Reproduction in Humans
Senior 3 · Biology
Reproduction in Humans
Lesson 5 of 5
25 min
Mukamana is twelve weeks pregnant with her first child. At the health centre the nurse weighs her, checks her blood pressure, tests her blood, gives her iron and folic acid tablets, and books her next visit. Over the coming months she will return several more times. None of these visits is because she is ill: they are how a healthy pregnancy is kept healthy, and how problems are found while they can still be treated. This lesson covers care during pregnancy, birth, and how young people can protect their own reproductive health.
Definition
Antenatal care: the health care a woman receives during pregnancy, from trained health workers, to keep her and her baby healthy.
Labour: the process of giving birth, from the first regular contractions of the uterus to the delivery of the placenta.
Sexually transmitted infection (STI): an infection passed from person to person mainly through sexual contact. Examples: gonorrhoea, syphilis, chlamydia, HIV.
PMTCT: prevention of mother-to-child transmission of HIV, during pregnancy, birth or breastfeeding.
Sexual abuse of a child: any sexual contact with, or sexual act involving, a child (anyone under 18). It is always the adult's crime and never the child's fault.
The World Health Organization recommends that every pregnant woman has at least eight antenatal contacts with a health worker, the first within the first 12 weeks of pregnancy. At these contacts:
A mother living with HIV can pass the virus to her baby during pregnancy, birth or breastfeeding. Without any intervention, WHO reports that between 15% and 45% of these babies are infected. With antiretroviral treatment for the mother, and care for the baby, the risk can be brought below 5%. This is one reason every pregnant woman is offered an HIV test.
At the end of pregnancy the baby usually lies head down. The hormone oxytocin makes the muscular wall of the uterus contract, and the contractions cause more oxytocin to be released: positive feedback (Unit 10). Labour has three stages:
WHO recommends that every birth is attended by a skilled health worker, so that problems such as heavy bleeding can be treated at once. After birth, the baby is dried, placed skin to skin with the mother to keep warm, and put to the breast within the first hour. WHO recommends exclusive breastfeeding for the first 6 months: breast milk has all the nutrients the baby needs, and it contains antibodies that protect against infections.
Worked example 1: planning antenatal contacts
WHO's schedule of eight contacts is: one by 12 weeks, then at 20, 26, 30, 34, 36, 38 and 40 weeks.
Worked example 2: what PMTCT achieves
Consider 1000 babies born to mothers living with HIV.
You studied STIs and HIV in detail in Senior 1 and Senior 2. The key facts:
| Infection | Cause | Common signs | Treatment |
|---|---|---|---|
| Gonorrhoea | Bacterium | Discharge; pain when passing urine; often no signs in women | Antibiotics |
| Chlamydia | Bacterium | Often none; can cause infertility if untreated | Antibiotics |
| Syphilis | Bacterium | A painless sore, later a rash; can pass to a baby in pregnancy | Antibiotics |
| HIV | Virus | Often none for years; weakens the immune system, leading to AIDS | No cure; antiretroviral therapy (ART) keeps people healthy |
| HPV | Virus | Usually none; some types cause cervical cancer | Prevented by vaccine; screening finds early changes |
Prevention, following WHO guidance:
Important
Any sexual contact with a child is abuse and a crime. A child, anyone under 18, cannot consent, and it is never the child's fault, whoever the adult is: a relative, a teacher, a neighbour or a stranger, and whatever gifts or money are offered. If this happens to you or to someone you know, tell a trusted adult and get help at once. After sexual violence, going to a health facility within 72 hours allows medicines that can prevent HIV infection and pregnancy.
The Rwanda Investigation Bureau (RIB) lists these free numbers:
Warning
Common mistakes and myths. (1) "You can tell if someone has an STI by looking at them": many STIs, including HIV, often have no signs; only a test can tell. (2) "Antibiotics cure HIV": HIV is a virus; antibiotics do not act on it, though ART controls it. (3) "A girl cannot become pregnant the first time she has sex": she can. (4) Thinking the cord is cut because it hurts the baby: the cord has no nerves.
Routine Antenatal Care, National University Hospital Singapore. Watch for the checks carried out at each visit, and compare them with the list in this lesson; the schedule of visits differs between countries.
Tip
Memory hook: the three stages of labour are "Open, Out, Afterbirth". The cervix opens, the baby comes out, then the placenta (afterbirth) follows.
Practice: pregnancy care, birth and reproductive health
Key points
Further reading
Sources and credits
Written by Ganzaa: the text, the table, the timeline diagram, the worked examples and the practice questions.
