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BiologyCh 3 Reproductive Health

Reproductive Health: Class 12 Biology Chapter 3 Hinglish mein

Biology · Hinglish notes, simulations aur practice · Official NCERT chapter PDF ↗

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  • 60 min
  • 1 simulation
  • 17 practice questions
  • 18 MCQs

Is chapter mein aap kya seekhenge

  • Samjhao ki reproductive health ka matlab kya hai, aur use behtar banane ki India ki strategies batao, jismein prenatal sex determination par ban bhi shaamil hai
  • Samjhao ki India ki population itni tezi se kyun badhi, aur birth, death aur growth rates, doubling time, IMR aur MMR calculate karo
  • Ek ideal contraceptive ki qualities batao, aur samjhao ki natural, barrier, intra-uterine, hormonal aur surgical methods pregnancy ko kaise rokte hain
  • Medical termination of pregnancy ke baare mein batao: iski zaroorat kab padti hai, timing kyun matter karti hai, aur India ke MTP law ke main provisions kya hain
  • Common sexually transmitted infections ke naam unke causes, failne ke routes aur complications ke saath batao, aur unse bachne ke tareeke list karo
  • Infertility define karo aur samjhao ki IVF–ET, ZIFT, IUT, GIFT, ICSI aur AI/IUI couples ko bachche paane mein kaise madad karte hain

NCERT Biology Class 12, Chapter 3, pp. 41–50 par based original companion text. Yeh NCERT se juda nahi hai aur NCERT ne ise endorse nahi kiya hai.

Doctors kisi heart ko sirf isliye healthy nahi kehte ki woh dhadak raha hai; woh yeh bhi dekhte hain ki woh daily life ko kitni achhi tarah sambhalta hai. Reproduction ko bhi aisi hi badi nazar se dekhna chahiye. Socho ek ladki har mahine school chhod deti hai kyunki kisi ne use periods ke baare mein samjhaya hi nahi. Ya ek family jo labour shuru hone par hospital tak nahi pahunch paati, ya ek teenager jo infections failne ke baare mein kisi afwaah par bharosa kar leta hai. Unke reproductive organs bilkul normal ho sakte hain, phir bhi kuch zaroori cheez missing hai.

Isliye World Health Organization (WHO) reproductive health (जनन स्वास्थ्य) ko broadly define karta hai: reproduction se jude har maamle mein well-being, physical, emotional, behavioural aur social, aur sirf bimaari se aazaadi nahi. Practice mein do cheezein saath chalni chahiye: aise bodies jinke reproductive organs theek se kaam karein, aur aise relationships jo safety, respect aur sahi knowledge par bane hon.

Definition
Reproductive health

Reproduction se jude sabhi maamlon mein physical, emotional, behavioural aur social well-being, sirf kisi disease ya disorder ka na hona nahi.

ExampleEk teenager jo puberty ke changes samajhta hai, menstrual problem ke liye madad le sakta hai aur bina dar ke na keh sakta hai, woh ek reproductively healthy society ka hissa hai.

  • Physical: reproductive organs jo normally develop hon aur kaam karein, safe pregnancy aur childbirth, infection se aazaadi.
  • Emotional: adolescence ke changes ke saath comfortable rehna, bina dar, guilt ya sharm ke.
  • Behavioural: soch-samajh kar, responsible choices lena, jismein na kehne ki choice bhi shaamil hai.
  • Social: ek doosre ki respect, ladkiyon aur ladkon ki baraabar value, aur abuse aur exploitation se protection.

Yeh chapter dikhata hai ki India is goal ki taraf kaise kaam karta hai. Shuru mein national strategies (Section 3.1) aur population growth aur birth control ke methods (Section 3.2) hain. Phir hum pregnancy ke legal termination (Section 3.3), sexual contact se failne wale infections (Section 3.4) aur un couples ki madad par aate hain jo conceive nahi kar paate (Section 3.5).

3.1 Reproductive Health – Problems aur Strategies

Aaj India mein is area ka kaam Reproductive and Child Health (RCH) programme ke roop mein chalta hai, jo National Health Mission ka hissa hai. Iski jadein 1951–52 tak jaati hain, jab India apne First Five-Year Plan mein national family planning programme shuru karne wale duniya ke sabse pehle deshon mein se ek bana. Dashakon ke saath focus sirf birth control se badhkar mothers aur children ki health tak pahuncha, aur RCH naam 1997 mein apnaya gaya.

Yeh programme teen tarah ki koshishon par tika hai jo ek doosre ko support karti hain (Fig. 3.1): sahi information failana, aisi services dena jahan tak log sach mein pahunch sakein, aur research jo dono ko lagataar behtar banati rahe.

4/4Saath milkar yeh maternal aur infant deaths kam karte hain, chhoti families ko badhawa dete hain aur infections ko jaldi pakad lete hain.

Fig. 3.1RCH approach: information, services aur research milkar reproductive health ko behtar banate hain.

Teen rangeen boxes aamne-saamne khade hain. Pehle step mein Awareness box highlight hota hai, jismein media aur schools, counselling aur couples likhe hain; baaki do faded hain. Doosre step mein Services box highlight hota hai, jismein clinics aur staff, safe deliveries, aur laws aur vaccines likhe hain. Teesre step mein Research box highlight hota hai, jismein naye methods aur behtar treatments likhe hain. Aakhri step mein teeno boxes dikhte hain aur unse arrows chaar outcome panels tak jaate hain: kam mothers ki maut, kam infants ki maut, chhoti families, aur STIs jaldi pakde gaye.

Awareness. Kai reproductive-health problems chuppi ya myths se shuru hoti hain. Young log badalte body ke baare mein apne sawaal aksar pehle dosto, parents, rishtedaaron ya teachers ke paas le jaate hain, isliye un logon ke paas bhi sahi jawaab hone chahiye. Schools umar ke hisaab se sexuality education de sakte hain, taaki facts afwaahon se pehle pahunch jaayein. Bade level par government aur voluntary agencies radio, television, print aur social media par campaigns chalati hain. Logon ko kya jaanna chahiye, yeh unki life ki stage par depend karta hai:

  • Adolescents: reproductive organs kaise develop hote hain aur kaam karte hain, puberty ke changes, menstrual hygiene, consent, aur HIV jaise infections kaise failte hain aur unse kaise bacha ja sakta hai.
  • Couples aur jinki shaadi hone wali hai: breastfeeding kyun zaroori hai, pregnancy ke dauraan aur childbirth ke baad healthy kaise rahein, kaun se methods births mein gap ya limit rakh sakte hain, aur kyun beti bhi bilkul bete jitni care ki haqdaar hai.
  • Poori community: sexual abuse aur doosre sex-related crimes ko kaise pehchaanein, rokein aur report karein, aur tez population growth ki society ko kya keemat chukaani padti hai.

Services. Information ka zyada fayda nahi agar sabse paas ka clinic ek din ki doori par ho. Isliye doosri strategy hai health centres aur hospitals banana jinmein trained staff, equipment aur medicines aur contraceptives ka bharosemand stock ho, jo childbirth, family planning, safe abortion, infections, menstrual disorders aur infertility sambhalne ke liye taiyaar hon. Har bachche ka immunisation bhi isi mein aata hai, aur woh laws bhi jo ladkiyon ko janm se pehle hi protect karte hain. Jaise-jaise behtar techniques aati hain, services ko unhe apnaate rehna padta hai.

Amniocentesis aur sex selection par ban

Amniocentesis (उल्ववेधन) ek prenatal test hai jo aam taur par pregnancy ke 15th week ke baad kiya jaata hai. Ultrasound screen par dekhte hue doctor ek patli needle maa ke abdomen se andar le jaata hai aur foetus ke aas-paas ke amniotic fluid ka chhota sa sample (lagbhag 15–20 mL) nikaalta hai (Fig. 3.2). Is fluid mein foetus se jhade cells aur kai ghule hue substances hote hain. Sample ke chromosomes, DNA aur chemistry ko study karke Down syndrome (ek extra chromosome 21), haemophilia aur sickle-cell anaemia jaise genetic disorders ka pata chal sakta hai. Isse doctors ko yeh bhi pata chalta hai ki foetus kitni achhi tarah develop hoga.

3/4Fluid se mile foetal cells check kiye jaate hain: chromosome 21 ki teen copies ka matlab hai Down syndrome.

Fig. 3.2Amniocentesis mein genetic disorders dhoondhne ke liye foetus ke aas-paas ke fluid ka chhota sa sample liya jaata hai.NCERT 3.1 · p. 42

Pregnant uterus ka side view, jismein muda hua foetus amniotic fluid mein tair raha hai aur placenta upper wall par hai. Pehle step mein amniotic fluid, foetus aur placenta label kiye gaye hain. Doosre step mein ek ultrasound probe abdomen par rakha hai aur ek syringe needle upar se, foetus se door, andar jaati hai, aur barrel mein thoda fluid bhar jaata hai. Teesre step mein ek panel chromosome check dikhata hai: do normal pairs aur ek chhote chromosome ki teen copies, jin par extra 21 likha hai. Aakhri step mein doosre panel par likha hai Sex test: banned by law, saath mein prohibition sign.

