TOPIC #7: REPRODUCTIVE SYSTEM

Types of reproduction
1. Sexual reproduction – is the creation of off-springs from the joining or fusion of male
and female gametes (sex cells).

Advantages Disadvantages
Produces variation. Loss of energy and time in searching for a
mate and courtship.
Some species will adapt to new situations. Fewer off-springs are produced and the
development is slow.
Mother protects and cares for the foetus
before birth and for the baby after birth
(human sexual reproduction).

2. Asexual reproduction – is the creation of off-springs from one parent without the fusion
of male and female gametes.

Advantages Disadvantages
Produces large numbers of off-springs Lack of variation.
quickly.
There is no need to search for a mate and Poor quality parent will produce poor
no courtship. quality off-springs.
All off-springs are clones. Off-springs cannot survive environmental
changes.
Good quality parent will produce good
quality off-springs.

Clones – are genetically identical individuals.

Structure of the male reproductive system pg. 229(CXC HSB)

151
 Function of the associated structures of the male reproductive system
1. Scrotum (scrotal sac) – contains the testes. Its position outside the body cavity is
important in keeping the temperature of the testes slightly lower than body temperature as
sperm cannot survive long at 370C. It also helps protect the testes from physical damage.

2. Testes (testicles) – produces sperm and male sex hormones.

3. Epididymis – coiled tube in which sperm is stored.

4. Vas deferens (sperm ducts) – tubes that carries sperm to the urethra.

5. Seminal vesicle / Prostate gland / Cowper’s gland – secrete seminal fluid containing
nutrients and enzymes which activate sperm and provide a medium in which they swim.

6. Urethra – tube running down the penis carrying urine and sperm at different times.

7. Urethra muscle – contracts to ejaculate semen.

8. Erectile tissue – makes the penis stiff.

9. Penis – becomes sexually aroused and erect and inserted into the vagina during sexual
intercourse.

10. Foreskin – the skin that covers the end of the penis.
Function of the male reproductive system
1. To manufacture the male gametes (sperm).

2. To deliver the gametes into the female reproductive system.

Circumcision – is a minor operation where the skin of the penis that covers the glans or erectile
tissue is cut.
Reasons for circumcision
1. If the skin fits too tightly over the glans.

2. Religious or tribal ceremony.

3. Ritual entry from childhood into manhood.

4. Hygiene – bacteria can breed under the skin folds as the moist warm conditions are ideal
for this which can lead to infections and unpleasant smells.

152
 Structure of the female reproductive system pg. 231 (CXC HSB)

Function of the associated structures of the female reproductive system

1. Ovary – organ that produces female sex gametes (eggs) and female sex hormones.

2. Oviduct funnel – collects the eggs released.

3. Oviduct / Fallopian tube – narrow tube that carries eggs from the ovary to the uterus.
Fertilization occurs in the upper part of the oviduct.

4. Uterus (womb) – pear-shaped organ in which a foetus develops and is supplied with
nutrients during pregnancy.

5. Cervix – a ring of muscle at the end of the uterus nearer to the vagina. It allows blood to
pass out during periods and sperm to pass through after sexual intercourse.

6. Vagina – elastic muscular tube that can accommodate a penis during sexual intercourse
and at childbirth stretches to let the baby out.

7. Clitoris – becomes sexually aroused and stiffen when stimulated e.g. during intercourse.

8. Vulva – surrounds the opening of the vagina.

Functions of the female reproductive system
1. To produce the female gametes (eggs / ova).

2. To receive the male gamete and provide a site for fertilization and development of the
zygote.

153
 Disorders of the reproductive systems
Cancer – is the abnormal uncontrolled division of cells.
Such cells produce a tumour (lump or growth). If it is detected early, it can be removed:
(i) surgically, (ii) by radiotherapy to destroy the tumour and (iii) chemotherapy using drugs to
reduce cell division. If it is not detected early, then metastasis can occur. This is when parts of
the tumour break off, migrate to other parts of the body and infect other organs.
1. Ovarian cancer – is often not detected until the ovary has greatly enlarged. The
symptoms such as pain in the abdomen and lower back are often attributed to other
causes. It is more common in females over 55 and those with parents and close relatives
who suffered. Activities that reduce ovulation such as numerous childbirths, the
contraceptive pill and breastfeeding make the disease less likely to occur.

2. Cervical cancer – is caused by a virus which is sexually transmitted; Human Papilloma

Virus (HPV). It can be detected early on by giving females a cervical smear test (Pap
smear test). Very recently, a vaccine Gardasil has been developed against cervical cancer
that has to be given in 3 doses over 6 months.

3. Breast cancer – can be detected by checking the breasts by hand to feel if there are any
lumps. In addition, a radiograph (X-ray) of the breast can be taken (mammogram). This is
often offered to those at risk e.g. heredity, smoking, exposure to radiation, use of oral
oestrogen and contraceptive pills for long periods and being more elderly. Removal of the
breast is one way of treatment, possibly followed by radiotherapy. A breast
reconstruction can be done at a later time.

