What is human reproductive health - what factors influence, how to maintain and prevent violations. Coursework: Reproductive health of the population Reproductive system and human health
The reproductive health of a woman is an integral part of the overall health of the body, which implies the absence of diseases of the reproductive system, the ability to reproduce offspring, as well as the ability to live a sexual life and receive satisfaction from it. Feminine depends on many factors: heredity, lifestyle, occupational hazards, diseases of other organs and systems. In our article, we will consider the main criteria for reproductive health and the factors that affect it.
Factors affecting reproductive health
The main criteria for reproductive health are birth rates, as well as maternal and child mortality. In the modern world, for many years there has been a trend towards a decrease in the birth rate, a deterioration in the quality of medical care in obstetric and gynecological hospitals (due to a sharp decrease in funding). Special attention is paid to the reproductive health of a woman, as she is born with a set of egg rudiments, which will gradually mature. They are very sensitive to the action of harmful factors, under the influence of which mutations can occur in the eggs.
Factors that destroy a woman's reproductive health include:
- bad habits (smoking, drug addiction, alcohol abuse);
- sexually transmitted diseases (HIV, chlamydia, syphilis);
- environmental factors (pollution of the atmosphere, water, soil);
- promiscuous sexual behavior;
- abortions that affect psychological and reproductive health.
Reproductive dysfunction in women
The reproductive period of a woman is a period of life during which a woman is able to conceive, bear and give birth to a child. It is characterized by the monthly maturation of the egg, in the absence of fertilization of which menstruation occurs. Women's reproductive health problems are caused by an increase in the number of gynecological diseases that lead to infertility or miscarriage (spontaneous abortion, non-developing pregnancies).
We examined the causes that lead to a violation of the reproductive function of women. A healthy lifestyle, proper sexual behavior, and prevention of abortions (protection from unwanted pregnancies) play an important role in maintaining reproductive health.
Content
The demographic situation in Russia in recent years has deteriorated significantly due to the reproductive health of the population, the lifestyle of the younger generation, the environment and the quality of life. The state is trying to prevent a decline in the birth rate, but the problem remains. Childbearing is not only a medical issue, but also a national situation.
The meaning of the concept of "reproductive health"
According to the definition of the World Health Organization, the reproductive health of the population is the psychological, social and physiological readiness of a person to create a family and continue the family line. This term includes sexual health, the absence of sexually transmitted diseases and other factors that may adversely affect conception, gestation, mental and physical health of the child. In recent years, the younger generation leads an unhealthy lifestyle, which negatively affects reproductive health.
Criteria
The main indicator of reproductive health is a successful pregnancy and childbirth. There are the following criteria for assessing reproductive health:
- the state of the maternal organism, the presence of pathologies of various nature, general immunity;
- father's health (50% of a successful outcome depends on the state of the male body, his chronic pathologies);
- hereditary diseases;
- STIs (sexually transmitted infections);
- HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome);
- low abortion and infant mortality;
- decreasing infertility;
- number of women using contraceptives.
Impact of risk factors on reproductive health
In recent years, research has been actively carried out to study the influence of causes of various nature on a woman's reproductive health. These risk factors include the following groups:
- Socio-psychological - are in a tense economic environment (material well-being), include the presence of stress, anxiety and fear.
- Professional - exposure to harmful or hazardous substances, working conditions that can affect the normal functioning of organs, should be excluded even before pregnancy.
- genetic reasons.
- environmental factors.
Nutrition
The quality of consumed products directly affects the state of health, including reproductive. It is important to avoid fatty, fried, smoked foods, a large amount of sweet. The daily diet should be divided into several (4-6 times) meals. It is recommended to drink 1.5-2 liters of pure water per day. Overeating or undereating adversely affects the state of the gastrointestinal tract and the body as a whole. Nutrition should be balanced, saturated with the necessary amount of vitamins, minerals and other useful substances.
Environment
The ecological situation in Russia and other countries of the globe leaves much to be desired, especially in recent years. The latest technologies can greatly facilitate human life, help fight serious diseases, but at the same time contribute to the emergence of new ones. The destruction of the ozone layer of the atmosphere leads to an increase in the amount of ultraviolet radiation that reaches the surface of the planet, which negatively affects the state of the general immunity of the population.
