Introduction: Why Reproductive Health Matters

Reproductive health is one of those terms that is easy to say and easy to underestimate. The World Health Organization's definition, which the WBCHSE syllabus follows, describes it as a state of complete physical, mental and social well-being in all matters relating to the reproductive system — not simply the absence of disease or infirmity of the reproductive organs. Read carefully, this definition is doing real work: it says that a person can be free of any diagnosable reproductive disease and still not have good reproductive health, if, for instance, they lack accurate information about their own body, cannot access safe contraception, are denied an equal voice in decisions about family size, or face an unsafe or poorly supervised pregnancy and delivery.

India was, in fact, among the very first countries in the world to recognise this as a national concern, launching an official family planning programme as early as 1951, well before the term 'reproductive health' came into common use internationally. Over the decades since, the emphasis of national policy has widened considerably — from an early, fairly narrow focus on limiting family size, to today's much broader Reproductive and Child Health Care (RCH) approach, which treats maternal health, child health, family planning, and the prevention of sexually transmitted diseases as parts of a single, connected effort (Section 3.2). Alongside government programmes, a great deal depends on awareness — on ordinary people, and especially adolescents approaching reproductive maturity, having correct, non-judgemental information rather than myths passed on informally.

This chapter takes up five specific, linked strands of that wider reproductive-health effort that are named in the WBCHSE syllabus: the prevention of sexually transmitted diseases; the need for, and the range of, birth-control methods; the legal and medical framework for medical termination of pregnancy; the diagnostic technique of amniocentesis, together with the serious ethical and legal problem created by its misuse; and infertility, along with the assisted reproductive technologies that now offer many otherwise childless couples a path to parenthood. Each is treated here as a matter of plain biological and social fact, in the same calm, clinical manner in which a textbook of human biology is expected to treat it.