"Infertility as a social and medical problem."

1. Breakfit marriage.

3. Abortion as a social phenomenon.

4. The role of social workers in preventing infertility.

Relevance The chosen topic is the need to raise the birth rate in the Russian Federation to overcome the complex demographic situation

Object is infertility.

The role of social workers in prevention of infertility.

The purpose of test work It is the study of the reasons for infertility in men and women and the role of social workers in preventing infertility.

Breakfit marriage.

Infertility - the inability of persons working age to reproduce offspring. Marriage is considered to be fruitless if the pregnancy of a woman does not occur during the year of regular sexual life without the use of means and methods of contraception. Infertility may be male and female. The male factor is 40-60% in childless marriage.

Consequently, the diagnosis of infertility in a woman can only be delivered after an impurity of infertility in a man (with positive samples confirming the compatibility of sperm and cervix).

Relative - The probability of pregnancy is not excluded. Absolute - Pregnancy is not possible. According to WHO classification, the main groups of reasons for infertility are distinguished:

· Disruption of ovulation 40%

· Pipe factors related to the pathology of uterine pipes 30%

· Gynecological inflammatory and infectious diseases of 25%

· Inexplicable infertility 5%

The primary incidence of infertility, according to official statistics, was in 1998. 134.3 per 100,000 women. In total, 47,322 women appealed for infertility for the year. These are married women who want to have children and those who affected the medical institution, therefore, the real level of infertility is significantly higher. According to special research, the number of fruitless marriages of Russia is 19%, according to international experts 24-25%. Thus, each fifth married couple cannot have children.

The reasons for infertility have social conditioning, being a consequence of abortion, transferred venereal, gynecological diseases, unsuccessful labor. Often, infertility is formed in childhood. Prevention of infertility should be aimed at reducing the gynecological morbidity of women, prevent abortion, forming a healthy lifestyle and optimal sexual behavior.

Infertility is an important medical and social problem, as it leads to a decrease in the birth rate. Deciding the problem of infertility, it would be significantly improved by the reproduction of the population. Infertility is an important socio-psychological problem, as it leads to socio-psychological discomfort of spouses, conflict situations in the family, an increase in the number of divorces.

cutting of morals, antisocial behavior (extramarital bonds, alcoholism), aggravation of selfish character traits, violation of psycho-emotional sphere and sexual disorders in spouses. Long-term infertility creates greater non-psychic tensions and leads to divorces. 70% of fruitless marriages are terminated. *

Diagnosis of infertility is carried out by female consultations, family planning service. And in some cases, inpatient treatment is required in gynecological departments.

Abortion.

According to experts, annually in the world produced from 36 to 53 million abortions, i.e., about 4% of women of fertile age are exposed to this operation. In Russia, an abortion remains one of the ways to regulate the birth rate. In 1998 1 293,053 abortion was produced, which is 61 per 1000 women. If at the end of the 80s 1 \\ 3 of all in the world, then from the beginning of the 90s, thanks to the development of the family planning service, the frequency of abortions is gradually decreasing. However, in Russia, compared to other countries, still remain high.

In most countries of the world, abortions are permitted by law. Only for 25% of women of the world, the reproduction of legal aorta is not available (mostly residents with a pronounced clerical influence or small population). In all European countries, with the exception of the Irish Republic, Northern Ireland and Malta, artificial interruption of pregnancy is allowed. In different countries there are various laws that determine the procedure for interrupting pregnancy.

· L. V. Anokhin and O. E. Konovalov

1. Laws allowing abortion at the request of a woman. In most European countries, abortion can be produced in terms of up to 12 weeks of pregnancy, in Holland up to 24 weeks, in Sweden to 18 weeks. Age in which the girl can independently decide on abortion:

Denmark and Spain - after 18 years

In a number of countries (Italy, Belgium, France), a woman is provided with a mandatory 5-7 days for reflection and taking a weighted solution. These laws operate in countries where 41% of the population of the Earth lives.

3. Laws limiting the right to abortion. In a number of countries, abortion is allowed only in the event of a threat to physical or mental health of women: congenital deformities, rape. About 12% of the population of the Earth live in the context of limiting the right to abortion.