In addition, the so-called global warming gradually leads to shifts in temperature regimes on the planet, which, along with electromagnetic radiation, negatively affects human reproductive health. The pace of life of modern society and the level of urbanization, especially in large cities, lead to an increase in stress in everyday life, nervous overload, and depression. In addition, over the past decades, the incidence of car accidents has increased significantly, which often leads to injuries that directly affect human reproductive health.
Impact of working conditions
Exposure to high or low temperatures, night shifts can significantly reduce the protective properties of the body. There are many working conditions and professional activities that cause serious pathologies that negatively affect a woman's reproductive health. The most common include:
- omission and prolapse of the female genital organs (as a rule, when performing heavy physical work);
- tumor formations of the mammary glands and genital organs of a malignant nature (under the influence of carcinogenic factors and ionizing radiation);
- pelvic inflammatory disease (eg, when working in the cold);
- menstrual dysfunction;
- hormonal disruptions;
- psycho-emotional stress during work.
Bad habits
Wrong lifestyle, the presence of any bad habits in parents (drug and alcohol addiction, smoking) negatively affect the reproductive health of both the mother and the father of the future offspring. Such toxicological factors can affect not only the maturing fetus during pregnancy, but also genetic information, causing various kinds of mutations at the cellular level. In addition, alcohol and tobacco use lead to the birth of seriously ill children or miscarriage.
Diseases
There are a number of drugs (anticonvulsants, antidepressants, corticosteroids, tranquilizers, neuroleptics) that can adversely affect reproductive health due to hormonal disorders. In addition, there are a number of pathologies that affect the state of reproductive health, male and female. Such diseases include the following deviations:
- Increasing the spread of sexually transmitted infections often leads to irreversible disorders of the genitourinary system.
- Cardiovascular pathologies affect the general condition of the body, limiting physiological capabilities.
- Some infectious diseases (eg, chicken pox, mumps) are causes of infertility, especially in boys.
- Diabetes mellitus, liver and kidney pathologies can lead to hormonal disruptions.
- Congenital diseases in most cases are initially the causes of reproductive problems.
Reproductive health
The concept of reproductive health includes various activities, services, methods aimed at maintaining the reproductive function at the proper level, even in adverse environmental conditions. There are the following preventive actions:
- prevention of sexually transmitted diseases;
- prevention of serious pathologies that affect the genital area;
- education of the adult population and adolescents about issues relevant to a particular generation;
- preventive measures to prevent abortion (especially at an early age).
Infertility treatment
Such a serious disease as infertility is diagnosed if pregnancy in the family does not occur within one year of regular sexual activity. There is absolute infertility and relative. In the first case, a woman cannot conceive a child due to the anatomical features of the body (absence of a uterus, ovaries), in the second, a number of factors may be the cause. In addition, there is primary infertility, in which the patient does not have the first pregnancy, and secondary.
According to statistics, 10-15% of families in Russia are deprived of the opportunity to have their own children. It is believed that in 40% of cases this is due to men's health, in 60% - due to problems in the female body. Infertility treatment includes conservative (drug) therapy and surgery. Common reproductive technologies:
- in vitro fertilization (IVF), in which the egg and sperm "merge" into one cell, which is then planted in the uterus of the expectant mother;
- surrogate motherhood - a fertilized egg is planted in the uterus of a surrogate mother;
- artificial insemination, in which spermatozoa are introduced into the uterus of a woman for fertilization.
Fetal development
An important characteristic of childbearing is the observation of the development of the fetus during pregnancy. To do this, during the 9 months of gestation, three ultrasound procedures are performed: at 12-14 weeks, 22-24 and 32-34 to assess several fetal parameters. If malformations are detected during the event, it is possible to eliminate them immediately after childbirth, but in our country such operations are performed only in rare cases. Therefore, parents face a difficult choice: to bear a sick child or to have an abortion for medical reasons.
How to maintain reproductive health
Childbearing function largely depends on the lifestyle of a person, the socio-economic situation in the country and family, the patient's attitude to his health. The most important points for preserving reproductive function:
- careful observance of personal hygiene;
- maintaining a healthy lifestyle, the formation of a proper diet;
- rejection of bad habits;
- sufficient amount of vitamins, minerals in food;
- physical activity;
- strengthening immunity;
- protection from STIs;
- timely treatment of existing pathologies (including general somatic ones).