Yahi cells yeh bhi dikhate hain ki foetus male hai ya female, aur yahin is test ka galat use hua. Jin families mein beton ko pasand kiya jaata tha, wahan female foetuses ko pehchaan kar abort kiya gaya, aur kai districts mein paida hone wali ladkiyon ki sankhya bahut gir gayi. Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act, 1994 (2003 mein aur sakht kiya gaya) foetus ka sex pata karne ya batane ke liye koi bhi test use karna crime banata hai. Disorders detect karne ke liye amniocentesis legal hai.

Hum kaise pakka kar sakte hain ki missing ladkiyan logon ka kiya-dhara hai, chance ka nahi? Nature ladkiyon se thode zyada ladke paida karti hai: har 100 ladkiyon par lagbhag 105 ladke, yaani har 1000 ladkon par lagbhag 950 ladkiyan. 2011 census ne 0–6 saal ke bachchon mein har 1000 ladkon par sirf lagbhag 918 ladkiyan ginin. Neeche ka simulation try karo aur dekho ki kya sirf chance itna bada gap bana sakta hai.

SimulationKya chance missing ladkiyon ko explain kar sakta hai?

Ek spinner jo 105 aur 100 ke ratio mein boy sector aur girl sector mein bata hai. Buttons ek baar mein 10, 100, 1000 ya 10000 births chalate hain, kul 100000 tak. Ek line chart count badhne ke saath girls wale births ka share track karta hai, lagbhag 0.488 ki theoretical value ke against, jo har 1000 ladkon par lagbhag 952 ladkiyon ke barabar hai.

Fig. 3.3Har spin ek birth hai, nature ke odds ke saath, lagbhag 105 ladke har 100 ladkiyon par. Births ko batches mein chalao aur ladkiyon ka share dekho.
Try karo
  • 10 ko kuch baar dabao. Chhote samples mein ladkiyon ka share kitna upar-neeche hota hai?
  • 10 000 births tak chalao. Kya share 0.488 ke aas-paas tik jaata hai, yaani har 1000 ladkon par lagbhag 952 ladkiyan?
  • 0.479 ka share matlab har 1000 ladkon par 918 ladkiyan. 100 000 births tak chalate raho: kya tumhara share kabhi itna neeche girta hai?

Laakhon births ke saath chance ratio ko 918 tak neeche nahi kheench sakta. Yeh kami sex-selective abortion aur betiyon ko kam care milne ka nateeja hai, aur isi wajah se law aur awareness campaigns dono ko target karte hain.

Progress kaise naapein

Hum kaise jaanein ki kisi society ki reproductive health behtar ho rahi hai ya nahi? Health surveys numbers track karte hain: kitni mothers aur babies ki maut hoti hai, kitne births trained staff wale hospitals mein hote hain, kitne couples apni pasand ka method use karte hain aur family chhoti rakhte hain, infections kitni jaldi pakde aur theek kiye jaate hain, aur logon ko kitna pata hai. Pehle do sabse zyada quote kiye jaate hain.

Definition
Maternal mortality ratio (MMR)

Har 100 000 live births par un auraton ki sankhya jinki maut pregnancy ya childbirth se jude kaarano se hoti hai (pregnancy ke dauraan ya uske khatam hone ke 42 din ke andar). Tumhari textbook ise maternal mortality rate kehti hai.

ExampleIndia ka MMR 1990 ke aas-paas lagbhag 550 se girkar 2018–20 tak 100 se neeche aa gaya.

Definition
Infant mortality rate (IMR)

Ek saal mein har 1000 live births par un babies ki sankhya jinki maut unke pehle birthday se pehle ho jaati hai.

ExampleIndia ka IMR 1990 mein lagbhag 80 aur 2020 mein lagbhag 28 tha.

Example

Ek district ki health report padhna

Ek saal mein ek district 40 000 live births record karta hai. Usi saal 1120 babies apne pehle birthday se pehle mar jaate hain, aur 38 auraton ki maut pregnancy ya childbirth se jude kaarano se hoti hai. District ka IMR aur MMR nikaalo.

Pehle khud try karo. Phir solution ek-ek step karke kholo.

Quick check
4 mein se 1
Ek doctor pregnancy ke 16th week mein amniocentesis suggest karta hai. India mein test ka kaun sa use illegal hai?
Answer dekho

Answer (A) Parents ko batana ki foetus ladka hai ya ladki

Sex-selective abortion rokne ke liye foetus ka sex batana banned hai. Down syndrome ya sickle-cell anaemia jaise genetic disorders ki screening hi test ka sahi purpose hai.

3.2 Population Stabilisation aur Birth Control

1900 mein duniya mein lagbhag 1.6 billion log the. 2000 tak lagbhag 6.1 billion ho gaye, aur United Nations ne November 2022 mein eight-billionth insaan ke aane ko mark kiya. India ne bhi yahi tez curve follow kiya. Aazaadi ke baad ke pehle census (1951) ne 361 million log gine aur 2011 census ne 1.21 billion; UN estimates ke hisaab se 2023 tak India China ko peeche chhodkar duniya ka sabse zyada population wala desh ban gaya.

Kya badla? Twentieth century mein vaccines, antibiotics, safe paani aur bharosemand food supply ne death rate ko tezi se gira diya, aur bahut kam mothers aur infants ki maut hui (girta MMR aur IMR). Birth rates bahut dheere gire. Zyada bachche bade hokar adult bane, isliye reproductive age wale logon ki har nayi generation pichhli se badi thi (Fig. 3.4).

4/4Phir bhi har dashak mein judne wali sankhya badhti rahi, lagbhag 182 million tak, kyunki base ab bahut bada hai.

Fig. 3.4Har census par India ki population. 1970s se percentage growth giri hai, lekin har dashak mein judne wale logon ki sankhya nahi giri.

Har census par India ki population (millions mein) ka bar chart. Pehle step mein 1951, 1961 aur 1971 ke bars 361, 439 aur 548 million dikhate hain. Doosre step mein 1981, 1991, 2001 aur 2011 ke bars judte hain, jo 683, 846, 1029 aur 1211 million tak pahunchte hain. Teesre step mein years ke neeche ek row har dashak ka percentage rise deti hai: 22, 25, 25, 24, 22 aur 18 per cent. Aakhri step mein us row ki jagah har dashak mein jude millions aa jaate hain: 78, 109, 135, 163, 182 aur 182.

Demographers growth ko har saal per 1000 logon par births minus deaths ke roop mein naapte hain. 1950s ki shuruaat mein India mein per 1000 lagbhag 42 births aur 23 deaths the, yaani growth rate lagbhag 2 % per saal. 2011 tak births girkar lagbhag 22 aur deaths lagbhag 7 per 1000 ho gaye. Growth dheemi hui, phir bhi census ne 2001–11 mein 17.7 % rise record kiya, yaani lagbhag 1.6 % per saal. Yeh chhota lagta hai, lekin growth compound hoti hai: 1.6 % per saal par population lagbhag 44 saal mein double ho jaati hai.

Is dheemi rate ne bhi ek dashak mein lagbhag 182 million log jod diye, jo kuch gine-chune deshon ko chhodkar baaki har desh ki poori population se zyada hai. Har ek ko khaana, paani, ghar, schooling, health care aur kaam chahiye. 1951 se farms, schools aur hospitals bahut badhe hain, lekin har saal lagbhag do crore extra logon ka intezaam in sab systems par bhaari padta hai.

Example

Growth rate aur doubling time

20 lakh (2 000 000) logon wala ek district ek saal mein 38 000 births aur 12 000 deaths record karta hai. Migration ko ignore karke uska birth rate, death rate aur growth rate nikaalo, aur estimate karo ki agar yeh rates same rahein to population double hone mein kitna time lagega.

Pehle khud try karo. Phir solution ek-ek step karke kholo.

InteractivePopulation growth explorer

Do sliders birth rate aur death rate set karte hain, per 1000 log per saal births aur deaths mein. Ek graph 100 million se shuru hokar 100 saal tak population dikhata hai, saath mein ek dashed no-growth line aur har doubling ko mark karte orange dots. Readouts growth rate (per cent per saal), doubling time, aur 25 aur 100 saal baad ki population dete hain. Preset buttons early 1950s, 2011 aur 2020 ke India ke approximate rates load karte hain, aur ek case jismein births deaths ke barabar hain. Ek message batata hai ki population tezi se badh rahi hai, dheere badh rahi hai, same level par hai ya ghat rahi hai.

Fig. 3.5Birth aur death rates set karo aur dekho ki 100 million ki population ek century mein kitni tezi se badhti hai. Presets 1950s, 2011 aur 2020 ke India ke approximate rates load karte hain.

Achhi khabar bhi hai. India ka total fertility rate (TFR) early 1950s mein lagbhag 6 bachche per woman se girkar 2019–21 ke National Family Health Survey mein 2.0 ho gaya. Yeh lagbhag 2.1 ke replacement level se thoda neeche hai, jis par har generation bas khud ko replace karti hai. Population kuch aur dashakon tak badhti rahegi, kyunki aaj young adults ki bahut badi generation ab bachche paida kar rahi hai, lekin yeh stabilisation ki taraf badh rahi hai.