4. Uterine cancer – more common in older women particularly after menopause. It is a

dangerous condition as the tumour grows in the uterus but causes few symptoms.

5. Testicular cancer – can be detected as new lumps on the testes. If it is caught early,
there is an excellent chance of a full recovery. The treatment is by surgically removing
the affected testis.

6. Prostate cancer – the enlarged tumour blocks the urethra causing slow but frequent
urination with a weak flow. Males with these symptoms should therefore have a prostate
specific antigen (PSA) test which would detect a high level of antibodies to the tumour. It
has been recently suggested that it is caused by a virus. Removal of the prostate may
cause sexual problems and other methods of treatment may not be successful.
Growth and Development
The human life cycle is the time from conception to death.
1. Prenatal – growth of the foetus during pregnancy.

2. Postnatal – after birth (0 – 1 year).

154
 3. Infancy – (1 – 4 years).

4. Childhood – (4 – 12 years).

5. Adolescence – (13 – 18 years).

6. Adulthood – (18+ years)

7. Old age
Puberty – is the period of time when the secondary sexual characteristics start to develop in
males and females.
Secondary sexual characteristics

Boys Girls
The whole body undergoes growth spurt and The whole body undergoes growth spurt and
boys get taller. girls get taller.
Facial hair, pubic hair and body hair begin to Pubic and underarm hair grows.
grow.
Larynx enlarges and voice deepens. Breasts develop.
Shoulders and chest broaden as more muscle External genitalia enlarge and darkens.
develops.
Testes grow larger, become active and start Ovaries begin egg production.
sperm production and other chemicals
necessary to produce semen.
Penis enlarges and its skin and that of the Menstruation begins.
scrotum may darken.
Sexual desire. Uterus grows and begins to produce thickened
endometrium (lining) in response to
hormones from the ovary.
Attraction to the opposite sex. Pelvic girdle widens.
Sex hormones are secreted. Sex hormones are secreted.
Sexual maturity causes psychological Sexual desire.
changes.
Attraction to the opposite sex.
Sexual maturity causes psychological
changes.

155
 Production of sperm

pg. 230 (CXC HSB)

The sperm are formed from the cells towards the outside of the seminiferous tubules in each
testis. As these cells move towards the inside they mature, change their appearance and develop
into sperm cell. “Nurse” (Sertoli) cells provide nourishment and protection of the developing
sperm.
NB: In males, meiosis (type of cell division) results in the production of gametes called sperm.
Each sperm has 23 chromosomes. From the time of puberty, a man typically produces 2 – 3
hundred million sperm each day.
Production of eggs
All the eggs a woman ever has are present in her ovaries at her birth. From the age of puberty, an
egg is released every 4 weeks or so, often from one ovary one month and the other the next
month. Eggs are produced as a result of meiosis. Each egg contains 23 chromosomes.
Comparison between a sperm and an egg

Sperm Egg
Contains one set of chromosomes. Contains one set of chromosomes.
Has a tail, so it is motile. Not motile.
Little food store. Possesses a large food store.
Lots of mitochondria. Less mitochondria.
Is not surrounded. Surrounded by a jelly-like coating of cells.
Possesses enzymes in its head to allow Possesses enzymes but not for digesting
chromosomes to enter the egg by digesting membranes.
the egg membrane.

156
Ovulation – is the release of an egg from the ovary into the oviduct.
The movement of the egg along the oviduct is brought about by:
(i) peristalsis – rhythmic contractions of the muscles in the walls of the oviduct.

(ii) cilia – tiny hair-like structures on the lining of the oviduct that sweeps the egg along.
Menstruation – is the breakdown and loss of the soft thickened endometrium (lining) of the
uterus.
Menstrual cycle – is the series of changes that occur in the body of the female to prepare for the
possibility of pregnancy.

pg. 242 (CXC HSB)

The pituitary gland secretes follicle stimulating hormone (FSH) which stimulates the ovary to
produce an egg in a follicle. The follicle secretes the hormone oestrogen which stimulates the
repair and growth of the uterine wall after menstruation and inhibits FSH production preventing
the growth of more follicles. Simultaneously, the pituitary gland secretes luteinizing hormone
(LH) which stimulates ovulation and the change of empty follicles into corpus luteum.
Luteotropic hormone (LTH) also produced by the pituitary gland stimulates the corpus luteum to
secrete the hormone progesterone. Progesterone inhibits FSH and LH secretion and stimulates
the maintenance of the uterine lining in preparation for the implantation of the embryo. If there is
no successful implantation, the corpus luteum degenerates and less progesterone is released
which results in the breakdown of the uterine wall (menstruation).

157
NB: If fertilization occurs, the corpus luteum continues to secrete progesterone and oestrogen
preventing further ovulation and maintaining the thick blood-filled uterine wall for 3 months
before the placenta takes over.
Importance of the menstrual cycle
1. Prepares the uterus to receive a fertilized egg.