Women
For women's health, quitting smoking, alcohol, enriching the food consumed with the necessary set of vitamins and minerals is important. The priority is to visit the gynecologist twice a year, timely and high-quality treatment of diseases. There are several useful substances that play an important role in pregnancy planning: for example, folic acid is needed for the proper development of the fetus, a lack of vitamin E can lead to miscarriage, vitamin A is involved in the synthesis of sex hormones, and iodine is necessary for the normal functioning of the thyroid gland.
Men
The reproductive health of a man depends on the existing chronic pathologies, high-quality personal hygiene. In addition, vitamins play an important role for the normal functioning of the male reproductive system: for example, vitamin A affects the quality of sperm, vitamin C can save the patient from certain types of infertility, and a lack of vitamin E leads to insufficient production of seminal fluid.
Teenagers
Prevention of violations
Future parents have a serious responsibility when planning a pregnancy. There are a number of preventive rules that must be observed to prevent violations of the reproductive function:
- education of the younger generation about abortion, infections, early onset of sexual activity;
- treatment of concomitant diseases (hormonal disorders, sexual dysfunction, STDs);
- maintaining a proper lifestyle, giving up bad habits;
- therapy of psychological disorders of childbearing function;
- proper family planning;
- assistance to young families;
- measures against maternal and infant mortality.
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The concept of reproductive health
According to the WHO, reproductive health - this 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;
Unhealthy lifestyle of the child's parents;
Lack of hormonal contraceptive industry in Russia;
Deteriorating health of newborns;
Heavy physical loads of women at work;
Impact of adverse chemical and physical environmental factors;
Reducing the reality of social guarantees;
Declining standard of living
Reproductive health - a system of measures to ensure the emergence of healthy offspring, prevention and treatment of reproductive organs, protection against sexually transmitted diseases, family planning, prevention of maternal and infant mortality.
The protection of 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 the provision of reproductive control for the birth of healthy and desirable children.
Family planning - a complex of medical, social and legal measures carried out with the aim of giving birth to desired children, regulating the intervals between pregnancies, controlling the time of childbirth, and preventing unwanted pregnancies.
Family planning includes:
preparation for the desired pregnancy;
examination and treatment of infertile couples;
o contraception.
Birth control - one of the most important tasks of the state, because the birth rate provides normal conditions for the existence of future generations.
The demographic situation in the Russian Federation in recent years has been characterized by a drop 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. The rates of infant and perinatal mortality and maternal mortality remain high. Unfavorable indicators of population reproduction are noted against the background of the deterioration in the health of pregnant women. Over the past 10 years, the incidence of anemia in pregnant women has increased by more than 6 times, by 4 times by the organs of the genitourinary system, by 2 times by the circulatory system and gestosis.
A consequence of the deterioration in the health of pregnant women is an increase in the number of births with various complications. The situation with HIV infection has deteriorated sharply, infertility is widespread, the level of reproductive culture of the population is low, and the population is not sufficiently informed about family planning.
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 the National Action Plan to improve the status of women and increase their role in society. Order No. 355 of October 7, 1996 of the Ministry of Health of the Russian Federation was issued, which determines the measures, procedure and deadlines for the implementation of the National Action Plan.
In recent years, Russia has also adopted important legislative documents that protect the rights of women and families and determine 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 Decree No. 567 dated May 8, 1996, which determined the list of social indications for abortion at a later date. The adoption of the above order is aimed at reducing the number of criminal interventions, maintaining the health and saving the lives of women.
Family planning is one of the most important health problems of the entire state as a whole. The solution to this problem is aimed at creating conditions for the birth of healthy and desirable children, protecting the reproductive health of the population and thereby preserving the gene pool of the nation. Family planning concerns every person, but in essence it is a problem of the country's national security, since it is directly related to the health of future generations. Therefore, by Decree of the President of the Russian Federation of 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, the prevention of childhood and maternal morbidity, and the reduction of mortality. .