4. Laws prohibiting abortion under any circumstances.

In the legislation of the USSR on abortion, three stages can be distinguished:

1. Stage (1920-1936) - the legalization of abortion.

2. Stage (1936-1955) - abortion prohibition.

3. Stage (1955 by our time) - abortion resolution.

Currently in Russia, any woman has the right to take an abortion at a pregnancy time up to 12 weeks. Artificial interruption of pregnancy for medical testimony is carried out with the consent of the woman regardless of the term of pregnancy. The list of medical testimony is determined by order of the Ministry of Health No. 242 from 12. 12. 96, an artificial interruption of pregnancy for up to 22 weeks of pregnancy can be made with the consent of a woman in social testimony. *

The prohibition system, including abortions, does not lead to the desired results. The prohibition of abortions and the lack of family planning programs lead to an increase in the number of criminal abortions. Teenagers with the help of criminal abortion interrupt their first pregnancy. At the same time, in developing countries, more than half of the cases of maternal mortality accounted for criminal abortion.

But even legal abortion has a serious negative impact ________________________________________________________________

* "Organization of work of women's consultation"

on the body of a woman.

Abortion is the cause of secondary infertility in 41% of cases.

After an abortion, the frequency of spontaneous miscarriages increases 8-10 times.

About 60% of the primary women over the age of 30 are suffering from pregnancy caused by the first abortions. In young women interrupting the first pregnancy abortion, the risk of developing breast cancer increases by 2-2.5 times.

The role of social workers in prevention of infertility.

- This is a freedom in solving the issue of the number of children, their birth rates, the birth of only welcome children from her parents' family.

· Helps a woman to regulate the offensive of pregnancy at optimal deadlines to preserve the health of the child, reduce the risk of infertility; Reduce the risk of infection with sexually transmitted diseases;

· Makes it possible to avoid conception during breastfeeding period, reducing the number of conflicts between spouses;

· Guarantees the birth of a healthy child in case of an unfavorable forecast for offspring;

· Promotes the solution about when and how many children may have a specific family;

· Enhances the responsibility of spouses in front of future children, cultivates discipline, helps to avoid family conflicts.

· Provides the opportunity to conduct a sex life, without fear of unwanted pregnancy, without exposing itself to stress unhindered to study, master the profession, to build a career;

It makes it possible to mature and prepare for the future paternity, helps the fathers provide their family materially.

Adjusting confusion is carried out in three ways:

2. Sterilization

CONTRACEPTION.

In economically developed countries of the West, more than 70% of married couples use contraceptives. About 400 million women developed countries use various methods of contraception to prevent unwanted pregnancy. For 30 years of operation of the family planning service in the world, more than 400 million conflicts were avoided.

in terms of intrauterine spirals and hormonal contraception. Thus, in 1998, 17.3% of femal ages with intrauterine spirals were under observation, and 7.2% of hormonal contraception. It should be noted that if the number of women having a spiral has not changed significantly since 1990, the number of women using hormonal contraception increased by 4.3 times. Special studies show that in Russia approximately 50-55% of married couples are regularly protected from pregnancy.

· Social factors (in particular, attitude to contraception of the government of the country, economic situation)

· Cultural factors (in particular traditions)

· Relationship to religion

· Legislative restrictions (limiting types of contraception that can be used)

When solving the choice of a particular contraceptive, it is necessary to take into account the following provisions:

· Any prevention method is better than protection at all;

· The most acceptable method is the one that suits both partners;

Basic requirements for protection methods:

· Method reliability;

· Minimum impact on the sexual partner;

· Easy to use;

·safety;

· Fast fertility restoration

Thus, the provision of reproductive health rights to women include family planning, is a fundamental condition for their full-fledged life and the implementation of gender equality. The implementation of this right is possible, only when developing the planning service, expansion and implementation of "Safe Motherhood" programs, improving sexual and hygienic education, ensuring the contraceptives of the population, primarily young people. Only such an approach will help solve the problem of abortions and STDs.

STERILIZATION.

indications and contraindications for surgical sterilization. Of the social, there are only three indicators:

3. Age older than 30 years old if there are 2 children

However, sterilization cannot be regarded as an optimal method of pregnancy protection, it does not take high popularity among the population.