Kai measures saath mein kaam karte hain. Law shaadi ki minimum age auraton ke liye 18 aur mardon ke liye 21 saal fix karta hai (Prohibition of Child Marriage Act, 2006), jisse pehla bachcha der se hota hai aur young mothers protect hoti hain. Chhoti families wale couples ko kabhi-kabhi incentives diye gaye hain, aur lambe public campaigns ne chhoti family ko social norm bana diya hai; shehron mein zyada se zyada couples ek bachche par ruk jaate hain. Sabse badhkar, har couple ko utne bachche, jab woh chahein, paane ka mauka hona chahiye, aur iska matlab hai birth control ke baare mein jaanna aur use paana aasaan banana.

Ek achha contraceptive kaisa hota hai?

Contraceptive (गर्भनिरोधक) koi bhi method, device ya medicine hai jo pregnancy rokne ke liye use hoti hai. Socho tum ek perfect contraceptive design kar rahe ho. Use yeh sab karna hoga:

  • bharosemand tarah se kaam kare;
  • safe ho, kam ya bilkul side-effects na hon;
  • use karne mein aasaan aur aasaani se mile;
  • reversible ho, taaki band karte hi fertility wapas aa jaaye;
  • sexual desire aur intercourse par koi asar na daale.

Koi bhi method har baat par perfect score nahi karta, isiliye itne saare methods hain. Yeh saat families mein aate hain: natural (traditional) methods, barriers, intra-uterine devices, oral pills, injectables, implants aur surgical methods. Har family gametes se pregnancy tak jaane wali chain ko alag kadi par todti hai (Fig. 3.6).

5/6Pills, injectables aur implants ovulation rokte hain, cervical mucus gaadha karte hain aur implantation mein rukawat daalte hain.

Fig. 3.6Contraceptives ki har family gametes se pregnancy tak ki chain kahan todti hai.

Boxes pregnancy tak ka safar dikhate hain: testes se vas deferens, sperm vagina aur cervix mein, phir uterus aur fallopian tube, jahan ovaries se ovum aata hai, aur ek curved arrow embryo ko uterus mein implant hone ke liye wapas aate dikhata hai. Pehle step mein sirf safar dikhta hai. Natural-methods step mein sperm aur ovum arrows par stop signs hain. Barrier step mein ek bar aur stop sign cervix se uterus ka raasta rokte hain. IUD step mein uterus mein tube ki taraf jaate raaste par aur implantation arrow par stop signs hain. Hormones step mein stop signs ovulation, cervix aur implantation ko mark karte hain. Surgery step mein vas deferens aur tube par cut marks aate hain, jin par vasectomy aur tubectomy likha hai.

Natural methods

Natural methods sirf timing aur behaviour par tike hain; koi medicine ya device nahi lagti.

Periodic abstinence. Ovum release hone ke baad sirf lagbhag ek din tak fertilise ho sakta hai, jabki sperm female tract mein kuch din zinda reh sakte hain. Regular 28-day cycle mein ovulation day 14 ke aas-paas hota hai, isliye conception ka chance lagbhag day 10 se day 17 tak sabse zyada hota hai, yahi fertile period hai. Yeh method use karne wale couples in dinon intercourse se bachte hain (Fig. 3.7).

3/3Sperm kuch din zinda rehte hain aur ovum lagbhag ek din, isliye days 10–17 mein conception ka chance sabse zyada hota hai.

Fig. 3.7Regular 28-day cycle mein fertile period lagbhag day 10 se day 17 tak hota hai. Asli cycles mein dates har mahine khisakti rehti hain.

Chaudah-chaudah ki do rows mein athaais numbered day boxes. Pehle step mein days 1 se 5 shaded hain aur un par period likha hai. Doosre step mein day 14 ke upar ek ovum symbol aata hai, jis par ovulation likha hai. Teesre step mein days 10 se 17 alag rang mein shaded hain, dono rows ke neeche brackets hain aur label hai fertile period: days 10 to 17.

Withdrawal (coitus interruptus). Aadmi ejaculate karne se pehle bahar nikaal leta hai, taaki semen vagina ke bahar release ho.

Lactational amenorrhoea (breastfeeding ke dauraan periods ka na aana). Jo nayi maa din-raat apne baby ko sirf breast milk pilaati hai, usmein aam taur par ovulation nahi hota, kyunki intense breastfeeding ke hormones cycle ko roke rakhte hain. Doctors is par sirf tab tak bharosa karte hain jab tak teen conditions poori hon: baby chhe mahine se chhota ho, use koi aur khaana na mile, aur maa ke periods wapas na aaye hon.

Natural methods free hain aur health ke liye inmein lagbhag koi risk nahi hai. Inmein kami hai bharose ki: cycles badalte rehte hain, ovulation ka exact din pakadna mushkil hai, aur withdrawal mein har baar perfect timing chahiye, isliye pregnancies aksar ho jaati hain.

Barrier methods

Barrier methods sperm ko physically rokte hain. Sabse jaana-maana condom hai, aur iska ek aisa fayda hai jo koi aur contraceptive nahi deta: har baar sahi tarah use karne par yeh sexually transmitted infections, HIV samet, ka risk bhi bahut kam kar deta hai. Isi double protection ki wajah se iska use badhta ja raha hai. Male condom ek patli latex sheath hai jo erect penis par chadhaayi jaati hai; female condom ek soft pouch hai jo vagina ki lining banata hai aur cervix ko dhak leta hai. Dono tarah semen andar hi phans jaata hai.

Condoms saste hain, inke liye prescription nahi chahiye aur ek baar use ke baad phenk diye jaate hain, aur kyunki log inhe khud lagaate hain, inka use private rehta hai. India mein government lambe samay se Nirodh naam se free male condoms baant rahi hai.

Spermicides, yaani creams, jellies ya foams jo sperm ko maar dete hain, par akele shayad hi bharosa kiya jaata hai. Inhe rubber devices ke saath use kiya jaata hai jo aurat intercourse se pehle apne cervix par lagaati hai: dome-shaped diaphragm, ya chhote cervical cap aur vault. Saath milkar yeh sperm ko uterus se bahar rakhte hain, aur rubber device ko dhokar dobara use kiya ja sakta hai.

Intra-uterine devices (IUDs)

Intra-uterine device (IUD) ek chhota plastic device hai jise doctor ya trained nurse vagina aur cervix ke raaste uterus ke andar lagaate hain. Yeh un auraton ke liye sahi hai jo pehli pregnancy delay karna chahti hain ya bachchon mein gap rakhna chahti hain: ek baar lagaane par yeh saalon kaam karta hai, aur nikaalne ke kuch hi samay baad fertility wapas aa jaati hai. Iske teen types hain:

  • Non-medicated IUDs, jaise Lippes loop, jo sirf plastic ke bane hote hain aur ab zyaadatar replace ho chuke hain.
  • Copper-releasing IUDs, jaise CuT, Cu7 aur Multiload 375. India ka programme mainly Cu-T 380A use karta hai, jo 10 saal tak lagi reh sakti hai, aur Cu-T 375, jo 5 saal tak.
  • Hormone-releasing IUDs, jaise Progestasert aur LNG-20, jo dheere-dheere ek progestogen release karte hain.

Ek chhota sa device pregnancy kaise rokta hai (Fig. 3.8)? Iski maujoodgi uterus mein ek halka reaction shuru karti hai, aur wahan jama hue extra phagocytes sperm ko nigal lete hain. Copper ek chemical effect jodta hai: iske release kiye copper ions sperm ko sust bana dete hain aur unki ovum ko fertilise karne ki taakat kam kar dete hain. Hormone IUD apne progestogen se kaam karta hai, jo cervical mucus ko ek gaadhi barrier bana deta hai aur uterine lining ko embryo ke liye taiyaar nahi hone deta.

2/3Copper ions sperm ko dheema karte hain aur unki fertilise karne ki power ghatate hain, aur phagocytes unhe nigal lete hain.

Fig. 3.8IUD pregnancy kaise rokta hai.NCERT Fig. 3.2 · p. 44

Uterus ka front view, jiske upar ke kono par chhoti fallopian tubes aur neeche cervix hai. Cavity mein ek T-shaped device hai jiske stem par copper coil lipti hai aur do threads cervix se neeche latak rahe hain. Pehle step mein copper T, uterus, cervix aur threads label kiye gaye hain. Doosre step mein coil ke chaaron taraf copper ion dots hain, do sperm par slowed likha hai, aur ek phagocyte ek sperm ko nigal raha hai. Teesre step mein coil gayab ho jaati hai, device par hormone IUD likha hai, cervical canal mein gaadhe mucus ka plug bhara hai aur uterine lining ko implantation ke liye unfit dikhane ke liye highlight kiya gaya hai.

IUDs government health centres mein free milte hain, aur copper IUD childbirth ke kuch hi samay baad bhi lagaaya ja sakta hai.