As part of the implementation of the federal program "Family Planning", a family planning service has been established in the country. Currently, there are approximately 200 regional family planning and reproduction centers in Russia. Their task is to change the established practice of achieving the desired number of children in the family, using contraception, and not abortion, which is harmful to women's reproductive health. In addition, the tasks of the centers include explanatory work on the optimal age for having children.
An important role in the implementation of the 2Family Planning program is played by public organizations: the Russian Association of Family Planning, which has 50 branches in the regions of the country; International Association "Family and Health"; Russian Society for Contraception.
The operation 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 an increase in sexually transmitted diseases among adolescents and an increase in pregnancies among minors.
Order of the Ministry of Health of the RSFSR dated November 15, 1991 No. 186 “On measures for the further development of gynecological care for the population” provides for the inclusion of social workers in the family planning service, the assignment of the functions of active patronage of women at risk, work with migrants, refugees , women on parental leave, women with antisocial behavior.
8.2.1. Preparing for a desired pregnancy
Preparing for a 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 not less than 2 months after the infectious disease suffered by the spouses. 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 in the absence of exacerbations for 1-5 years.
Pregnancy for women 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 occurrence of unwanted (unplanned)
Pregnancy.
In the prevention of unplanned pregnancy, the use of various methods of contraception by partners is of great importance, which makes it possible to avoid induced abortion. The method of contraception 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 that are inserted before intercourse. Their preventive role in relation to sexually transmitted diseases, including HIV infection, has been proven;
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 at the end of the menstrual cycle. But this method is not recommended in case of emotional or physical overload, climate change, irregular cycle and after abortion;
4. intrauterine contraception- the most common in our country (VMK). Intrauterine contraceptives are highly effective (97%), do not affect the body, are easy to use, available to all social groups, they can be used for a long time and continuously. There are two types of IUDs: 1) inert (not containing chemicals) and 2) medication. Of the inert, an intrauterine contraceptive made of polyethylene, having the shape of a double letter S, has become widespread. The size is selected by the doctor, the duration of use is 2 years. Of the medicinal known spirals of copper wire. Sometimes silver is included in the composition of the spiral material in addition to copper. Duration of use 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 common are Logest, Novinet, Regulon, Mercilon, Marvelon, Trimersi, etc.
6. interrupted intercourse is a common method of contraception. Unfortunately, this method violates the physiology of sexual intercourse and negatively affects the female and male organisms;
7. surgical methods- sterilization of men and women, maintenance of subcutaneous implants that provide contraception for up to 5 years.
The selection of contraceptives should be individual, this should be done by a doctor.
It should be noted that the Church has a negative attitude towards contraception, considering it unacceptable to interfere in the Providence of God, especially since, in essence, contraceptives are abortive means, i.e. the use of contraceptives is tantamount to abortion, "because it destroys the life that has already begun." The Church considers the only acceptable way to avoid pregnancy to be the rejection of sexual intimacy.
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Reproductive health (RH), a-priory World Health Organization (WHO), is a state of complete physical, mental and social well-being in all matters relating to the functions and processes of the reproductive system, as well as psycho-sexual relationships at all stages of life.
In other words, it is the ability of people to conceive and give birth to children, the possibility of sexual relations without the threat of sexually transmitted diseases, the guarantee of the safety of pregnancy and childbirth, the survival of the child, the well-being of the mother and the possibility of planning subsequent pregnancies, including the prevention of unwanted ones.
Thus, RH is the most important component of the overall health of each individual, each family and society as a whole.
Human reproductive health is influenced by many factors. First of all, it is his way of life. Sexually Transmitted Infections (STIs) lead to infertility and infection of the unborn child. Alcoholism, tobacco smoking and drug addiction lead to miscarriage and the birth of seriously ill children. The early onset of sexual activity, and as a result of this, abortions in nulliparous women are the causes of infertility and the development of many diseases of both the reproductive system itself and the whole organism.
Compared to the recent pre-industrial past, when infertility was an exceptional, single phenomenon, today the complete loss or decrease in fertility (from Latin fertills - fertility) - the ability to bear children among citizens of reproductive age is a characteristic feature of Russian reality.