2. Controls the development of mature eggs.

Follicle – is a structure that forms inside the ovary for the development of the egg cell.
Copulation
Copulation – is sexual intercourse
Process of copulation
When a man becomes sexually excited, the penis becomes erect and stiff. This is due to an
increase in blood pressure in the erectile tissue spaces surrounding the urethra. The pressure
increases because arteries supplying the tissues dilate as the veins constrict. the penis is inserted
into the vagina of the woman and movement causes ejaculation of semen into the vagina.
Ejaculation is brought about by contraction of the urethra muscle. This expels semen through the
urethra into the vagina.
Fertilization / Conception
Fertilization / Conception – is the fusion of the male and female sex gametes to produce a
zygote.
Process of fertilization
When a man ejaculates, he only produces about 3 – 5 cm3 of semen which contains between 180
and 500 million sperm. The uterus of the woman also contracts and some of the semen is moved
into the cavity of the uterus. The sperm then swim up the oviduct. If an ovum is moving down
the oviduct, one of the sperm may enter head first, losing its tail as it does so. The acrosome
produces enzymes to help penetrate the ovum. Only one sperm is capable of entering into one
ovum due to a chemical change at the membrane surface immediately after penetration. The
resulting zygote has the contents of both male and female nuclei which fuse.
NB: Fertilization takes place in the upper part of the oviduct.

158
 In Vitro Fertilization (IVF)
In Vitro Fertilization (IVF) – occurs when an egg is fertilized by a sperm outside a woman’s
body, typically when a woman is unable to conceive.
Procedure
1. A sample of semen is obtained from the father-to-be.

2. The woman is given hormone – based drugs to increase the number of eggs she will
produce at ovulation.

3. Usually around half a dozen eggs are removed from the woman under anesthetic just a
few hours before they would normally be ovulated.

4. The eggs and semen are mixed in a small Petri dish.

5. The fertilized eggs are left to develop into young embryos in an incubator at 370C for 2 –
3 days.

6. One or more of the embryos are transferred to the uterus in the hope that they implant.

7. If the procedure is successful, nine months later one or more healthy babies will be born.
NB: If the problem is with the man’s sperm, sperm from a donor male is collected and then
inserted into her uterus at ovulation (Artificial Insemination).
Implantation
Implantation – is the process by which an embryo becomes embedded in the lining of the uterus
of a mammal.
Process of implantation
When an egg is fertilized, the cell that results has 46 chromosomes, 23 from the egg and 23 from
the sperm. During the next six days or so, the fertilized egg slowly moves down the oviduct,
dividing first into two cells, then four cells and then into a ball of cells (embryo). Once it reaches
the uterus, it settles into the lining of the uterus (implantation).
Growth and development of the fetus
Growth – is the repeated division of the zygote to provide the many cells that make up the baby.
Development – is the organization of the cells into tissues and organs.

159
5 weeks – embryo is about 0.5 cm long. Head, body and main features can be seen. Brain,
nervous system, heart and blood vessels are visible.
8 weeks – reproductive organs start to develop. Eyelids and ears form. Embryo is about 4.5 cm
in length.
9 – 12 weeks – all structures are developing. Bone and muscles allow movements which may be
felt by the mother. Embryo begins to hear sounds inside and outside of the mother’s body.
Placenta fully developed and the embryo which is about 9 cm in length is now called a fetus.
20 weeks – fetus is about 18 cm in length and has perfectly formed eyebrows, fingernails,
fingerprints and body hair.
28 weeks – development is almost complete.
37 – 40 weeks – baby is about 50 cm long, fully developed and ready for birth.
Pregnancy
As soon as the embryo implants into the lining of the uterus, some of the embryo’s cells together
with the mother’s cells form the placenta. This region develops a rich supply of blood capillaries
under the influence of the hormones oestrogen and progesterone from the ovary. Outgrowths
from the embryo called chorionic villi pass into this region and become surrounded by maternal
blood.
The blood of the mother and fetus never actually mix, although they come very close to each
other. A thin layer of cells acts as a barrier separating maternal and fetal red blood cells. This is

160
important because the mother and fetus are genetically different and their blood often belongs to
different blood groups. As a result, the fetus might die if its blood is mixed with that of its
mother.
Another advantage of the blood being kept apart is that any disease – causing organisms
(pathogens) in the mother’s blood are generally unable to pass from the mother to the developing
baby. However, some pathogens, nicotine, alcohol and other drugs do pass across the placenta to
cause harm.
Food nutrients and oxygen diffuse from the maternal blood capillaries to those of the embryo,
while carbon dioxide and other waste materials diffuse from the embryo to the mother.
Capillaries in the placenta are joined to an artery and vein which pass through the umbilical cord
running from the embryo’s abdomen to the placenta.
Protective membranes form around the embryo. The amnion makes a sac of water which acts as
an excellent shock absorber. The water distributes pressure evenly around the fetus which allows
movement of the fetus.
Functions of the parts during pregnancy

pg. 236 (CXC HSB)

Uterus wall – muscular for contraction at birth and also protects the fetus.
Amnion – the membrane that encloses the amniotic fluid. It is ruptured just before birth.
Amniotic fluid – protects the fetus against mechanical shock, drying out, temperature
fluctuations and allows movement.

