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close this bookUnderstanding Reproductive Health: A Guide for Media (CMFR - UNFPA, 1996, 49 p.)
View the document(introduction...)
View the documentData card
View the documentI. Introduction
View the documentII. Tracing policy shifts from family planning to reproductive health
View the documentIII. Reproductive health: a perspective and an approach
View the documentIV Why reproductive health?
View the documentV. Fundamental principles
View the documentVI. Issues within and beyond the pelvic zone: some reflections
View the documentNotes
View the documentReferences
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III. Reproductive health: a perspective and an approach


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Reproductive health is concerned with the health of both men and women. But since women’s reproductive role is more marked than men’s, reproductive health becomes more important to women. (Women in this country and in other less developed countries die more from pregnancy-related and gynecological causes than from any other cause like car accidents or suicides. The Philippines’ maternal mortality rate is 209 per 100,000 live births.)

Two points need to be emphasized here.

One, while reproductive health refers to the physiological process of reproduction, it is important to understand that it is part of a woman’s overall health, and should never be taken in isolation or separate from it.

Two, it is important to stress that reproductive health goes well beyond biomedical definitions and categories, extends far beyond genital areas, and way beyond the erogenous zones, though all these are all part of it. Reproductive health is influenced as much by viruses, bacteria, protozoa, or other germs as it is by cultural practices, customary norms, legal structures, poverty levels, educational systems, gender relations, and economic policies, even.

Reproductive health constitutes a perspective, a way of looking at the reproduction and sexuality of women and men, as they live day-by-day in the socio-cultural, political, and economic contexts of their time.

At the same time, it is an approach, a way of dealing with and responding to the actual needs of women and men through the shaping of policies and the design of services.

Reproductive health, as it is presented here, is not a fixed concept and is definitely not engraved in stone. It is flexible and it changes, according to what women and men need, and according to what their circumstances and conditions are.

As a Perspective

Given this, reproductive health, as a perspective, recognizes the roles of women and men, the expectations arising from these roles, the status accorded to these roles, and how such roles and status affect their state of well-being and health.

Reproductive health is to a large extent a reflection of women’s status and relative power. Husbands or partners who abuse and sexually assault their wives or partners or who forbid them to take the pill or use the IUD illustrate the dynamics of power which have adverse consequences for women’s reproductive and overall health.

Men and women have specific roles which society traditionally has ascribed to them (e.g., man, the primary breadwinner, the head of the household; woman, the mother, the wife and housekeeper; and if she needs or is allowed to be, the secondary breadwinner). These roles are indicative of the relative positions of men and women in society. They also give rise to the different expectations which men and women have to fulfill. Further, such roles generate needs which policies or programs may focus on, to the exclusion of other equally vital needs.

For example, nutrition programs have largely been directed towards the effects of malnutrition on women’s ability to give birth to healthier infants, to breastfeed, and to care for their growing children. Such efforts are obviously important to infants and children but manifest a benign negligence towards women whose health, per se, is important. Apart from this, such efforts are blind to the other aspects of women’s persona and the different passages in a woman’s life. Assuming that women’s only role is motherhood, they see all of women’s needs as related to this role and position in life. But as anybody can see, women are not pregnant and lactating the whole time. And sometimes, they never do.


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To achieve reproductive health, therefore, it is important that women and men, but particularly women, should break free from the stereotypes. For instance, women, the stereotype goes, fulfill their potential and are at their best when they are mothers; that their reason for being is motherhood; that they engage in sex for the sole purpose of getting pregnant; that they have little or non-existent libidos. Their enjoyment of sex is denied. Female orgasm is reduced only to phantasm.

Reproductive health is then the ability of women and men to have sexual relations wholly and freely, without coercion, without fear of unwanted pregnancy, without fear of disease.

It is moreover the ability to control one’s fertility, by whatever method or technique one chooses, to avoid or minimize adverse side-effects and consequences, be these physical, emotional, or social.

It is being able to live out one’s sexual orientation without suffering discrimination, stigma or other violent threats to one’s person.

Reproductive health is likewise the ability of women to go through pregnancies safely and, together with their husbands and partners, raise healthy children in a manner that is free from gender discrimination and stereotyping.

It also refers to men sharing and assuming responsibility not only in the control of fertility and birth but also in men being able to destroy oppressive, age-old stereotypes and practices that are harmful and disrespectful to women.

As a Policy Approach

As an approach, reproductive health deals with the needs an problems of each stage in the life cycle of an individual. Each stage in the life cycle of a human being from infancy to elderly – involves special needs and different problems (see Table 2) and these directly and indirectly affect reproductive health.

Table 2 lists some of the health problems that occur in a woman’s life cycle. This list is not inclusive. But it illustrates how each stage builds on the previous stage, how the health and survival of an infant, for instance, is influenced by the mother’s state of health during conception and pregnancy, or how the health of an adolescent may be affected by illness during infancy and childhood.

Certain problems, however, run throughout the entire life cycle and these are called lifetime problems. Violence against women is one problem – as a child, adolescent, a young adult, and an elderly woman, she may be the object of sexual abuse, rape, and incest. It is a critical problem and urgent issue as it erodes the gains which government programs like Child Survival and Safe Motherhood have achieved.

Table 2. Health Problems Affecting Women During the life Cycle

Infancy and Childhood (0-9 years)

Differential feeding and discriminatory nutrition

Discriminatory health care

Adolescence (10-19 years)

Early childbearing
Abortion
STDs, Reproductive Tract Infections (RTls), and HlV/AIDS
Undernutrition and micronutrient deficiency

Rising trend in cigarette smoking and substance abuse

Reproductive years (20-44)

Unplanned pregnancy
STDs, RTls, and HIV/AIDS
Abortion
Pregnancy complications
Malnutrition, especially iron deficiency

Infertility

Post-reproductive years (45+ years)

Cancers, including breast and gynecological cancers
Osteoporosis
Cardiovascular diseases
Osteoarthritis

Diabetes

Lifetime health problems

Violence against women (battering, sexual assault, rape, incest)
Certain occupational and environmental health hazards

Mental illness, depression