitary hormones, or more precisely, luteinizing and follicle-stimulating hormones. They are the ones involved in the production of sperm and testosterone;

autoimmune disorder. This deviation in reproductive health occurs when immune cells the body produces antibodies for sperm.

There are other reasons that affect men's reproductive health:

psychological: anejaculation or impaired sperm emission;

sexual: erectile dysfunction, failure of the ejaculation process;

neurological: the cause is spinal cord injury.

With secretory infertility, the most important point for restoring reproductive health is to eliminate the cause of its occurrence. Infectious diseases are treated, all inflammatory processes are suppressed, the patient is prescribed hormonal drugs to return spermatogenesis to normal. For diseases such as hernia groin area and cryptorchidism is applied surgical intervention. Surgical intervention is also prescribed in cases of infertility in men caused by obstruction of the vas deferens. The most difficult process in treating pathologies of reproductive health in men is treating a patient with impaired sperm movement. In this case, hormonal medications are prescribed, and laser therapy is widely used.

Causes of reproductive health failure in women:

cystomas; reproductive health secretory

hormonal disorders;

endometriosis;

consequences inflammatory processes, occurring in the pelvis;

uterine tumor or fibroids.

Methods for treating reproductive health disorders in women

The main point in the treatment of any type of reproductive health pathology is its correct diagnosis. At endocrine pathology, treatment of abnormalities in reproductive health is normalization hormonal levels and application medicines stimulating the work of the ovaries. If the patient is diagnosed with tubal obstruction or endometriosis, laporoscopy is used. In case of defects in the functioning of the uterus, reconstructive surgery methods are used to restore reproductive health in this type of infertility. The immune cause of infertility can be eliminated through artificial insemination with the husband's sperm.

Doctors say that every person’s caring attitude towards their body, as well as ways to prevent deviations, are the basic rules for maintaining reproductive health! Awareness and a smart approach help to avoid a number of pathologies and diseases that subsequently affect the ability to conceive. If the problem of infertility exists, it must be diagnosed and eliminated in time. In this way, reproductive health problems can be minimized. The awareness of future fathers and mothers and their readiness to conceive a child will contribute to an easy pregnancy process, and as a result, the appearance of a healthy baby.

Prevention of reproductive health disorders among schoolgirls

In contrast to traditional preventive technologies for educational institutions, aimed at preventing schoolchildren from visual impairment, posture, neuro-mental health and other “school diseases”, the proposal of this program is dictated by the predominantly unfavorable socio-demographic situation in society, which can be characterized as follows .

For almost 10 years now, there has been no natural population growth in the country, which is due to a significant decrease in the birth rate, an increase in the number of deaths, including infancy. The demographic crisis is aggravated by the increase in obstetric and gynecological diseases among pregnant women and women in labor, as well as the high prevalence of chronic diseases among modern schoolgirls (up to 75%), which threatens the reproductive capabilities of the younger generation of women.

Medical and sociological studies indicate a younger age at the onset of sexual activity and insufficient physiological and hygienic literacy of young people in this area. Thus, according to data carried out by the Research Institute of Hygiene and Health Protection of Children and Adolescents in 1997-1998. a survey of about 5,000 city schoolgirls and students of vocational schools (vocational schools) aged 15-17 years old, it was found that 90% of those surveyed had never consulted a gynecologist, despite the fact that 35% of vocational school students and 25% of schoolgirls considered it possible for themselves to join sexual activity before 16 years of age.

Screening examinations of the state of menstrual function in schoolgirls of modern educational institutions reveal the presence of an unformed menstrual cycle in a third of them with a “experience” of menstruation of 3 or more years. In new types of educational institutions (gymnasiums, lyceums, specialized schools), an even greater prevalence of this disorder has been revealed.

It is known that the gynecological service in the country is focused primarily on adult women, who actively seek the necessary gynecological care. Teenage girls are not as active as they are due to age psychological characteristics(bashfulness, fear of exposing the loss of virginity, etc.), and because their lack of physiological literacy makes it difficult to objectively assess those changes in the body that occur during puberty and have prognostic significance for the formation of reproductive capabilities. In particular, the inability of the majority of high school girls to correctly assess the state of their menstrual function, the fundamental basis of their reproductive health, has been established. The most common mistakes were incorrect calculation of the duration of the menstrual cycle (from the end of the previous to the beginning of the next menstruation, instead of counting from the beginning of the previous to the beginning of the next menstruation), recognition of short (less than 3 days) periods as normal, and skepticism about keeping a calendar menstruation, etc.

According to the latest data, menstrual dysfunction in adolescent girls is business card the presence of a complex of somatic disorders and diseases.

Literature

1. Bardakova L.I. Reproductive rights and reproductive health in the light of the implementation of the Program of Action of the International Conference in Cairo // Population. - 2004.

2. Gaplicnik T.I. Reproductive sexual behavior, motives, attitudes of adolescents and youth // Sociology, - 1999.

3. German I. Deterioration of reproductive health - the price of sexual ignorance of youth / I. German.

4. Dmitrieva E.V. From the sociology of medicine to the sociology of health // Sociological Research, - 2003.

5. Kulakov V. I. Reproductive health in the Russian Federation / Vladimir I. Kulakov, Olga G. Frolova // Population. - 2004.

6. Leonova T. A. Prevention of reproductive health disorders in children and adolescents / T. A. Leonova // Healthy life. - 2004.

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Lectures on reproductive health and healthy lifestyle. Reproductive health - what is it? Factors influencing human reproductive health

What is reproductive health?

What is the state of reproductive health of the Russian population?

How to preserve the reproductive health of the nation?

How to plan a future family?

How to form adequate reproductive behavior of adolescents?

Reproductive health

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