Pills, injectables aur implants

Pill ek roz ki tablet hai jismein hormone ki chhoti dose hoti hai: sirf progestogen, ya progestogen–estrogen combination. Combined pills ka ek typical pack 28 din ke rhythm par chalta hai. User period ke pehle paanch din ke andar shuru karke 21 din tak roz ek tablet leti hai, phir saat tablet-free din aate hain jinmein bleeding hoti hai, aur phir naya pack shuru hota hai (Fig. 3.9). Kuch packs is break ko saat iron tablets se bharte hain taaki roz ki aadat na chhoote; progestogen-only pills bina break ke li jaati hain.

3/3Uske baad saat pill-free din aate hain, jinmein bleeding hoti hai; phir agla pack shuru hota hai.

Fig. 3.9Combined oral pills ka usual schedule.

Ek blister pack jismein saat-saat pills ki teen rows hain aur chauthi row mein saat khaali dashed circles hain jin par break likha hai. Pehle step mein sirf pehli pill bhari hai, aur start in the first 5 days of a period label se ek curved arrow uski taraf point karta hai. Doosre step mein saari 21 pills bhari hain aur labels hain 1 pill a day for 21 days aur no ovulation. Teesre step mein break row shaded hai aur us par likha hai 7 days off: bleeding comes, then a new pack.

Hormones teen tarah se pregnancy rokte hain: yeh ovulation rokte hain, implantation ko mushkil banate hain, aur cervical mucus ko aisa badal dete hain ki sperm ko paar hone mein dikkat hoti hai. Bina koi tablet miss kiye lene par pill sabse effective reversible methods mein se ek hai, aur iske side-effects aam taur par halke hote hain. Saheli, jo non-steroidal weekly pill Section 3.1 ke box mein bataayi gayi hai, ek alag tarah ka oral contraceptive hai.

Injectables aur implants wahi hormones, sirf progestogen ya estrogen ke saath, bina daily tablet ke dete hain, aur pill ki tarah hi pregnancy rokte hain. Ek injection hafton se mahino tak protect karta hai; India ka free injectable, Antara, har teen mahine mein diya jaata hai. Upper arm ki skin ke neeche lagaayi gayi ek patli rod teen saal ya usse zyada kaam kar sakti hai, isliye roz kuch yaad rakhne ki zaroorat nahi.

Emergency contraception us kabhi-kabhaar ki situation ke liye hai jab unprotected intercourse ho chuka ho, jaise condom phat jaaye ya sexual assault ke baad. 72 ghante ke andar jitni jaldi ho sake li gayi progestogen, ya progestogen–estrogen, tablets, ya usi samay ke andar lagaaya gaya IUD pregnancy rok sakta hai. Yeh back-up hai, regular method nahi.

Surgical methods

Sterilisation (नसबंदी) un logon ke liye hai jo pakka jaante hain ki unhe aur bachche nahi chahiye. Yeh bahut effective hai, lekin ise ulatna mushkil hai aur aksar fail hota hai, isliye ise permanent maana jaata hai. Idea simple hai: gametes le jaane wali tubes ko block karo aur baaki sab waisa hi chhod do (Fig. 3.10).

  • Vasectomy (mardon mein): scrotum ki skin mein ek chhote se opening se har vas deferens ko kaata jaata hai aur uske ends baandh ya seal kar diye jaate hain, aksar ek chhota tukda nikaalne ke baad.
  • Tubectomy (auraton mein): har fallopian tube ko baandh kar kaata jaata hai, ya ek chhota section nikaal diya jaata hai, abdomen mein chhote cut se ya vagina ke raaste.

3/3Gametes ab aage nahi ja sakte, lekin testes aur ovaries kaam karte rehte hain aur hormones banate rehte hain.

Fig. 3.10Sterilisation gametes ka raasta block karta hai; yeh gonads ko na hataata hai, na band karta hai.NCERT Fig. 3.4 · p. 45

Close-up ke roop mein do seedhi tubes. Upar wali vas deferens hai jo testis se nikalti hai, aur uski poori length mein andar sperm hain. Neeche wali ovary aur uterus ke beech ki fallopian tube hai, jismein ovary ke paas ek ovum aur uterus ke paas sperm hain. Pehle step mein dono tubes khuli hain. Doosre step mein har tube ka beech ka chhota section gayab ho jaata hai aur uske do kate ends bandhe hote hain, jin par cut and tied likha hai. Teesre step mein vas deferens mein cut ke aage wale sperm gayab ho jaate hain, label testis still works padhta hai, aur neeche ki tube mein ovum cut tak aakar ruk jaata hai, jis par ovum and sperm kept apart likha hai.

Gonads ko chhua nahi jaata. Testes sperm aur testosterone banate rehte hain, aur ovaries ova aur hormones release karti rehti hain; jo gametes aage nahi ja paate, unhe body bas absorb kar leti hai. Isliye sexual function aur secondary sexual characters nahi badalte. Vasectomy ke baad, cut ke aage pehle se maujood sperm lagbhag teen mahine tak reh sakte hain, isliye jab tak semen test mein koi sperm na dikhe, tab tak doosra method use karna padta hai.

InteractiveMethods compare karo

Natural, barrier, IUD, hormonal aur surgical groups mein bante buttons solah options dikhate hain, comparison ke liye no method bhi. Ek chunne par ek card dikhta hai jismein method kaise kaam karta hai, woh kis par act karta hai yeh batate chips, kaun use karta hai, kya woh reversible hai aur kya woh sexually transmitted infections se protect karta hai. 100 dots ka ek grid batata hai ki typical use ke pehle saal mein 100 mein se lagbhag kitni auratein pregnant hongi, no method par lagbhag 85 se lekar implants, IUDs aur sterilisation par 1 se kam tak; ranges dashed outlines se dikhaayi gayi hain, aur jin methods ka comparable figure nahi hai, woh yeh bata dete hain.

Fig. 3.11Ek method chuno aur dekho ki woh kaise kaam karta hai, kaun use karta hai, kya woh reversible hai, kya woh STIs se bachata hai, aur 100 typical users mein se kitni ek saal mein pregnant ho jaati hain.
Table 3.3Contraceptives ki families ek nazar mein (sirf condoms STIs se bachate hain)
FamilyMain actionReversible?
Naturalgametes ko time ke hisaab se alag rakhta haihaan
Barriersperm ko rokta hai; condoms STIs se bhi bachate hainhaan
IUDsperm ko kamzor karta hai; implantation mein rukawat daalta haihaan
Hormonalovulation rokta hai; mucus gaadha karta hai; implantation mein rukawat daalta haihaan
Surgicalgametes ka transport block karta haimushkil se
Quick check
4 mein se 1
Har method ko us tareeke se match karo jisse woh pregnancy rokta hai.

Left mein koi item tap karo, phir right mein uska match.

Answer dekho
Answer
  • Copper IUD : copper ions sperm motility kam karte hain
  • Combined pill : ovulation rokti hai
  • Vasectomy : sperm transport block karta hai
  • Diaphragm : cervix ko dhak deta hai
Har family alag kadi par kaam karti hai: copper uterus mein sperm ko kamzor karta hai, pill ovulation rokti hai, vasectomy vas deferens ko block karti hai, aur diaphragm cervix ko block karta hai.

3.3 Medical Termination of Pregnancy (MTP)

Har pregnancy poore term tak nahi chalti. Kuch apne aap khatam ho jaati hain, jise spontaneous abortion ya miscarriage kehte hain. Jab kisi pregnancy ko jaan-boojhkar medical procedure se khatam kiya jaata hai, to is process ko medical termination of pregnancy (MTP), ya induced abortion kehte hain.

Abortion ko lekar societies mein gehra matbhed hai. Log ise apne emotional, ethical, religious aur social beliefs ke hisaab se tolte hain, aur deshon ne legal line bahut alag-alag jagah kheenchi hai. India ne 1971 mein ise kuch limits ke andar allow karna chuna, aur yeh limits kuch had tak isliye hain taaki abortion ko female foetuses ko khatam karne ke liye use na kiya jaaye. Duniya bhar mein WHO ka estimate hai ki har saal lagbhag 73 million induced abortions hote hain, yaani har das pregnancies mein se lagbhag teen.

Kabhi-kabhi pregnancy khatam karna medical zaroorat hoti hai: use jaari rakhne se aurat ki jaan ya health khatre mein pad sakti hai, ya foetus mein koi serious abnormality hai. Doosre cases mein pregnancy shuru se hi unwanted thi, contraceptive fail hone ke baad, unprotected intercourse ke baad, ya rape ke baad.

Safety ke liye timing matter karti hai. Pregnancy lagbhag teen-teen mahine ke teen trimesters mein bati hoti hai. Pehle trimester mein, lagbhag 12 weeks tak, trained provider dwara kiya gaya MTP ek safe procedure hai. Doosre trimester mein risks kaafi badh jaate hain (Fig. 3.12).

3/420 weeks tak ek doctor ki opinion; 20–24 weeks mein do, specified auraton ke liye; 24 weeks ke baad sirf serious foetal abnormality ke liye, medical board ke through.

Fig. 3.12MTP pregnancy mein jaldi sabse safe hai; law alag-alag stages par alag requirements rakhta hai.