161
Umbilical cord – connects the fetus to the placenta. It contains blood vessels:
(a) umbilical artery – carries deoxygenated blood and waste products e.g., urea from the
fetus to the placenta.

(b) umbilical vein – carries oxygenated blood and useful substances e.g., glucose, amino
acids, iron from the placenta to the fetus.
Villi – large surface area for the exchange of materials between blood of the mother and fetus.
Placenta – is a disc – shaped organ with numerous functions:
(a) exchange of soluble materials such as foods, wastes and oxygen between mother and
fetus.

(b) physical attachment of the fetus to the wall of the uterus,

(c) secretion of the hormone progesterone which maintains the uterus lining as the corpus
luteum degenerates by the third month.

(d) protection against dangerous fluctuations in mother’s blood pressure.

(e) helps to prevent the mixing of antibodies between mother and fetus.

(f) helps to prevent the passage of pathogens from mother to fetus.

(g) helps to prevent the exchange of some toxic substances.

(h) prevents mixing of the rhesus factor.

Rhesus factor is a protein on red blood cells that will induce the immune system to make
antibodies to it. If the mother is rhesus – negative, she will lack these rhesus antibodies. The
problem arises if her fetus is rhesus – positive (inherited from the father). At childbirth, the
rupture of capillaries causes the blood of the mother and fetus to mix. The mother now makes
rhesus – positive antibodies. Should she have a second pregnancy with a rhesus – positive fetus,
these antibodies will destroy the red blood cells of the fetus (haemolytic disease). As a result, the
baby will be jaundiced and anaemic. Unless medical attention is given, the baby will die.
NB: During pregnancy it helps if the woman’s partner, family and friends are present to provide
both practical and emotional support. Pregnancy makes very considerable physical and mental
demands on the mother. These may include:
(a) nausea (feeling sick) as a result of “morning sickness” caused by hormonal changes.

(b) tender breasts.

(c) tiredness.

162
 (d) backache.

(e) frequent visits to the toilet due to pressure on the bladder from the enlarged womb.

(f) a loss of sexual drive.

(g) worries over money and the additional demands that a baby may make.
Checking for genetic abnormalities in the fetus
1. Amniocentesis – is a test to check for abnormalities of the fetus.

A sample of amniotic fluid is collected in a syringe through the abdominal wall of the
mother. The fluid contains cells from the fetus which are cultured and then analyzed.
There is a risk of miscarriage following the test.

NB: (a) The procedure is usually offered to older women because fetal abnormalities are
more common in older mothers.
(b) The test which is carried out at 16 – 18 weeks gives information about chromosomal
and gene mutation.

2. In chorionic villus sampling, a sample from the placenta is taken about 8 – 10 weeks into
pregnancy. The sample can be tested within 2 – 3 days to reveal the presence of certain
genetic abnormalities.
Labour
Labour – is the process by which a baby is delivered from its mother’s uterus to the outside
world.
NB: It begins with the contraction of the uterus muscle. These contractions are:
(a) prevented by progesterone – level falls as birth nears.

(b) stimulated by oxytocin – hormone released from mother’s pituitary gland.

(c) helped by oestrogen – makes uterus more sensitive to oxytocin and the level rises as birth
nears.
Stages of labour
By the end of pregnancy, the baby normally lies in the womb with its head towards the woman’s
vagina.
Stage 1: the contractions are gentle at first and come approximately every 20 minutes. Later,
they become more frequent and very intense. The contractions cause the amnion to break
releasing the amniotic fluid. The cervix gradually dilates (widens) for the baby’s head to pass
through. This is typically within 4 – 12 hours of the first contractions.

163
Stage 2: the baby’s head is pushed out of the cervix into the vagina (crowning/”ring of fire”).
The uterus, cervix and vagina together form a continuous birth canal. Strong contractions
continue to push the baby along and within 10 – 60 minutes the baby’s head emerges from the
birth canal. The rest of the baby’s body follows within minutes, helped by a midwife (nurse who
specializes in births) or obstetrician (doctor who specializes in births). The mother bending
forward, holding her breath aids this, to push the diaphragm on top of the uterus. Once the baby
is breathing, the umbilical cord is clamped in two places (to prevent subsequent bleeding) and
then cut.
Stage 3: contractions of the muscular uterine wall continue after delivery and the placenta and
umbilical cord are soon pushed out of the vagina as the afterbirth.
NB: Babies can get quite short of oxygen as they pass out through the birth canal. The skin of
white babies may look bluish immediately after birth. A few breaths of air, often accompanied
by cries soon oxygenate the blood sufficiently for the red blood cells to develop their usual
reddish colour due to the presence of oxyhaemoglobin.
Complications at the end of pregnancy
1. Breech birth – if the baby’s bottom or feet emerge first, the baby is said to be in a breech
position. If detected early enough, the baby can be turned around so that it is born head
first as normal. If not, labour might take longer than usual. This could endanger the baby,
so forceps may be used or a Caesarean section performed to remove the baby from the
womb.