According to different authors (V.Yu. Albitsky, N.N. Vaganov, I.I. Grebesheva, T.Ya. Pshenichnik, V.N. Serov and others), the frequency of infertile marriages ranges from 10-15 to 18- 20%, i.e. at best, every tenth, and at worst, every fifth married couple is faced with the problem of infertility. As a result, their total number is already measured in millions!
According to N.N. Kuindzhi, a survey of 5,000 schoolgirls and students in Moscow showed that 90% of the girls surveyed had never visited a gynecologist, of which 35% of students and 25% of schoolgirls had their first sexual experience before the age of 16, which indicates a low level of sexual education and sexual awareness.
To improve the indicators of RH, it is necessary, first of all, to educate young people in chaste behavior, i.e. virgin marriage. Billions of dollars are spent on chastity programs for teenagers in the United States, since the sexual revolution that swept this country among the first brought nothing but venereal diseases, AIDS, early abortions and infertility.
According to Chastity Day coordinator Rina Lindevaldsen, more than 3 million American teenagers are infected with sexually transmitted diseases every year. In addition, 20% of America's 1.3 million abortions each year are among young people, the highest rate of teenage pregnancy in the developed world.
Drawing the attention of his pupils to the high moral value - love in marriage, V.A. Sukhomlinsky spoke! “You are future fathers and mothers. In a few years you will have children, you will think about raising them the way your fathers and mothers think about you now. Remember that the relationship between a man and a woman leads to the birth of a new person. This is not only a biological act, but above all a great creativity.”
The problems of RH in women are dealt with by gynecologists and obstetricians, and in men - by urologists and andrologists. Gynecology (from the Greek gine + logos - female + science) is a field of clinical medicine that studies the anatomical and physiological characteristics of the female reproductive system, its diseases and develops methods for their prevention and treatment.
Issues related to pregnancy and childbirth are studied by obstetrics (from the French accjucher - to help with childbirth). Urology (from the Greek uron + logos - urine + science) is a field of clinical medicine that studies diseases of the urinary system. Andrology (from the Greek andros + logos - man + science) is a branch of urology that studies diseases of the male genitourinary organs.
Reproductive health indicators
The main indicator of good reproductive health is a successful pregnancy and the birth of a healthy child.Every month, a follicle matures in one of the woman's ovaries - a vial with an egg. Reaching a certain size, the follicle ruptures - ovulation occurs, and the mature egg leaves it and begins to travel through the abdominal cavity and fallopian tubes towards the uterus.
Only at this moment can fertilization occur - the fusion of the egg with the sperm, since the life expectancy and ability to fertilize the female cell lasts only 24 hours. Ovulation occurs approximately in the middle of the menstrual cycle.
In the uterus, an already fertilized egg is implanted and attached to its wall. The egg is the largest cell in the human body, and when it fuses with the sperm, it immediately begins to divide and becomes even larger. A fertilized egg can successfully pass into the uterine cavity only through healthy fallopian tubes.
Their lumen is very narrow, and if they are changed due to inflammatory processes, they become even narrower and the egg gets stuck there - an ectopic (tubal) pregnancy develops. Such a pregnancy, at best, ends with a planned operation to remove it, and at worst, an emergency operation to remove part of the fallopian tube.
That is why it is very important to take care of your health from childhood, to ensure that the legs and lower back are warm and that there are no inflammatory processes in the ovaries and their appendages. The fashion for wearing cropped jackets and jeans with a low waist leads to the exposure of the lumbar region and the development of inflammatory diseases because of this. Such styles of clothing are not suitable for countries with a cold climate, such as Russia, but many girls will lead to infertility.
Gynecologists consider the first day of the last menstruation to be the beginning of pregnancy.
Pregnancy in a woman or the antenatal period (from Latin ante + natalis - before + relating to childbirth) - the period of intrauterine development of the unborn child is divided into two stages:
- embryonic (from the Greek embryon - embryo) - up to 12 obstetric weeks of pregnancy, during which the formation and differentiation of all organs and systems occurs;
- fetal (from lat. fetalis - offspring, fetus) - from 12 weeks to 40 weeks of pregnancy (birth), when the final formation of all organs of the fetus occurs.
In the third week of development, the rudiments of internal organs are already beginning to form in the embryo. On the 18th day from the moment of fertilization, the first heartbeat sounds.
