Introduction to Reproductive

Health
Prepared by
Naseem Akhter
Nursing Instruction
College of Nursing
King Edward Medical University
Lahore
Objectives
• Define reproduction Health?
• Describe the role of CHN and Health care team in reproductive
health.
• Discuss the women health ,and its relation with poverty access and
quality of life
Reproductive Health
• Health is a complete state 0f physical, mental and social well-being,
and not merely the absence of disease or infirmity, in relation to
reproductive health , reproductive processes, functions and system at
all stages of life.
Components of Reproductive Health
• Safe motherhood{Guidelines about delivery, prenatal, postpartum
care e. t.c}
• Fertility regulation{intentional method of avoidance of pregnancy}
• Prevention and control of reproductive tract infections.
• Sexually transmitted infections (STI).
• [Genital herpes{HSV},gonorrhea ,hepatitis B] etc
• Malignancies of the reproductive tract.
• Newborn care.
Infertility
• The WHO defines “ Infertility is “a disease of the reproductive system
defined by the failure to achieve a clinical pregnancy after 12 months
or more of regular unprotected sexual intercourse (and there is no
other reason, such as breastfeeding or postpartum amenorrhea)
Nurse Role in Reproductive heath
• Health promotion:
• According to WHO” the process of enabling people to increase control
over and to improve the health”.
• illness {period of sickness affecting the mind or body} prevention
• Wellness {free from illness}
• Provide support & counseling
Encourage women in their health goals
and behaviors
• personal hygiene .
• stress management & well-being .
• healthy lifestyles, & avoiding risky behaviors .
• preventing diseases (STIs).
• Diet & exercises.
• Sexuality issues- menopause, contraception, preconception,
• Pre-/postnatal care.
Nurse Role in Reproductive Heath
• Nurses need to model lifestyle for patients.
• Recommend & promote regular examinations.
• Non-judgmental, understanding & sensitive.
• Screen for recognize sexual abuse.
• Recognize cultural differences & beliefs.
• Respect sexual orientation{Sexual orientation is an enduring pattern
of romantic or sexual attraction (or a combination of these) to
persons of the opposite sex or gender, the same sex or gender, or to
both sexes or more than one gender.
Nurse Role in Reproductive Heath
• Provision of ante natal care.
• Monitoring the growth of the fetus & its well being .
• Supplementation of requisite vitamins & micro nutrient ( Folic acid ,
iron , calcium , Vit D , Vit C and B , Iodine ).
• Provision of health aspects related to new born.
• Promotion of good delivery practices.
• Promotion of breast feeding & maternal bonding.
Nurse Role in Reproductive Heath
• Promote & implement good prenatal care.
• Promote institutional deliveries.
• Promote delivery by trained personnel.
• Provide optimal ante natal care.
• Ensure clean delivery table, clean hands, clean cord, clean stump,
clean scissors, & clean delivery practices.
• Promote & maintain optimal deliver.
Nurse Role in Reproductive Heath
• Promote & maintain optimal delivery progress practices such as;
• right identification of stage of delivery
• progress of delivery
• fetal heart rate monitoring
• monitoring of vital signs during delivery
• Episiotomy & appropriate mode of delivery of the baby.
Nurse Role in Reproductive Heath
• Provision of immediate post natal care.
• Promote breast feeding & maternal bonding.
• Monitoring of post natal care, abnormalities of the post natal period.
• Examine lochia, involution pattern of the uterus.
Episiotomy:
• A surgical procedure for widening the outlet of the birth canal to
facilitate delivery of the baby and to avoid a jagged rip of the area
between the anus and the vulva (perineum).
 Cont……..
Postnatal Care:
Care given to the mother and her newborn baby immediately
after birth and for the first six weeks of life.
Maternal Bonding:
The attachment that forms between an infants and its mother
beginning at birth.
Lochia
Lochia is Lochia is the vaginal discharge you have after giving birth. It
contains a mix of blood, mucus and uterine tissue. It has a stale, musty
odor like menstrual period discharge and can last several weeks.
Cont……..
• Encourage the mother on the importance of post natal check ups
(minimum 2 visits within 42 days of delivery).
• Assess for feeding difficulties.
• Promote iron & calcium supplementation.
• Monitor & promote balanced diet & good dietary habits.
• Monitor for post natal blues.
Postnatal Blues:
• Postpartum depression (PPD), also called postnatal depression, is a
type of mood disorder associated with childbirth, which can affect
both sexes.
• Onset is typically between one week and one month following
childbear Postpartum depression (PPD), also called postnatal
depression, is a type of mood disorder associated with childbirth,
which can affect both sexes.
• Onset is typically between one week and one month following
childbirth.
• Encourage plenty of fluids & roughage(fiber) diet.
• Promote adoption of contraception & family planning practices
• Educate the mother on the importance of child bearing & self care
practices including diet, exercise & sleep.
• Screen for sexually transmitted disease & take necessary action.
• Promote the concept of single partner among sexually active population.
• Promote & familiarize community about contraceptive methods.