1. V. K. Yuriev, G. I. Kutsenko "Public Health and Health"

PETROPOLIS Publishing House St. Petersburg »2000

2. Magazine "Socis" No. 12 2003.

The urgency of the chosen topic is to increase the birth rate in the Russian Federation to overcome the complex demographic situation

Objectis infertility.

Subject:the role of social workers in prevention of infertility.

Goal goalit is the study of the reasons for infertility in men and women and the role of social workers in preventing infertility.

Breakfit marriage.

Female infertility can be primary (in the absence of pregnancy in history) and secondary (in the presence of a history of history). There are relative and absolute female infertility.

Relative- The probability of pregnancy is not excluded.

Absolute -pregnancy is not possible.

According to WHO classification, the main groups of reasons for infertility are distinguished:

· Disruption of ovulation 40%
· Pipe factors related to the pathology of uterine pipes 30%
· Gynecological inflammatory and infectious diseases of 25%
· Inexplicable infertility 5%

The primary incidence of infertility, according to official statistics, was in 1998. 134.3 per 100,000 women. In total, 47,322 women appealed for infertility for the year.

The reasons for infertility have social conditioning, being a consequence of abortion, transferred venereal, gynecological diseases, unsuccessful labor. Prevention of infertility should be aimed at reducing the gynecological morbidity of women, prevent abortion, forming a healthy lifestyle and optimal sexual behavior.

Infertility is an important medical and social problem, as it leads to a decrease in the birth rate. Infertility is an important socio-psychological problem, as it leads to socio-psychological discomfort of spouses, conflict situations in the family, an increase in the number of divorces. Birth of infertility social

Social and psychological disadvantages are manifested by a decline in interest in the events, the development of an inferiority complex, a decrease in general activity and performance. In marriage can be observed with a coating of morals, antisocial behavior (extramarital bonds, alcoholism), aggravation of egoistic traits, violation of psycho-emotional sphere and sexual disorders of spouses. Long-term infertility creates greater non-psychic tensions and leads to divorces. 70% of fruitless marriages are terminated.

The urgency of the chosen topic is to increase the birth rate in the Russian Federation to overcome the complex demographic situation

Object is infertility.

Subject:the role of social workers in prevention of infertility.

The purpose of test work It is the study of the reasons for infertility in men and women and the role of social workers in preventing infertility.

Breakfit marriage.

Consequently, the diagnosis of infertility in a woman can only be delivered after an impurity of infertility in a man (with positive samples confirming the compatibility of sperm and cervix).

Female infertility can be primary (in the absence of pregnancy in history) and secondary (in the presence of a history of history). There are relative and absolute female infertility. Relative- The probability of pregnancy is not excluded. Absolute -pregnancy is not possible. According to WHO classification, the main groups of reasons for infertility are distinguished:

· Disruption of ovulation 40%

· Pipe factors related to the pathology of uterine pipes 30%

· Gynecological inflammatory and infectious diseases of 25%

· Inexplicable infertility 5%

Diagnosis of infertility is carried out by female consultations, family planning service. And in some cases, inpatient treatment is required in gynecological departments.

Genetic factors as oversized constants. The genotype is a set of genes, healthy and pathologically changed from parents. Mutations - changes in genes occurring throughout individual life.

Groups of diseases caused by genetic risk.

Chromosomal and gene hereditary diseases (Down disease, hemophilia and others).

· Hereditary diseases arising under the influence of external factors (gout, mental disorders, etc.).

· Diseases with hereditary predisposition (hypertensive and ulcerative disease, eczema, tuberculosis, etc.).

6.Frees as a social and medical problem. Breakfit marriage. Female and male infertility. The role of social workers in prevention of infertility.

Infertility can be male and female.

Causes of female infertility: violation of the ripening of an egg, violation of the patency or contractile activity of uterine pipes, gynecological diseases. Endocrine causes of female infertility.

Timely appeal to the doctor about the disorders of the menstrual cycle, inflammatory genital processes as prevention of infertility.

Male infertility.

Factors affecting male infertility: malforms for the development of genital organs, operations on genitals, injuries, inflammatory process, chronic diseases, sexually transmitted diseases, alcoholism, drug addiction, toxicizing, endocrine factors.

The male factor is 40-60% in childless marriage. Consequently, the diagnosis of infertility in a woman can only be delivered after an impurity of infertility in a man (with positive samples confirming the compatibility of sperm and cervix).