2. Forceps delivery – forceps can be used to turn the baby around or help ease the baby out
of the uterus if the mother’s contractions are rather weak. Nowadays, forceps are used
less often because there is a slight risk that they might damage the baby’s head.

3. Caesarean section – is a surgical procedure in which the baby is “born” through a cut in
the mother’s abdominal wall and uterus. It can be used when a pregnancy is too long and
is risky to the health of the mother and baby. The mother is given an anesthetic and may
need to stay in hospital longer until she has recovered.

4. Induction – is an artificial process that triggers labour either by cutting the amnion
releasing the amniotic fluid or by giving the mother an injection of the hormone oxytocin
to start the contractions. A baby may be induced if the health of the mother or baby is at
risk or if the birth is overdue by more than a week or two.

164
 Birth defects
1. Genetic – results from a faulty gene.

(a) Down’s syndrome – the baby has an extra copy of chromosome 21. As a result, it has
47 instead of the usual 46 chromosomes in each of its cells.

(b) Sickle cell anaemia – a disease in which a person’s blood is less efficient at carrying
oxygen because its red blood cells are sickle – shaped instead of bi-concaved as
usual.

(c) Cystic fibrosis – a disease in which the person’s lungs produce a very sticky mucus.

2. Social and physical – results from the environment such as exposure to radiation and
certain metals e.g. aluminum.

(a) Spina bifida – is a condition in which part of the spinal cord protrudes through the
vertebral column.

(b) Cleft palate – a congenital split in the roof of the mouth.

(c) Fetal alcohol syndrome – if the mother drinks too much alcohol during pregnancy.

(d) Cigarette smoking leads to reduced birth weight, more respiratory tract infections and
a higher risk of dying from a cot death.
Multiple births
Multiple births – is when two or more babies are born at the same time.
(a) Monozygotic / Identical twins – two individuals produced from one fertilized egg.

(b) Dizygotic / Non – identical twins – two individuals produced from the fertilization of two
eggs.

165
 Antenatal / Prenatal care
Antenatal / Prenatal care – is the care and advice needed during pregnancy for the mother
along with checks on fetal growth.
Antenatal clinic – is a place where care and advice is given to the mother during pregnancy
along with checks on the fetus.
This includes:
(a) Advice on a healthy diet, exercise, rest and sleep patterns.

(b) Health precautions such as avoiding infections, cigarettes, alcohol, illegal drugs and
unnecessary medication.

(c) Guidance on motherhood.

(d) Regular checks by a doctor or at a clinic which will provide:

 Weight checks – measured each visit. Weight should increase due to the
increasing mass of fetus, growing uterus, placenta, amniotic fluid, umbilical cord
and the fat reserves that may build up in anticipation of lactation (milk
production).

 Blood pressure measurement – taken regularly to check that it is not too high.
Too high a blood pressure results in a build-up of proteins and waste substances in
the mother’s blood (toxaemia) which can be dangerous and even fatal to both
mother and fetus.

 Internal examination of vagina and cervix – check for the presence or absence
of infection such as thrush which is a fungal condition. A cervical smear is taken
to check for cancer cells.

 Blood tests – to check that the mother has enough haemoglobin and is not
developing anaemia. Provides the blood group which is noted in case of an
emergency blood transfusion. Checks for the presence of antibodies to German
measles (Rubella).

 Urine tests – checks for the presence of sugar or proteins. Sugar may indicate
gestational diabetes while proteins suggest that the kidneys are not working
properly and can indicate toxaemia.

 Ultrasound scans – produce a visual image of the fetus to check its development,
if the heart is beating, sex and presence or absence of physical abnormalities,
position of placenta, etc.

166
  Mother will be asked about her medical record, general health and personal
circumstances.
NB: Placenta praevia – is the condition where the placenta forms lower down near the cervix.
As a result, the placenta could be delivered before the baby, which would then die from lack of
oxygen. The mother would also be at risk from loss of blood from the site of the placenta if left
without medical intervention.
Postnatal care
Postnatal care – provides advice to the mother on her diet, behaviour and how to care for the
baby, with checks on its growth and development.
This includes:
(a) Initial checks to ensure that there is no bleeding from the uterus or damage to the vagina
and cervix.

(b) Knowledge about vaccinations.

(c) Advice on how to wean the baby onto semi-solid and then solid foods.

(d) The importance of keeping the baby warm and clean.

(e) The importance of regular checks.