0 se 40 tak weeks mein marked ek horizontal bar first, second aur third trimesters mein bata hai, aur 12, 20, 24 aur 28 weeks par ticks hain. Pehle step mein sirf trimesters dikhte hain. Doosre step mein pehla trimester shaded hai aur us par safest likha hai, aur doosra shaded hai aur us par riskier likha hai. Teesre step mein bar ke upar brackets dikhate hain 1 doctor up to 20 weeks, 2 doctors from 20 to 24 weeks aur medical board after 24 weeks. Aakhri step mein poore bar ke neeche ek bracket par likha hai to save her life: any stage.

LawMTP Act, 1971 (2021 mein amended)

Ek registered medical practitioner aurat ki consent se do mein se kisi ek aadhaar par pregnancy khatam kar sakta hai. Use jaari rakhne se aurat ki jaan ko risk ho ya uski physical ya mental health ko gambhir nuksaan pahunche; ya is baat ka substantial risk ho ki bachcha kisi serious physical ya mental abnormality ke saath paida hoga.

  • 20 weeks tak: ek registered medical practitioner ki opinion kaafi hai.
  • 20 se 24 weeks tak: do practitioners ka agree karna zaroori hai, aur sirf specified groups ki auratein qualify karti hain. Inmein rape ya incest survivors, minors, woh auratein jinki marital status pregnancy ke dauraan badal jaaye, aur disabilities wali auratein shaamil hain.
  • 24 weeks ke baad: sirf foetus ki substantial abnormalities ke liye, jaisa state medical board tay kare.
  • Kisi bhi stage par: jab aurat ki jaan bachaane ke liye termination turant zaroori ho.
  • Rape se hui pregnancy ko maana jaata hai ki woh aurat ki mental health ko gambhir nuksaan pahunchati hai. Kisi bhi aurat ya uske partner dwara use kiye gaye contraceptive ka fail hona bhi 20 weeks tak ek maanya aadhaar hai.
  • Aurat ki identity confidential rakhni zaroori hai, aur minor ke liye guardian ki likhit consent chahiye.

Tumhari textbook ka margin box alag limits deta hai (12 aur 24 weeks, ek amendment ke tahat jise woh 2017 ka batati hai). Upar di gayi limits 2021 mein amended Act ki hainThe Medical Termination of Pregnancy (Amendment) Act, 2021, 24 September 2021 ko laagu hua.; check karo ki tumhara exam kaun sa version expect karta hai.

Abortion ko khatarnaak procedure khud kam hi banata hai, balki yeh ki use kaun aur kahan karta hai. Untrained logon dwara gande jagahon par kiye gaye abortions aaj bhi infection, heavy bleeding, infertility aur maut ka kaaran bante hain. Upaay hain: aasaani se milne wala safe, legal MTP, safer sex par counselling taaki kam unwanted pregnancies hon, aur illegal abortion ke risks ke baare mein imaandaar information. Foetus ko female hone ki wajah se abort karna crime hai: sex test PCPNDT Act todta hai, aur foetus ka sex MTP ke liye koi legal aadhaar nahi hai.

Quick check
3 mein se 1
Miscarriage ek spontaneous abortion hai: pregnancy bina kisi medical procedure ke khatam ho jaati hai.
Answer dekho

Answer Sahi

True. Abortions apne aap ho sakte hain (spontaneous) ya jaan-boojhkar karaaye ja sakte hain (induced abortion, MTP).

3.4 Sexually Transmitted Infections (STIs)

Jo infections ek insaan se doosre mein mainly sexual contact se failte hain, unhe sexually transmitted infections (STIs) (यौन संचारित संक्रमण) kehte hain. Inke purane naam venereal diseases (VD) aur reproductive tract infections (RTI) hain. Yeh bacteria, viruses aur protozoa se hote hain (Table 3.4).

Table 3.4Common STIs, unke causes aur kya woh theek ho sakte hain (bacterial wale antibiotics se); "vaccine" ka matlab hai ki vaccine use rokti hai
InfectionKiske kaaranTheek ho sakta hai?
Gonorrhoeabacteriumhaan
Syphilisbacteriumhaan
Chlamydiasisbacteriumhaan
Trichomoniasisprotozoanhaan
Genital herpesvirus (HSV)nahi; control hota hai
Genital wartsvirus (HPV)warts ka ilaaj ho sakta hai; vaccine
Hepatitis Bvirus (HBV)nahi; vaccine
HIV infection, jo AIDS tak le jaata haivirus (HIV)nahi; control hota hai

HIV, jo AIDS tak le jaata hai, inmein sabse serious hai; Chapter 7 mein iske baare mein detail mein padhenge. Hepatitis B aur HIV sirf sex se nahi failte. Yeh infected maa se uske baby mein pregnancy, birth ya breastfeeding ke dauraan ja sakte hain, infected blood chadhaane se, aur aisi needles, syringes ya surgical aur tattooing instruments se jo share kiye gaye hon ya sterilise na kiye gaye hon.

Bacterial aur protozoan STIs poori tarah theek ho sakte hain agar unhe jaldi pakda jaaye aur treatment ka poora course liya jaaye. Viral STIs alag hain: HIV, hepatitis B aur genital herpes theek nahi ho sakte, haalaanki medicines unhe control mein rakhti hain. Ab vaccines hepatitis B aur us human papillomavirus (HPV) ko rokti hain jo genital warts aur zyaadatar cervical cancers ka kaaran banta hai.

STIs ki problem yeh hai ki inhe miss karna aasaan hai. Kai infected auratein, aur kuch mard, mahino tak kuch notice nahi karte. Doosron ko sirf halki khujli, thoda dard, unusual discharge, ya genital area mein ghaav ya sujan mehsoos hoti hai, jise woh ignore kar sakte hain, aur sharm ya judge kiye jaane ka dar der ko aur badha deta hai. Is beech infection upar ki taraf badh sakta hai (Fig. 3.13). Lambe samay ke nuksaan mein pelvic inflammatory disease (PID), scarred fallopian tubes, ectopic pregnancy, miscarriage aur stillbirth, infertility, aur kuch cases mein reproductive tract ka cancer shaamil hain.

5/5Ek embryo patli tube mein phans sakta hai (ectopic pregnancy), ya blocked tube sperm aur ovum ko milne nahi deti.

Fig. 3.13Bina ilaaj ka STI ectopic pregnancy ya infertility tak kyun le ja sakta hai.

Female reproductive tract ka front view: vagina, cervix, uterus, do fallopian tubes aur do ovaries. Pehle step mein parts label kiye gaye hain. Doosre step mein infection ke laal dots vagina aur cervix mein hain, jin par infection starts here, often no symptoms likha hai. Teesre step mein dots uterus aur dono tubes mein fail jaate hain, jin par pelvic inflammatory disease likha hai. Chauthe step mein dono tubes mein zigzag scars dikhte hain, jin par scarred, narrowed tubes likha hai. Aakhri step mein ek tube mein scar se pehle ek embryo phansa hai, jis par ectopic pregnancy likha hai, aur doosri tube par blocked likha hai.

STI rates 15–24 saal ke logon mein sabse zyada hain. Yeh jaanna darne ki nahi, kaam ki baat hai, kyunki lagbhag har STI ko roka ja sakta hai, aur RCH programme prevention, early testing aur poore treatment ko apne kaam ke centre mein rakhta hai. Yeh aadatein insaan ko protect karti hain:

  • Anjaan partners ya bahut saare partners ke saath sexual contact se bacho.
  • Har baar condom sahi tarah use karo.
  • Needles, syringes ya razors kabhi share mat karo, aur injections, piercing aur tattoos ke liye sterile instruments par zor do.
  • Hepatitis B ki vaccine lagwao, aur jahan HPV vaccine milti ho wahan woh bhi.
  • Agar infection ka shak ho, to jaldi kisi qualified doctor ko dikhao, aur symptoms chale jaane ke baad bhi treatment ka poora course khatam karo.
Quick check
4 mein se 1
Inmein se kaun se STIs jaldi ilaaj hone par poori tarah theek ho sakte hain?
Saare sahi options chuno
Answer dekho
Answer
  • (A) Syphilis
  • (C) Trichomoniasis
Syphilis (bacterium) aur trichomoniasis (protozoan) medicines se theek ho sakte hain. Hepatitis B aur genital herpes viral hain: inhe control ya prevent kiya ja sakta hai, cure nahi.

3.5 Infertility

Kuch couples ke liye problem us problem ka ulta hai jise contraception solve karta hai. Infertility (बंध्यता) ka matlab hai regular unprotected intercourse ke baawajood pregnancy na ho paana. Doctors aur WHO ise aam taur par 12 mahine koshish ke baad diagnose karte hain; tumhari textbook ki summary do saal ka period use karti hai. WHO ka estimate hai ki reproductive age ke lagbhag har chhe mein se ek insaan zindagi mein kabhi na kabhi infertility face karta hai.

Infertility clinics shuruaat dono partners ki testing se karte hain, aur iski achhi wajah hai: haalaanki India mein bachcha na hone par aksar aurat ko dosh diya jaata hai, lagbhag aadhe cases mein male factors shaamil hote hain. Tests kai tarah ke causes dhoondhte hain: kam sperm count ya blocked tubes, purane infections jaise bina ilaaj ke STIs se hua nuksaan, hormonal ya immune problems, janm se maujood conditions, drugs, alcohol aur tobacco ke effects, aur psychological stress. Inmein se kai medicines ya surgery se theek ho sakte hain. Baaki ke liye assisted reproductive technologies (ART) hain.