Female infertility can be primary (in the absence of pregnancy in history) and secondary (in the presence of a history of history). There are relative and absolute female infertility.

Relative - the probability of pregnancy is not excluded. Absolute - pregnancy is not possible. According to WHO classification, the main groups of reasons for infertility are distinguished:

· Disruption of ovulation 40%

· Pipe factors related to the pathology of uterine pipes 30%

· Gynecological inflammatory and infectious diseases of 25%

· Inexplicable infertility 5%

In marriage can be observed with a coating of morals, antisocial behavior (extramarital bonds, alcoholism), aggravation of egoistic traits, violation of psycho-emotional sphere and sexual disorders of spouses. Long-term infertility creates greater non-psychic tensions and leads to divorces. 70% of fruitless marriages are terminated. * Diagnosis of infertility is carried out by female consultations, family planning service. And in some cases, inpatient treatment is required in gynecological departments.

Family planning - This is a freedom in solving the issue of the number of children, their birth rates, the birth of only welcome children from her parents' family.

Family planning:

· Makes it possible to avoid conception during breastfeeding period, reducing the number of conflicts between spouses;

· Guarantees the birth of a healthy child in case of an unfavorable forecast for offspring;

· Promotes the solution about when and how many children may have a specific family;

· Enhances the responsibility of spouses in front of future children, cultivates discipline, helps to avoid family conflicts

· Provides the opportunity to conduct a sex life, without fear of unwanted pregnancy, without exposing itself to stress unhindered to study, master the profession, to build a career;

It makes it possible to mature and prepare for the future paternity, helps the fathers provide their family materially. Adjusting confusion is carried out in three ways:

1. Contraception

2. Sterilization

CONTRACEPTION.

Providing women to protect reproductive healthinclude family planning, is a fundamental condition for their full-fledged life and the implementation of gender equality. The implementation of this right is possible, only when developing the planning service, expansion and implementation of "Safe Motherhood" programs, improving sexual and hygienic education, ensuring the contraceptives of the population, primarily young people. Only such an approach will help solve the problem of abortions and STDs.

STERILIZATION.

In order to protect women's health, reducing the number of abortions and mortality from them since 1990, surgical sterilization of women and men is allowed in Russia.

It is made at the request of the patient in the presence of appropriate testimony and contraindications for surgical sterilization. Of the social, there are only three indicators: 1. age older than 40 years;

2. Availability of 3 or more children

3. Age older than 30 years old if there are 2 children

However, sterilization cannot be regarded as an optimal method of pregnancy protection, it does not take high popularity among the population.

Abortion - artificial interruption of pregnancy. According to modern medical standards, an abortion is carried out, as a rule, under a period of up to 20 weeks of pregnancy or, if the term of pregnancy is unknown, with the weight of the fetus until 400 g.

The methods of abortion are divided into surgical, or instrumental, and drug. Surgical methods involve the extraction of the fetus using special tools, but do not necessarily include surgical operation. Medical, or pharmaceutical abortion is a provocation of spontaneous abortion using drugs.

Medical abortion

Drug abortion is carried out to 9-12 weeks of pregnancy, depending on the recommendations and norms in a particular country. In Russia, the border for conducting a medication abortion is usually lower: up to 42 or 49 days from the beginning of the last menstruation. The medication method relates to secure abortion methods and is recommended WHO upon pregnancy time up to 9 weeks. There are also diagrams of medical abortion for the second trimester of pregnancy.

Medical abortion is usually carried out using a combination of two drugs: mifepristone and misoprostol. According to Russian standards, the patient can get these drugs only at his doctor and takes them in his presence. Free sale of medication abortion is prohibited. In regions where mifepristone is lowered, the drug abortion is performed using only mizoprostol.

The drug abortion combination of mifepristone and misoprostol leads to a complete abortion in 95-98% of women. In other cases, the abortion is completed by the method of vacuum aspiration. In addition to incomplete abortion, the following complications may occur during drug abortion: increased blood loss and bleeding (probability of 0.3% -2.6%), hematometome (accumulation of blood in the uterine cavity, probability 2-4%). For their treatment, hemostatic and antispasmodic preparations are used, the duration of therapy is 1-5 days.