(f) The importance of the use of sterilizers.

(g) Advice on the importance of breastfeeding.

(h) Advice on sleep patterns for the baby.

(i) Advice on a healthy diet so that her milk is nutritious and well balanced.

(j) Advice on and the importance of how to bathe, touch and talk to the baby.

Weaning – is gradually changing the baby’s diet from the mother’s milk to other foods.
Lactation (breast feeding) – is the secretion of milk by a female mammal in their breasts.
Colostrum – is the first breast milk rich in antibodies to protect against infections and in
nutrients for growth.

167
 Advantages of breast feeding
1. Contains antibodies which protect the baby against infections.

2. Contains all the nutrients the baby needs for growth and development in the correct
proportions.

3. It is sterile and at the correct temperature.

4. Prevents gas which can be passed on by bottle feeding.

5. It is readily available.

6. It helps to prevent breast cancer.

7. Helps the womb to return to its normal size.

8. Fosters a closer relationship between mother and child physically and emotionally.

9. It is more economical.

10. The passing of germs is less likely.

11. It curtails the amount of air entering the child’s bowel.

Disadvantages of breast feeding
1. Pain due to nipple tenderness.

2. Leaking milk when breasts are full.

3. Embarrassment about breast feeding especially in public.

4. Feeling tied down to the demands of breast feeding.

5. Unequal feeding responsibilities since the fathers are left out.

6. Perceptions about diet restrictions.

7. Limited birth control options.

8. Vaginal dryness.

9. Concerns about the safety of medications and breast feeding.

168
 Advantages of bottle feeding
1. Exact quantities of the baby’s food intake can be measured.

2. Other people can help with the baby’s feeding.

3. No worry about breast feeding in public or pumping at work.

4. No sore nipples for the mother.

5. Frees up the mother to deal with older children.

6. Less frequent feedings.

7. Infant sleeps for longer periods.

Disadvantages of bottle feeding
1. Formula milk is expensive.

2. Formula milk is not easily digested as breast milk and infant may not tolerate the
formula.

3. Microbes can be passed to the baby if bottles are not sterilized or milk is made with
unclean water.

4. No transfer of passive immunity; i.e. antibodies from mother to child to fight infections.

5. Greater wastage since the unused portion of the formula has to be discarded after about
one hour or so.

6. More time needed to get the formula ready for the infant to consume.

7. May have to try infant with many different formulas before finding the right one, hence
more time is spent shopping.
Family planning
Family planning – is where the number and timing of children in the family is controlled.
Importance of family planning
1. It is less expensive to have a smaller family.

2. Both parents may wish to pursue a career.

3. More time can be devoted to each child if the family is small.

169
 4. Housing availability.

5. Empowering people and enhancing education.

6. People may not want children later in life as older parents have a higher risk of having
babies with birth defects.

7. Further development of industry e.g. tourism which is opening up more opportunities for
females to obtain employment.

8. To reduce the number of births because of the rapidly expanding population.

9. Helps reduce infant mortality.

10. Reducing adolescent pregnancies.

11. Preventing pregnancy-related health risks in women.

Contraception
Contraception – is the prevention of pregnancy.
Methods of contraception
1. Natural – understanding the body’s natural cycles.

Method Definition Advantages Disadvantages

Abstention Not having sexual Completely Relies on self-
intercourse. effective (100%) control of both
against STIs partners.
infections and
pregnancy. May not be prepared
with a “back-up”
It is free. method if or when
persons decide to
No medical or have sex.
hormonal side
effects.
Withdrawal / Withdrawal of the No supplies Very unreliable
Coitus interruptus penis from the needed. because pre-
vagina prior to ejaculatory fluid
ejaculation. No health problems may contain viable
or side effects. sperm.

Immediately It relies on self-

available and free. control of both

170
 partners.
Rhythm / Safe Avoidance of Can be effective if High failure rate and
period sexual intercourse the woman has unreliable because
during the fertile regular periods and of cycle variations.
period. keeps careful
records of the No protection
dates. against STIs.

No physical side Inhibits spontaneity.

effects.

No method-related
health risks.

Very economical.

NB: In the rhythm / safe period method, the woman calculates her fertile period each month by:
(a) Using a calendar.

(b) Taking her body temperature.

171
(c) Noticing changes in the mucus in her cervix.