In a four-week-old embryo, black spots are clearly visible on the head - the rudiments of the eyes. This is the period of transition from the formation of the embryo to the formation of the organs of the unborn child. The embryo takes its final form and becomes like a bean with outgrowths that will become limbs, with the rudiments of organs that will then develop. At the end of the first month, the embryo is 4 mm long.
At five weeks, the rudiments of the cerebral hemispheres appear.
At six weeks, tooth formation begins. The heart is already the size of a small bump, four cavities of the heart have formed. The stomach, intestines, pancreas, and kidney apparatus develop.
During this period, with the help of special equipment, the work of the heart can be recorded, which is reduced at a speed of 110 beats per minute. With the help of an electroencephalograph, brain impulses can be recorded confirming that the fetus is a living person. But it is during this period that the largest number of mini-abortions occurs!
A seven-week-old embryo feels touch.
At eight weeks, the embryo can already move its arms and legs. From the 8th week, the development of the embryo ends and the development of the fetus begins. From this moment until the birth of a child, the main changes in the fetus are associated with its growth and subsequent specialization.
By the end of the tenth week, all organ systems begin to work and the embryo acquires the status of a fetus. Facial features appear more clearly: two small slits - eyes, two grooves - ears, one hole for the nose and mouth. At the end of this period, the embryo measures 3-4 cm and weighs 2-3 g. This is the 12th obstetric week. Just for the period of 10-12 weeks there is the largest number of medical abortions - instrumental.
At eighteen weeks, the fetus is fully formed and becomes viable.
Fig.5. The position of the fetus in the uterus
Three times during pregnancy, all women are sent for an ultrasound examination:
- at 12-14 weeks of pregnancy;
- 22-24;
- 32-34 weeks.
In developed countries, when malformations are detected using ultrasound, in many cases they are eliminated using intrauterine operations on the fetus, and sometimes they are simply prepared to correct defects immediately after the birth of the child. In our country, such operations are a huge rarity even in the capital, and you don’t even have to think about the periphery.
If congenital deformities are detected, then Russian women are informed about this and are faced with a choice: continue to carry a pregnancy in order to give birth to a obviously sick child, doom him and themselves to suffering for the rest of their lives, or terminate the pregnancy for medical reasons. Termination of pregnancy at 22 weeks is possible by artificial labor.
The paradox lies in the fact that just during this period of time, according to international standards, the fetus is already viable and cannot be considered as abortive.
- gestational age - 28 weeks or more;
- body weight - 1000 g or more.
Folic acid deficiency is the most common hypovitaminosis among pregnant women, newborns and young children. Moreover, a lack of vitamin B 12 is transmitted from mother to fetus due to its insufficient content during pregnancy in the mother's body or to a newborn child with a lack of folic acid in milk.
Vitamin B deficiency 12 during pregnancy in the mother's body can lead to various negative consequences:
- miscarriage;
- partial or complete detachment of the placenta;
- spontaneous abortions and stillbirths;
- the development of neural tube defects in the fetus; in hydrocephalus (dropsy of the brain);
- anencephaly (absence of the brain);
- mental retardation in the unborn child, etc.
To preserve pregnancy, the health of the mother and the birth of a healthy child, doctors prescribe folic acid tablets when planning pregnancy and during the gestation period. But you need to take vitamin B 12 in a strict dosage prescribed by your doctor. An overdose of folic acid is no less dangerous to health than a deficiency.
In order to solve all the problems of reproductive health, family planning and reproduction centers were created in the Russian Federation.
The main tasks of the family and reproduction centersare:
- the use of modern technologies for the treatment of infertility;
- treatment of the reproductive system using the latest achievements of science and technology, including endoscopic operations;
- implementation of prenatal (prenatal) diagnosis of fetal pathology.
Infertility
Infertility in marriage is the absence of pregnancy with regular sexual activity of the spouses for 1 year or more without the use of any methods of contraception. Modern methods of infertility treatment allow the absolute majority of such families to have healthy children.Diagnosis and treatment of infertility should be carried out by specialists - reproductologists, and both spouses should be included in the treatment process.
When applying modern methods aimed at improving RH, many ethical problems arise. Such a science as biomedical ethics is engaged in them.