Surgical methods of abortion

Abortion surgical methods, that is, using medical instruments, is carried out only by specially trained medical professionals in medical institutions. The main instrumental methods of abortion are a vacuum aspiration ("mini abortion"), dilatation and banking (acute banking, "scraping") and dilatation and evacuation. The choice of one or another method depends on the period of pregnancy and the possibilities of a particular medical institution. In Russia, the surgical abortion is also often called the procedure for dilatation and bank.

1. Vacuum aspiration

Vacuum aspiration, along with a drug abortion, is a secure method for carrying out an abortion of WHO assessment and is recommended as the main method of abortion under pregnancy up to 12 weeks. When manual (i.e. manual) vacuum aspiration in the uterine cavity, a syringe with a flexible plastic tube (cannula) is introduced at the end. A fruit egg is suused through this tube with fruit inside it. With an electrical vacuum aspiration, the fruit egg is suused using an electric vacuum suction.

Vacuum aspiration leads to a complete abortion in 95-100% of cases. This is an atraumatic method that practically eliminates the risk of uterine perforation, damage to endometrial and other complications that are possible in dilatation and co-usage. According to WHO, the frequency of serious complications to be treated under the hospital, after vacuum aspiration, is 0.1%.

2. Division and Kyuezhezh

Dilatation and Curetzh (also acute Curetzh, in use "scraping") - this is a surgical procedure, in which the doctor first expands the cervical channel (dilatation), and then scraps the walls of the uterus with the help of a curetie (Curetzh). The expansion of the cervix can be carried out with the help of special surgical expansion or by receiving special drugs (in this case, the risk of injury to tissues and development subsequently cervical insufficiency is strongly reduced). Before the procedure, a woman must make pain relief and give soothing drugs.

3.Detation and evacuation

Dilatation and evacuation is an abortion method, which is used in the second trimester of pregnancy. WHO recommends it as the most secure abortion method at these timing. Nevertheless, abortions in the second trimester are generally more dangerous and more often lead to complications than abortions in earlier deadlines. The procedure of dilatation and evacuation begins with the expansion of the cervix, which can take from several hours to 1 day. After that, electric vacuum suction is used to remove the fetus. In some cases, this is enough for a complete abortion, in other cases, surgical instruments are used to complete the procedure.

4.IsMistical childbirth

Artificial childbirth is an abortion method used in late terms (starting from the second trimester of pregnancy) and representing an artificial stimulation of childbirth.

"Infertility as a social and medical problem."

1.Frequent marriage.

2. Female and male infertility.

3.About as a social phenomenon.

4. Roll of social workers in preventing infertility.

The urgency of the chosen topic is to increase the birth rate in the Russian Federation to overcome the complex demographic situation

The object is infertility.

The subject: the role of social workers in infertility prevention.

The purpose of the test work is to study the reasons for infertility in men and women and the role of social workers in preventing infertility.

Breakfit marriage.

Infertility is the inability of persons working age to reproduce offspring. Marriage is considered to be fruitless if the pregnancy of a woman does not occur during the year of regular sexual life without the use of means and methods of contraception. Infertility may be male and female. The male factor is 40-60% in childless marriage.

Consequently, the diagnosis of infertility in a woman can only be delivered after an impurity of infertility in a man (with positive samples confirming the compatibility of sperm and cervix).

Female infertility can be primary (in the absence of pregnancy in history) and secondary (in the presence of a history of history). There are relative and absolute female infertility. Relative - the probability of pregnancy is not excluded. Absolute - pregnancy is not possible. According to WHO classification, the main groups of reasons for infertility are distinguished:

· Disruption of ovulation 40%

· Pipe factors related to the pathology of uterine pipes 30%

· Gynecological inflammatory and infectious diseases of 25%

· Inexplicable infertility 5%

Diagnosis of infertility is carried out by female consultations, family planning service. And in some cases, inpatient treatment is required in gynecological departments.

According to experts, annually in the world produced from 36 to 53 million abortions, i.e. Each year about 4% of femal ages are subjected to this operation. In Russia, an abortion remains one of the ways to regulate the birth rate. In 1998 1 293,053 abortion was produced, which is 61 per 1000 women. If at the end of the 80s 1 \\ 3 of all in the world, then from the beginning of the 90s, thanks to the development of the family planning service, the frequency of abortions is gradually decreasing. However, in Russia, compared to other countries, still remain high.