2. Barrier – a physical barrier between the egg and sperm.

Method Definition Advantages Disadvantages

Condom A thin latex rubber Very effective if Can sometimes
sheath which is used properly. break or slip off.
rolled onto a
man’s erected Easily accessible Need to plan ahead;
penis before and inexpensive. must be available
sexual intercourse when you have sex.
in order to trap Full personal
sperm. control over use; Latex and/or
no special spermicidal
procedures or allergies; other
exams. brands and types of
plastic available for
Side effects those who suffer.
uncommon.
Loss of sensation.
Helps prevent

172
 pregnancy and Must be stored and
most STIs. handled properly
(expiry date).
Can be used with
other methods.
Intra-uterine device Is a loop or coil of Very effective but Heavy bleeding and
(IUD) steel, copper or needs to be fitted pain.
plastic that fits in by a doctor.
the uterus and Pelvic
prevents sperm Safe, inexpensive Inflammatory
from passing and reversible. Disease (PID).
through and a
fertilized egg from Have long-lasting May come out
being implanted in effects. accidentally if not
the womb. properly inserted.
Do not interfere
with spontaneity. Ectopic pregnancy
(occurs when the
Reduces or fertilized egg
eliminates attaches itself in a
menstrual flow and place other than
cramping. inside the uterus.)

Diaphragm / Cap A dome-shaped Very effective and Difficult for women

piece of rubber pose no serious to insert and
which covers the health risks. remove.
entrance to the
cervix and Can be put in up to No protection
prevents sperm six hours before against STIs.
from reaching the sex, so it doesn’t
egg. It is used with affect spontaneity. Allergic reaction to
a spermicidal the contraceptive
cream to kill Can last for a long cream used with in.
sperm. time once it is
properly taken care Can cause vaginal
of. irritation.

Needs to remain in
the vagina for up to
six hours after
intercourse to
ensure that the
sperm is killed by
the spermicidal
creams used with it.
3. Hormonal – use of a chemical.

173
 Method Definition Advantages Disadvantages
Spermicide A cream, jelly or Contains no May cause
foam which is hormones. irritation or allergic
placed into the reaction.
vagina before Used only when
sexual intercourse needed. No protection from
in order to kill STIs.
sperm. Easily accessible
and inexpensive. Very unreliable or
less effective than
May provide some other contraceptive
lubrication. methods.

Can be messy.
Needs to be used
with another
contraceptive
method.

May have to
interrupt sex to
apply.
Combined pill Contains the Very effective and No protection from
hormones completely STIs.
oestrogen and reversible.
progestogen. The Some women have
oestrogen inhibits Easy to take and a hard time
FSH production so can be used at any remembering to
that no eggs age and by breast take the pill.
mature. feeding women.
Some women
May result in experience side
lighter, shorter effects e.g. weight
periods. gain / loss, nausea,
vomiting, breast
May reduce tenderness,
menstrual cramps. decreased sex
drive, etc. and other
No interruption of medical conditions
sex. e.g. hypertension,
blood clots, heart
Regulates a attacks, strokes,
woman’s period. etc.

174
 Can have positive Must be taken
effects on the skin within 12 hours of
e.g. improve acne. the same time each
day.
May provide some
protection against Must be prescribed
ovarian and by a doctor.
uterine cancer
including benign
cysts of the breast.
Progestogen-only pill Contains Very effective if Offers no
progestogen which used properly. protection from
works partly by STIs.
making the Reduce menstrual
woman’s mucus in cramps. Must be taken at
the cervix thicker, the same time
so that the man’s May eliminate every day.
sperm can’t get periods. May cause
through. It also irregular periods
prevents a No interruption of and spotting.
fertilized egg from sex.
implanting. May initially
Can be used while induce temporary
breast feeding. side effects such as
pimples, greasy
skin, breast
tenderness,
bloating and
headaches.

4. Surgical – medical operation which sterilizes the individual.

Method Definition Advantages Disadvantages

Vasectomy A surgical Very effective, Reversal is
procedure in permanent and difficult, expensive
which the sperm safe. and often
ducts are cut and unsuccessful.
tied. Quick recovery.
Patient may regret
No routine decision.
contraceptive
required. No protection from
STIs.
No interference

175
 with sexual Not immediately
intercourse. effective since all
sperm have to be
Simple procedure. cleared from the
reproductive tract
No significant which make take
long-term side about 3 months.
effects.

Less invasive and

more cost
effective.

Allows the male

partner to assume
some responsibility
for birth control.

Allows sexual
spontaneity.

Tubal ligation A surgical Highly effective, Possibility of

procedure in safe and patient regret.
which the two permanent.
oviducts are cut Difficult to reverse.
and tied. Quick recovery.
More expensive
Lack of significant than vasectomy.
long-term side
effects. Future pregnancies
could require
Partner assistive
cooperation not reproductive
required. technology e.g.
IVF.
Cost effective in
the long run. No protection from
STIs.
No effect on sexual
pleasure. Some health risks
including abnormal
Protects women bleeding and
whose health ectopic pregnancy.
would be seriously
threatened by Infection or abscess
pregnancy. of wound.

176
 Reduces Pelvic Feelings of
Inflammation discomfort.
Disease (PID) and
ovarian cancer.

NB: Emergency contraception:

1. Morning-after pill – taken within 3 days of unprotected sexual intercourse.
2. Having an IUD fitted within 5 days of unprotected sexual intercourse.
Birth control – is prevention of birth by contraception or abortion.
Abortion
Abortion – is the termination of a pregnancy by the removal of an embryo or fetus from the
uterus, resulting in or caused by its death.
Types of abortion
1. Spontaneous / Miscarriage – is a natural abortion when the developing embryo or fetus
dies and is lost from the body.
Reasons: (a) The embryo has not implanted properly into the uterine lining so that the
fetus has not developed normally. (b) Severe genetic abnormality.