Assisted reproductive technologies

Sabse jaani-maani technique IVF–ET hai, yaani test-tube baby programme. Iska naam hi ise samjhaata hai: fertilisation in vitro ('glass mein', yaani lab dish mein) aur uske baad embryo transfer. Doctors aurat ki ovaries se, ya kisi donor se, ova collect karte hain aur unhe uske partner ya donor ke sperm ke saath ek dish mein milaate hain, jo nutrient medium mein body temperature par rakhi hoti hai (Fig. 3.14). Jab zygote ban jaata hai aur divide hona shuru karta hai, to use wapas aurat ki body mein daala jaata hai. Woh kahan jaata hai, yeh uski stage par depend karta hai:

  • ZIFT (zygote intra-fallopian transfer) zygote, ya 8 se zyada blastomeres na hon aise embryo, ko fallopian tube mein daalta hai.
  • IUT (intra-uterine transfer) 8 blastomeres se aage badh chuke embryo ko uterus mein daalta hai.

5/58 se zyada blastomeres wala embryo uterus mein jaata hai (IUT).

Fig. 3.14IVF ke steps aur embryo kahan transfer hota hai.

Ek uthli lab dish mein sperm se ghira ek bada ovum hai. Pehle step mein label padhta hai ova and sperm in a lab dish. Doosre step mein ek patli pipette ek sperm ko ovum mein inject karti hai jabki ek holding pipette use thaame rakhti hai, label hai ICSI. Teesre step mein free sperm gayab ho jaate hain aur cell ke andar do nuclei dikhte hain, label hai zygote formed outside the body. Chauthe step mein neeche ek row 2-cell, 4-cell aur 8-cell embryos dikhati hai, ZIFT: into tube label wale bracket ke neeche. Aakhri step mein ek arrow 16 ya zyada cells wale embryo tak jaata hai, IUT: into uterus label wale bracket ke neeche.

Transfer donor ki body ke embryos ke saath bhi kaam karta hai: natural (in vivo) fertilisation se bana embryo us aurat mein shift kiya ja sakta hai jo khud conceive nahi kar sakti. Doosri techniques doosri problems solve karti hain (Fig. 3.15):

  • GIFT (gamete intra-fallopian transfer): ek ovum (agar aurat khud ova nahi bana sakti to donor se) sperm ke saath uski fallopian tube mein rakha jaata hai. Phir fertilisation aur development uski body ke andar hote hain. Yeh us aurat ke liye sahi hai jiski tubes aur uterus healthy hain lekin jo ova nahi bana sakti.
  • ICSI (intra-cytoplasmic sperm injection): lab mein ek single sperm ko seedhe ovum ke cytoplasm mein inject kiya jaata hai, aur bane hue embryo ko phir transfer kiya jaata hai. Yeh tab use hota hai jab sperm bahut kam ya itne kamzor hon ki khud ovum ko fertilise na kar sakein.
  • Artificial insemination (AI): pati ka semen, ya kisi healthy donor ka, vagina mein, ya seedhe uterus mein (IUI, intra-uterine insemination) daala jaata hai. Yeh tab madad karta hai jab aadmi semen ko vagina mein deposit nahi kar paata, ya jab uska sperm count bahut kam ho.

7/7Paanchon destinations ek saath.

Fig. 3.15Har technique kya transfer karti hai, aur kahan.

Female tract ka front view: vagina, cervix, uterus, fallopian tubes aur ovaries. Pehle step mein parts label kiye gaye hain. AI step mein neeche se ek dashed arrow vagina mein khatam hota hai, jahan sperm hain. IUI step mein arrow cervix se hokar upar uterus tak jaata hai, jiske andar sperm hain. GIFT step mein ek arrow uterus ke upar se mudkar left tube tak jaata hai, jahan ek ovum aur ek sperm hain. ZIFT step mein ek arrow right tube ki taraf point karta hai, jahan do nuclei wala zygote hai. IUT step mein arrow cervix se hokar uterus mein ek embryo tak jaata hai. Aakhri step mein paanchon destinations chhote labels ke saath ek saath dikhte hain.

Example

Problem ke hisaab se technique chunna

Har couple ke liye ek sahi assisted technique suggest karo, aur wajah batao. (a) Purane infection ne aurat ki dono fallopian tubes block kar di hain; aadmi healthy hai. (b) Aurat healthy hai, lekin aadmi ke semen mein bahut kam sperm hain. (c) Aurat koi ova nahi banati, lekin uski tubes aur uterus normal hain.

Pehle khud try karo. Phir solution ek-ek step karke kholo.

ART aasaan option nahi hai. Ek IVF cycle mein aam taur par ek lakh rupaye ya usse zyada kharch hota hai, aksar ise dohrana padta hai, aur yeh specialists aur labs par depend karta hai jo zyaadatar bade shehron mein hain. Kai couples emotional, religious ya social wajahon se bhi hichkichaate hain. 2021 se Assisted Reproductive Technology (Regulation) Act ke tahat ART clinics aur banks ka registered hona zaroori hai, aur yeh donors aur consent par rules tay karta hai.

Parenthood ka biological hona zaroori nahi. India mein kai anaath aur chhode gaye bachche ek family ka intezaar kar rahe hain, aur Central Adoption Resource Authority (CARA) ki nigraani wale legal process se bachcha adopt karna us bachche ko ghar aur couple ko family deta hai.

Quick check
3 mein se 1
Har technique ko match karo ki kya transfer hota hai, aur kahan.

Left mein koi item tap karo, phir right mein uska match.

Answer dekho
Answer
  • ZIFT : zygote ya early embryo fallopian tube mein
  • IUT : 8 se zyada cells wala embryo uterus mein
  • GIFT : ovum aur sperm fallopian tube mein
  • IUI : semen uterus mein
ZIFT zygote (ya 8 blastomeres tak ke embryo) ko tube mein le jaata hai, IUT bade embryo ko uterus mein, GIFT gametes ko tube mein, aur IUI semen ko uterus mein.
Recap

Summary aur key points

  1. Reproductive health ka matlab hai reproduction se judi har cheez mein physical, emotional, behavioural aur social well-being, sirf healthy organs nahi.
  2. India ne 1951–52 mein national family planning shuru kiya; ab RCH programme awareness, services aur research ko saath jodta hai (Section 3.1).
  3. Amniocentesis foetus mein genetic disorders detect karta hai; foetus ka sex jaanne ke liye ise, ya koi bhi test, use karna PCPNDT Act ke tahat banned hai (sex selection).
  4. Girti maternal aur infant mortality, zyada hospital births aur chhoti families dikhati hain ki reproductive health behtar hui hai (indicators).
  5. Death rates birth rates se tez gire, isliye India ki population 361 million (1951) se badhkar 1.21 billion (2011) ho gayi; TFR ab lagbhag 2.0 hai (Section 3.2).
  6. Ideal contraceptive effective, safe, use karne aur paane mein aasaan, reversible hota hai aur sexual life mein dakhal nahi deta (contraceptives).
  7. Natural methods aur barriers sperm aur ovum ko alag rakhte hain; sirf condoms STIs se bhi bachate hain (natural methods, barriers).
  8. IUDs sperm ko kamzor karte hain aur implantation mein rukawat daalte hain; pills, injectables aur implants ovulation rokte hain, cervical mucus gaadha karte hain aur implantation mein rukawat daalte hain (IUDs, hormonal methods).
  9. Vasectomy aur tubectomy gametes ka transport block karte hain; yeh bahut effective hain lekin inhe ulatna mushkil hai, aur gonads kaam karte rehte hain (surgical methods).
  10. India mein MTP 1971 se legal hai; yeh pehle trimester mein sabse safe hai, aur amended Act 20 aur 24 weeks ki limits rakhta hai (Section 3.3).
  11. Bacterial aur protozoan STIs jaldi ilaaj se theek ho sakte hain; HIV, hepatitis B aur genital herpes nahi. Bina ilaaj ke STIs PID, ectopic pregnancy aur infertility kar sakte hain (Section 3.4).
  12. Infertility kisi bhi partner mein ho sakti hai; IVF–ET (ZIFT, IUT), GIFT, ICSI aur AI/IUI madad kar sakte hain, aur legal adoption parenthood ka ek aur raasta hai (Section 3.5).
Practice · 17 questions

Practice questions answers ke saath (NCERT “Exercises”)

  1. Short answerEasyNCERT Exercises Q1

    Ek state health minister kehte hain ki reproductive health par kharch kiya paisa "poori society par kharch kiya paisa" hai. Is daave ko support karne wali chaar wajahein do.

    Solution dikhao

    (1) Safe pregnancies aur deliveries ka matlab hai kam mothers aur infants ki maut, isliye families bani rehti hain aur bachche zyada healthy bade hote hain. (2) Jo couples apni family plan kar sakte hain, woh unwanted pregnancies se bachte hain aur har bachche ko behtar khaana, schooling aur care de sakte hain. (3) HIV samet STIs ko rokna aur unka ilaaj karna partners aur newborn babies ko protect karta hai aur baad ki problems jaise infertility kam karta hai. (4) Dheemi population growth khaane, paani, schools, hospitals aur jobs par pressure kam karti hai. Awareness myths, sexual abuse aur sex selection ko bhi kamzor karti hai, taaki ladkiyon aur ladkon ko baraabar value mile.