· L.V. Anokhin and O.E. Konovalov

1. Zakons allowing abortion at the request of a woman. In most European countries, abortion can be produced in terms of up to 12 weeks of pregnancy, in Holland up to 24 weeks, in Sweden to 18 weeks. Age in which the girl can independently decide on abortion:

United Kingdom and Sweden - after 16 years

Denmark and Spain - after 18 years

Austria - after 14 years.

2. Laws allowing the production of abortion for social indications. About 25% of women in the world have the right to abortion on social indications.

4. Laws prohibiting abortion under any circumstances.

In the legislation of the USSR on abortion, three stages can be distinguished:

1. Stage (1920-1936) - the legalization of abortion.

2. Stage (1936-1955) - abortion prohibition.

3. Stage (1955 by our time) - abortion resolution.

Currently in Russia, any woman has the right to take an abortion at a pregnancy time up to 12 weeks. Artificial interruption of pregnancy for medical testimony is carried out with the consent of the woman regardless of the term of pregnancy. The list of medical testimony is determined by order of the Ministry of Health No. 242 of 12.12.96, the artificial interruption of pregnancy up to 22 weeks of pregnancy can be made with the consent of a woman in social testimony. *

But even legal abortion has a serious negative impact ________________________________________________________________

* "Organization of work of women's consultation"

on the body of a woman.

Abortion is the cause of secondary infertility in 41% of cases.

After an abortion, the frequency of spontaneous miscarriages increases 8-10 times.

The role of social workers in prevention of infertility.

As part of the competence of social services, it is possible to provide the population of specialized medical and psychological advice on confusion regulation. Family planning is freedom in solving the issue of the number of children, their birth rates, the birth of only desirable children from ready-to-family parents.

Family planning:

· Makes it possible to avoid conception during breastfeeding period, reducing the number of conflicts between spouses;

· Guarantees the birth of a healthy child in case of an unfavorable forecast for offspring;

· Promotes the solution about when and how many children may have a specific family;

· Enhances the responsibility of spouses in front of future children, cultivates discipline, helps to avoid family conflicts.

· Provides the opportunity to conduct a sex life, without fear of unwanted pregnancy, without exposing itself to stress unhindered to study, master the profession, to build a career;

It makes it possible to mature and prepare for the future paternity, helps the fathers provide their family materially.

Adjusting confusion is carried out in three ways:

1. Contraception

2. Sterilization

CONTRACEPTION.

In Russia, the proportion of married couples protected from unwanted pregnancy is lower than in economically developed European countries, but there are no official statistics. Statistical accounting is carried out only by the number of intrauterine spirals and hormonal contraception. Thus, in 1998, 17.3% of femal ages with intrauterine spirals were under observation, and 7.2% of hormonal contraception. It should be noted that if the number of women having a spiral has not changed significantly since 1990, the number of women using hormonal contraception increased by 4.3 times. Special studies show that in Russia approximately 50-55% of married couples are regularly protected from pregnancy.

The frequency of application of contraception in certain countries affect:

· Social factors (in particular, attitude to contraception of the government of the country, economic situation)

· Cultural factors (in particular traditions)

· Relationship to religion

· Legislative restrictions (limiting types of contraception that can be used)

When solving the choice of a particular contraceptive, it is necessary to take into account the following provisions:

· Any prevention method is better than protection in general;

· The most acceptable method is the one that suits both partners;

Basic requirements for protection methods:

· Method reliability;

· availability;

· Hygienicity;

· Minimum impact on the sexual partner;

· Easy to use;

· safety;

· Fast fertility restoration

STERILIZATION.

In order to protect women's health, reducing the number of abortions and mortality from them since 1990, surgical sterilization of women and men is allowed in Russia. It is made at the request of the patient in the presence of appropriate testimony and contraindications for surgical sterilization. Of the social, there are only three indicators:

1. Age older than 40 years;

2. Availability of 3 or more children

3. Age older than 30 years old if there are 2 children

However, sterilization cannot be regarded as an optimal method of pregnancy protection, it does not take high popularity among the population.

Literature:

1. V. K. Yuriev, G.I. Kutsenko "Public Health and Health"

PETROPOLIS Publishing House St. Petersburg »2000

2. Magazine "Socis" No. 12 2003.

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