Biomedical ethics is a complex phenomenon of modern culture that emerged in the early 1970s. last century in the USA. The term "bioethics" was first proposed by the American oncologist Van Rensselaer Potter. In the 70s. the first research and educational centers of bioethics are being created in the United States, and the problems studied by it begin to attract the closest attention of politicians, journalists, religious figures, and the general public in general.
The interdisciplinary study of anthropological, moral, social and legal problems caused by the development of the latest biomedical technologies (genetic, reproductive, translantological, etc.)
In the next decade, biomedical ethics is rapidly gaining recognition in Western Europe, and since the early 90s. - in the countries of Eastern Europe (including Russia) and Asia (primarily in Japan and China).
Many perinatal centers have genetic counseling rooms and departments. Genetics (from the Greek genetikos - referring to birth, origin) is a science that studies the laws of heredity and variability of an organism.
Today, medical genetics has many moral issues:
- The suffering “subject” is not only an individual, but also a group (genus, family), therefore, a conflict arises between the right to confidentiality of the possession of this information by the client and the communication of this information to his relatives.
- There is a significant gap between the number of hereditary diseases that can be diagnosed and the number of diseases that can be treated, and if so, why traumatize a person by telling him that a fatal gene is present?
- The concern of a geneticist is often the health of an unborn or even conceived individual, but do we have the right to spend money on this, tearing them away from already living people?
- In genetics, one has to deal not with unambiguous, but with probabilistic information.
Reproductive technologies
Reproductive technologies- these are methods of infertility therapy, in which some or all stages of conception and early development of embryos are carried out outside the body.There are the following reproductive technologies associated with human birth:
- artificial insemination (fertilization) with the sperm of a donor or husband;
- in vitro fertilization (IVF) (fertilization outside the body, in vitro, i.e. in vitro) with subsequent implantation of the embryo into the woman's uterus;
- "surrogate motherhood" - when one woman's egg is fertilized in a test tube, and then the embryo is implanted in another woman who acts as a womb donor, carrying a fetus for the genetic mother.
In addition, the very process of donating sperm is considered by opponents of this method to be either promiscuity or an irresponsible attitude towards the highest gift (God, Nature) that every healthy person possesses.
Another modern reproductive technology is in vitro fertilization. The IVF method was created by English scientists - embryologist R. Edwards and obstetrician-gynecologist P. Steptoe. Their research led to the birth in 1978 at the Cambridge University Hospital of the first "test-tube baby" - Louise Brown.
The use of the IVF method is associated with a risk for a woman. In addition, since the probability of pregnancy is not too high when the embryo is transferred to the uterus, several embryos are introduced into the uterine cavity to increase it.
This entails the risk of multiple pregnancy, which is many times greater than with natural conception. Therefore, during IVF, it is often necessary to perform an “embryo reduction” operation, that is, to abort extra accustomed embryos. It turns out that treatment, the meaning of which is to overcome infertility, to ensure the emergence of a new life, leads to the artificial interruption of the same lives ...
The problems of “surrogate motherhood” cause especially heated debate. In this case, in addition to the surrogate mother, the child has a “carrier mother”, “donor woman”, “temporary mother”, etc. - there is also a social mother - a "tenant", an employer.
She, in turn, may not be the woman who dates her egg - in this capacity, the third woman will generally act. Thus, a child born due to such manipulations may have five (!) Parents: three biological (a male sperm donor, a female egg donor and a female uterus donor) and two social ones - those who act as customers.
Are all these tricks with reproductive technologies really necessary, if there are so many orphans, homeless and abandoned children in the world? No less controversial are the issues of cloning, i.e. reconstruction from one cell of the whole human organism or some separate tissue or organ.
Distinguish between reproductive and therapeutic cloning:
- reproductive cloning pursues the goal of producing a genetic copy of an existing or existing person;
- The purpose of therapeutic cloning is to obtain genetically identical embryonic stem cells, which are supposed to be used to treat various diseases (myocardial infarction, Alzheimer's disease, diabetes mellitus, etc.).
Thus, it becomes clear how important it is to carefully preserve your reproductive health by leading a healthy lifestyle, undergoing regular examinations by a gynecologist and maintaining chastity before marriage.