  2. Short answerMediumNCERT Exercises Q2

    Agar tum aaj RCH programme ko salaah de rahe hote, to tum use reproductive health ke kaun se chaar areas par focus karne ko kehte? Har choice ko ek sentence mein justify karo.

    Solution dikhao

    Inmein se koi bhi chaar, achhi tarah justify kiye gaye, sahi hain. (1) Adolescents ke liye sexuality education aur menstrual hygiene, kyunki myths aur chuppi ab bhi aam hain. (2) Reversible spacing methods tak aasaan pahunch, kyunki ab bhi female sterilisation hi sabse aage hai. (3) Safe, legal MTP services, taaki unqualified logon ke unsafe abortions khatam hon. (4) STIs aur HIV ki prevention, testing aur poora treatment, khaaskar 15–24 saal ke logon mein. (5) Sex selection ke khilaaf sakhti se kanoon laagu karna, kyunki child sex ratio ab bhi bigda hua hai. (6) Door-daraaz ke areas mein mothers aur newborns ki care, jahan MMR aur IMR sabse zyada hain. (7) Sasti infertility care.

  3. Short answerEasyNCERT Exercises Q3

    Kuch parents school mein sexuality education ka virodh karte hain, is dar se ki isse jaldi sexual activity ko badhawa milega. Tum kya jawaab doge? Ise padhaane ki kam se kam teen wajahein do.

    Solution dikhao

    UNESCO aur WHO ke school programmes ke reviews paate hain ki achhi tarah design ki gayi, umar ke hisaab se sexuality education young logon ko jaldi sexual activity shuru nahi karwaati; kai programmes ise delay karte hain aur zyada safe banate hain. Yeh dosto aur internet ke myths ki jagah sahi facts deti hai. Yeh students ko puberty ke changes ke liye taiyaar karti hai, menstrual hygiene samet. Yeh sikhaati hai ki STIs, HIV aur unplanned pregnancy kaise roki ja sakti hain. Yeh young logon ko consent samajhne aur abuse ko pehchaanne aur report karne mein madad karti hai. Aur yeh stigma kam karti hai, taaki problems wale log jaldi madad lein.

  4. Short answerMediumNCERT Exercises Q4

    Chaar evidence do ki pichhle kuch dashakon mein India ki reproductive health behtar hui hai, aur batao ki har ek humein kya batata hai.

    Solution dikhao

    (1) Infant mortality 1990 mein lagbhag 80 per 1000 live births se girkar 2020 mein lagbhag 28 ho gayi: newborn aur child care behtar hui hai. (2) Maternal mortality lagbhag 550 se girkar 100 per 100 000 live births se neeche aa gayi: pregnancy aur delivery bahut zyada safe hain. (3) Health facilities mein births ka share lagbhag 39 % (2005–06) se badhkar lagbhag 89 % (2019–21) ho gaya: zyada deliveries trained staff ki dekh-rekh mein hoti hain. (4) Total fertility rate lagbhag 6 se girkar 2.0 ho gaya: couples contraception use karke chhoti families chun rahe hain. STIs ka behtar diagnosis aur treatment aur infertility clinics ka failna, yeh bhi signs hain.

  5. NumericalMediumNCERT Exercises Q5

    1950 ke baad India ki population bahut tezi se badhi.

    1. Is tez growth ki teen wajahein do.

      Solution dikhao

      Vaccines, antibiotics, safe paani aur behtar khaane ki wajah se death rates tezi se gire. Maternal aur infant mortality (MMR aur IMR) giri, isliye zyada mothers aur babies bache. Birth rates bahut dheere gire, isliye reproductive age ke logon ki sankhya badhti rahi.

    2. 5 lakh logon wale ek town ka birth rate 24 aur death rate 8 per 1000 per saal hai. Iska growth rate, per cent per saal mein, kya hai?

      % per saal
      Answer dekho

      Answer 1.6 % per saal

      24−8=16 per 1000 =1.6 % per saal.

    3. Rule of 70 use karke batao, agar rates same rahein to town ko double hone mein lagbhag kitne saal lagenge?

      saal
      Answer dekho

      Answer 44 saal

      70/1.6≈44 saal.
  6. Long answerMediumNCERT Exercises Q6

    "Kisi insaan ko healthy rakhne ke liye contraceptives ki zaroorat nahi hai." Kya phir bhi unka use justify kiya ja sakta hai? Apna paksh rakho, aur ek limitation bhi batao.

    Solution dikhao

    Haan. Haalaanki contraceptives kisi bimaari ka ilaaj nahi karte, woh couples ko unwanted pregnancies rokne aur yeh tay karne dete hain ki bachche kab aur kitne hon. Births mein gap maa ki health ko protect karta hai aur har bachche ko behtar care deta hai. Unwanted pregnancies se bachne se unsafe abortions kam hote hain, condoms STIs bhi rokte hain, aur contraception ke wide use ne India ki population growth dheemi karne mein madad ki hai. Limitations: koi method perfect nahi hai, kuch ke side-effects hain jaise nausea, irregular bleeding ya, hormonal methods mein, breast-cancer risk mein thoda badhaav, aur sterilisation ko ulatna mushkil hai. Isliye choice soch-samajh kar aur kisi qualified health worker ke saath karni chahiye.

  7. Short answerMediumNCERT Exercises Q7

    Testes ya ovaries nikaal dene se pregnancy pakka ruk jaayegi, phir bhi ise kabhi family-planning method ke roop mein offer nahi kiya jaata. Wajah samjhao, aur batao ki sterilisation isse kaise alag hai.

    Solution dikhao

    Gonads endocrine glands bhi hain: testes testosterone banate hain, aur ovaries estrogen aur progesterone banati hain. Inhe nikaalne se hormone production khatam ho jaayega, jisse sexual drive khatam hogi, secondary sexual characters badlenge aur bones aur general health ko nuksaan hoga, upar se yeh ek badi, irreversible surgery hogi. Contraception ko sirf gametes ka milna rokna hai. Vasectomy aur tubectomy ek chhote operation mein vas deferens ya fallopian tubes ko kaat ya baandh kar bilkul yahi karte hain, aur gonads aur unke hormones ko chhoote nahi.

  8. Short answerMediumNCERT Exercises Q8

    Amniocentesis genetic disorders detect karne ke liye allowed hai, lekin foetus ka sex jaanne ke liye banned hai. Kya yeh ban zaroori hai? Wajahon ke saath apni raay do.

    Solution dikhao

    Haan. Jahan beton ko pasand kiya jaata hai, wahan foetus ka sex jaanne se female foetuses ka abortion hua hai. Iske nateeje mein 2011 mein child sex ratio girkar har 1000 ladkon par lagbhag 918 ladkiyan reh gaya, jabki natural ratio lagbhag 950 hai. Aisi kami ka matlab hai population mein kam auratein, zyada violence aur trafficking, aur ladkiyon ke saath gehra anyaay. Isliye PCPNDT Act foetus ka sex batane ke liye koi bhi test use karna ban karta hai, aur amniocentesis ko uske sahi purpose ke liye available rakhta hai: Down syndrome jaise disorders detect karna.

  9. Short answerMediumNCERT Exercises Q9

    Ek couple teen saal se bachche ki koshish kar raha hai. Tests dikhate hain ki aadmi ka sperm count bahut kam hai; aurat healthy hai. Do assisted techniques suggest karo jo madad kar sakti hain aur samjhao ki har ek kaise kaam karti hai. Parenthood ka ek aisa raasta batao jismein ART shaamil na ho.

    Solution dikhao

    (1) Artificial insemination, aam taur par IUI ke roop mein: semen collect karke concentrate kiya jaata hai aur seedhe uterus mein rakha jaata hai, taaki zyada sperm ovum tak pahunchein. (2) ICSI: ova collect kiye jaate hain aur lab mein har ovum mein seedhe ek sperm inject kiya jaata hai. Phir embryo tube (ZIFT, 8 blastomeres tak) ya uterus (IUT, 8 se zyada) mein transfer kiya jaata hai. Donor semen ek aur option hai. ART ke bina, couple CARA ke through legally bachcha adopt kar sakta hai.

  10. Short answerEasyNCERT Exercises Q10

    Paanch measures list karo jo sexually transmitted infection hone ka risk kam karte hain. Kam se kam ek aisa shaamil karo jo hepatitis B ke non-sexual spread se bhi bachaata ho.

    Solution dikhao

    Anjaan ya kai partners ke saath sexual contact se bacho. Har baar condom sahi tarah use karo. Needles, syringes ya razors kabhi share mat karo, aur injections, piercing aur tattoos ke liye sirf sterile instruments hi accept karo; isse blood se failne wale hepatitis B aur HIV bhi rukte hain. Hepatitis B aur HPV ki vaccine lagwao. Infection ka shak ho to jaldi qualified doctor ko dikhao, aur poora treatment complete karo.