2. Induced abortions – either medically using hormones or surgically.

(a) Medical – involves taking the abortion pill which has hormones that cause the
removal of the pregnancy via the vagina. It has to be performed early in pregnancy
between 1 – 9 weeks. The pill creates sickness e.g., vomiting, diarrhoea.

(b) Surgical – involves the removal of the pregnancy by either suction or by scraping.

(i) Vacuum aspiration – is performed during the first 6 -12 weeks of pregnancy. The
woman lies on her back with her feet in stirrups and an instrument called a speculum
is inserted to open the vagina. A local anesthetic is administered to her cervix. Then
an instrument is used to hold open the cervix which is then dilated. When the cervix
is wide enough, a long plastic tube called a cannula connected to a suction device, is
inserted into the uterus to suction out the fetus and placenta. The procedure usually
lasts 10 – 15 minutes and requires a few hours to recover after the abortion.

(ii) Surgical dilation and evacuation – is carried out during the first 12 – 15 weeks of
pregnancy. A long, loop-shaped knife is inserted through the dilated cervix that
scrapes the linin, placenta and fetus from the uterus. A cannula may be inserted for a
final suctioning. This procedure usually lasts 10 minutes with a possible recovery
period of 5 hours.

177
 Reasons for abortion
1. There is a risk to the life of the mother.

2. The female’s mental or physical health would be greatly damaged; more so than if the
pregnancy was not terminated.

3. There is a strong likelihood of the child being born with severe physical or mental
impairments.

4. There is a large risk to the health of the female’s existing children as a result of
continuing the pregnancy.

5. Lack of parental readiness, maturity and willingness to accept responsibility.

6. Inadequate finances to raise a child.

7. Being a victim of rape or incest.

8. Continuation of educational goals.

9. Problems with relationship.

10. Previous children are grown and do not want to have any more children.
Ethical Concerns of Abortion
Abortion is a very controversial topic with people having very strong opinions.
When discussing abortion, you might like to consider the following points:
1. Many women have died and many more been seriously injured from having illegal
abortions carried out by people who do not have a medical training or appropriate
facilities to carry out abortions safely. Since, in some countries, it is easier now to have
an abortion, there have been fewer reported deaths. The argument is that there have
always been abortions (and always will) so it is better to have control over them and
make them safe.

2. The rights of the baby must be weighed against those of the mother. The mother may be
physically and/or psychologically harmed. She, therefore, has the right to decide whether,
or not, to have the child. Because no method of contraception is 100% effective, abortion
will be necessary.

3. The birth of a child with physical or mental impairments can place an intolerable burden
on parents leading to the child (and the parents) suffering.

178
4. Unwanted children (with physical or mental impairments or not) may be neglected or
abandoned. Problems will be created for society to deal with.

5. In certain circumstances, for example rape cases, some people will say that abortion is the
only practical and humane solution so that a woman does not give birth to an unwanted
child who will remind her of a traumatic event in her life.

6. Some people have the firm belief that life begins at conception. To destroy an embryo or
fetus after this time is considered to be murder by the people who hold these beliefs.

7. Some women use abortion as a method of birth control rather than use contraception
methods.

8. Most religions view abortion as morally wrong.

9. Techniques, such as chorionic villus sampling, allow abnormalities to be detected with

the possibility of remedial measures to be undertaken whilst the fetus is in the womb.

10. Fewer than 10% of abortions are carried out for reasons of fetal impairment. Some people
argue that the majority are performed for social reasons and state that this is the easy way
out. More, they argue, should be done to improve the quality of life of the child.

11. People with mental or physical impairments can often lead happy and creative lives. Any
aborted fetus will not have this opportunity.

12. Abortions are a health risk to the female and may lead to physical and psychological
scars. Sometimes these do not become evident until many years later when women feel
guilt about having had an abortion.

13. There is no method of contraception that is 100% effective. This means that even though
they took precautions to prevent becoming pregnant, women may get pregnant when they
are unable to support a child. Abortion is a way to ensure that an unwanted child is not
brought into the world.
Rules of abortion
1. The procedure must be carried out under medical supervision in a licensed clinic or
hospital.

2. The woman should seek counselling from an appropriate guidance or advice centre.

179
 Advantages of medical abortion
1. Gets rid of unwanted pregnancies.

2. To save a life in certain instances where there is a choice between woman and child.

3. Safer and more effective.

Disadvantages of medical abortion
1. Can be fatal.

2. Painful process.

3. Lead to post-mortem depression.

4. May lead to infections in the womb.

5. Sterilization – inability to have future children.

180