• Implement the reproductive health initiatives implemented by the
RCH(Rural Health Clinics) program.
EDUCATIONIST :
• Organize training programe for health care professionals.
• Conduct workshops & conferences relating to reproductive health
care & sensitize the community, health care professionals & policy
makers.
• Design curriculum in medical & Para medical curriculum incorporating
aspects of RH( Rural Health) services.
• Develop separate channels in order to sensitize the public on RH
services.
• Practice counseling for eligible couples on the range of RH services.
What Factors Affect Reproductive Health?
• Health and healthcare in general are closely connected with people’s
cultural, political, economic and social circumstances, but none so
starkly as reproductive health.
• Very early childbearing brings heightened risks of complications or
even death, and adolescent girls are in a weak position to negotiate
or gain access to contraception{to prevent pregnancy} or to refuse
sexual relations.
Factors cont…….
• Early and child marriage means losing the chance to gain life
experience, education and opportunities to work.
• Across the world, men marry later than women.
• Gender inequality limits women’s and girls’ control over their sexual
and reproductive lives. Across the world this is manifested in
widespread violations of health and human rights, including sexual
trafficking{when a person causes another to take part in sexual
behavior}.
Factors cont…
• sexual violence and coercion{any act or attempt to obtain a sexual
act}, female genital mutilation (FGM)female genital cutting or
circumcision.}, and pressure to marry and start bearing children at an
early age.
• Poverty effect unsafe health situations and rapid population growth.
High fertility rates can exacerbate and perpetuate poverty both of
individuals and countries.
Factors cont…
• Number of births. Each pregnancy multiplies a woman’s chance of
dying from complications of pregnancy and childbirth.
• Access to contraception saves lives. One in three deaths related to
pregnancy and childbirth could be avoided if women who wanted
effective, appropriate contraception had access to it. That means,
175,000 women each year could be saved and many more could avoid
severe or long lasting injuries.
Factors cont…
• Access to skilled attendance at birth is a key factor in saving lives and
maintaining the health of both mothers and babies. Major gains have
been made since the year 2000 in increasing skilled attendance at
birth, particularly in Northern Africa and Southern Asia.
• Complications during pregnancy and childbirth.
• Every year 10-15 million women a year suffer severe or long-lasting
illnesses or disabilities caused by complications during pregnancy or
childbirth.
Cont…
• The health care solutions to prevent or manage complications are
well known and many can be averted or treated if women have access
to antenatal{ care before birth or relating to pregnancy} in pregnancy,
skilled care during childbirth, and care and support in the weeks after
childbirth.
• It is particularly important that all births are attended by skilled health
professionals, which can make the difference between life and death.
Factors cont…….
• Unsafe abortion: Every year a quarter of all pregnancies end in
abortion, and a quarter of these abortions (around 22 million) are
unsafe.
• This means they are either performed by someone without the
necessary skill to do a procedure safely, or they are carried out in
unhygienic conditions, or both.
• These unsafe abortions result in 68,000 deaths each year, almost half of
them among young women. About 90% of abortionrelated deaths and
disabilities worldwide could be avoided if women who wished to, had
access to effective contraception and comprehensive, safe abortion
care.
Factors cont…
• Social, emotional and psychological support:
• Social inclusion incorporates the degree to which women feel valued,
connected, empowered and able to participate within their
community.
• Interactions of factors such as poor physical or mental health,
inadequate housing or homelessness, exposure to violence and
economic insecurity will limit women’s ability to integrate with their
community and fulfill their potential as valued citizens.
Factors cont…
• Recent research shows the impact of social networks on health
outcomes. Support systems—both formal and informal—play an
important role in women’s health and wellbeing. Belonging to a
family, a community and a society makes people feel good. It also
contributes to healthier communities.
• Social support can also improve health through a variety of
mechanisms including emotional assistance, care giving, support for
access to treatment, and financial or physical help.
Factors cont…
• Safety and security:
• Women’s access to a safe and secure environment has a significant
impact on their health.
• Women’s safety and security can be undermined in range of settings,
including their family, neighborhood, workplace and community
through experiences of verbal, physical and sexual harassment and
violence.
Factors cont…
• QUALITY OF HEALTH CARE
Quality of health care consists of the “degree to which health services
for individuals and populations increase the likelihood of desired health
outcomes and are consistent with current professional knowledge.”
• Receiving high quality of care is an important component of
maintaining the health of any population.
• Quality of health care can be evaluated on the basis of structure,
process, or outcome.
Factors cont…
• ACCESS TO HEALTH CARE:
• Access to health care refers to the degree to which people are able to
obtain appropriate care from the health care system in a timely
manner.
Expected delivery date
• The E.D.D is calculated by adding 9 months and 7 days from the first
day of the last menstrual period (LMP).
• For Example LMP = March 4th, 2008.
• March + 9 months = December.
• 4th + 7 days = 11
• Therefore EDD is 11th December 2008
• Expected date of delivery (EDD) is calculated as followed: 1 st day of
LMP −3 months +7 days, and change the year. Example: calculate EDD
if LMP was august 30, 2007. = June 6, 2008