  11. Quick answerEasyNCERT Exercises Q11

    Tay karo ki har statement true hai ya false, aur wajah samjhao.

    1. Har abortion kisi medical procedure ka nateeja hota hai.

      Answer dekho

      Answer Galat

      False. Pregnancy apne aap bhi khatam ho sakti hai: spontaneous abortion, ya miscarriage.

    2. Jab couple infertile hota hai, to lagbhag har case mein wajah aurat mein milti hai.

      Answer dekho

      Answer Galat

      False. Infertility kisi bhi partner mein ho sakti hai, aur lagbhag aadhe cases mein male factors shaamil hote hain.

    3. Jo maa poori tarah breastfeed karti hai aur jiske periods wapas nahi aaye, uske delivery ke baad pehle chhe mahine mein conceive karne ki sambhavna kam hai.

      Answer dekho

      Answer Sahi

      True. Intense breastfeeding ovulation ko dabaati hai (lactational amenorrhoea), lekin sirf lagbhag chhe mahine tak aur sirf jab tak periods na aayein.

    4. Reproduction ke baare mein sahi information se population ki reproductive health mein khaas sudhaar nahi hota.

      Answer dekho

      Answer Galat

      False. Awareness RCH programme ki pehli strategy hai: sahi information myths door karti hai, safe behaviour ko badhawa deti hai aur logon ko jaldi care lene ke liye prerit karti hai.
  12. Short answerMediumNCERT Exercises Q12

    Neeche ka har statement galat hai. Use sahi karke dobara likho.

    1. Vasectomy testes ko sperm banane se rok deti hai.

      Solution dikhao

      Vasectomy vas deferens ko kaat ya baandh kar sperm ke transport ko block karti hai; testes sperm (aur testosterone) banate rehte hain.

    2. Antibiotics har sexually transmitted infection ko theek kar sakte hain, hepatitis B aur genital herpes samet.

      Solution dikhao

      Antibiotics syphilis aur gonorrhoea jaise bacterial STIs ko theek karte hain; hepatitis B aur genital herpes viral infections hain jo theek nahi ho sakte, sirf control ho sakte hain (aur hepatitis B vaccination se roka ja sakta hai).

    3. India mein oral pills sabse zyada use hone wala contraceptive method hai.

      Solution dikhao

      India mein female sterilisation sabse zyada use hone wala method hai (NFHS-5 mein lagbhag 38 % married women); pills sirf lagbhag 5 % use karti hain, jo condoms (lagbhag 10 %) se bhi kam hai.

    4. ZIFT mein 16 cells wala embryo fallopian tube mein rakha jaata hai.

      Solution dikhao

      ZIFT mein zygote ya 8 blastomeres tak ka early embryo fallopian tube mein rakha jaata hai. 16 cells wale embryo mein 8 se zyada blastomeres hain, isliye use IUT se uterus mein rakha jaata hai.

  13. Quick answerEasy

    Inmein se kaun sa IUD hormone release karta hai?

    Answer dekho

    Answer (C) LNG-20

    LNG-20 ek progestogen (levonorgestrel) release karta hai. Multiload 375 aur Cu7 copper release karte hain, aur Lippes loop non-medicated hai.
  14. Quick answerMedium

    Ek saal mein ek district 25 000 live births aur 30 maternal deaths record karta hai. Iska maternal mortality ratio kya hai?

    per 100 000 live births
    Answer dekho

    Answer 120 per 100 000 live births

    3025 000×100 000=120, yaani har 100 000 live births par 120 maternal deaths.
  15. Quick answerEasy

    IVF–ET ke steps ko sahi order mein lagao.

    1. Zygote ko early embryo mein divide hone do
    2. Embryo ko tube ya uterus mein transfer karo
    3. Ova aur sperm collect karo
    4. Lab mein ovum ko fertilise karo
    Answer dekho
    Answer
    1. Ova aur sperm collect karo
    2. Lab mein ovum ko fertilise karo
    3. Zygote ko early embryo mein divide hone do
    4. Embryo ko tube ya uterus mein transfer karo
    Gametes collect kiye jaate hain, body ke bahar fertilise kiye jaate hain, divide hone diye jaate hain, aur phir zygote ya embryo transfer kiya jaata hai.
  16. Quick answerEasy

    Regular 28-day menstrual cycle mein fertile period lagbhag day se day tak hota hai.

    Answer dekho

    Answer (1) 10, (2) 17

    Ovulation day 14 ke aas-paas hota hai; sperm aur ovum kitne din zinda rehte hain, yeh jodne par lagbhag days 10–17 milte hain.
  17. Quick answerEasy

    Inmein se kaun sa sexually transmitted infection protozoan se hota hai?

    Answer dekho

    Answer (B) Trichomoniasis

    Trichomoniasis protozoan Trichomonas vaginalis se hota hai. Syphilis bacterial hai; genital herpes aur hepatitis B viral hain.

Apna NCERT exercise question dhoondo

Hamare practice questions ncert.ai ke liye likhe gaye hain aur NCERT exercises ko follow karte hain. Apni textbook ke question se match karne wala question dhoondo; uska answer uske saath hai.

Tumhari NCERT textbook meinYahan practice question
NCERT Exercises Q1Practice Q1
NCERT Exercises Q2Practice Q2
NCERT Exercises Q3Practice Q3
NCERT Exercises Q4Practice Q4
NCERT Exercises Q5Practice Q5
NCERT Exercises Q6Practice Q6
NCERT Exercises Q7Practice Q7
NCERT Exercises Q8Practice Q8
NCERT Exercises Q9Practice Q9
NCERT Exercises Q10Practice Q10
NCERT Exercises Q11Practice Q11
NCERT Exercises Q12Practice Q12

Quick check: MCQs

  1. Progress kaise naapein4 questions
  2. Surgical methods4 questions
  3. 3.3 Medical Termination of Pregnancy (MTP)3 questions
  4. 3.4 Sexually Transmitted Infections (STIs)4 questions
  5. Assisted reproductive technologies3 questions
Glossary · 15

Key terms (English + Hindi)

amniocentesisउल्ववेधनulvavedhan
Ek prenatal test jismein thoda amniotic fluid nikaala jaata hai aur uske foetal cells ko genetic disorders ke liye check kiya jaata hai.Chapter mein pehli baar yahan aaya →
assisted reproductive technologies
IVF, GIFT, ICSI aur artificial insemination jaisi medical techniques jo infertile couples ko bachche paane mein madad karti hain.Chapter mein pehli baar yahan aaya →
contraceptiveगर्भनिरोधकgarbhnirodhak
Pregnancy rokne ke liye use hone wala method, device ya medicine.Chapter mein pehli baar yahan aaya →
fertile period
Ovulation ke aas-paas ke din jab conception ki sambhavna sabse zyada hoti hai; regular 28-day cycle ke lagbhag days 10–17.Chapter mein pehli baar yahan aaya →
in vitro fertilisation–embryo transfer
Lab mein ova ko sperm se fertilise karna aur zygote ya embryo ko fallopian tube (ZIFT) ya uterus (IUT) mein rakhna.Chapter mein pehli baar yahan aaya →
infant mortality rateशिशु मृत्यु दरshishu mrityu dar
Ek saal mein har 1000 live births par ek saal se kam umar ke babies ki maut.
infertilityबंध्यताbandhyata
Regular unprotected intercourse ke baawajood pregnancy na ho paana, aam taur par 12 mahine ya usse zyada tak.Chapter mein pehli baar yahan aaya →
intra-uterine device
Uterus mein rakha jaane wala chhota device jo pregnancy rokta hai; yeh non-medicated, copper-releasing ya hormone-releasing ho sakta hai.Chapter mein pehli baar yahan aaya →
lactational amenorrhoea
Childbirth ke baad full breastfeeding ke dauraan periods ka na aana, jab ovulation dabaa rehta hai; lagbhag chhe mahine tak contraception ke roop mein kaam ka.Chapter mein pehli baar yahan aaya →
maternal mortality ratioमातृ मृत्यु दरmatri mrityu dar
Har 100 000 live births par pregnancy se jude kaarano se auraton ki maut.
medical termination of pregnancy
Pregnancy ko full term se pehle jaan-boojhkar khatam karna; India mein MTP Act ke tahat legal.Chapter mein pehli baar yahan aaya →
reproductive healthजनन स्वास्थ्यjanan swasthya
Reproduction se judi har cheez mein physical, emotional, behavioural aur social well-being.Chapter mein pehli baar yahan aaya →
sexually transmitted infectionयौन संचारित संक्रमणyaun sancharit sankraman
Mainly sexual contact se failne wala infection, jaise syphilis, gonorrhoea, hepatitis B ya HIV.Chapter mein pehli baar yahan aaya →
sterilisationनसबंदीnasbandi
Ek permanent surgical method jo vas deferens (vasectomy) ya fallopian tubes (tubectomy) ko block karta hai.Chapter mein pehli baar yahan aaya →
total fertility rate
Current birth rates par ek aurat apni zindagi mein average kitne bachche paida karegi; lagbhag 2.1 har generation ko replace karta hai.Chapter mein pehli baar yahan aaya →

Tum chapter ke end tak pahunch gaye