Grade

12
Personal Development

UNDERSTANDING
UNDERSTANDING THE
THE
HUMAN
HUMAN REPRODUCTION
REPRODUCTION

Reproductive Health, Productive Life

"With great power there must also come
great responsibility"
Table of Contents
Introduction to Understanding
Human Reproduction 1
Chapters

1 Puberty & Development 2

2 The Menstrual Cycle 5

3 Fertilization & Conception 10

4 Pregnancy & Embryonic

Development
14

5 Birth & Postpartum Period

18

6 Contraception & Family Planning 22

7 Reproductive Health & Wellness 26

Booklet Contributors
29

INTRODUCTION
E very human being possesses a
reproductive system, a remarkable
mechanism that allows us to create new life.
Remember what Spiderman says: 'With
great power, there must also come great
responsibility.' This means that since we
have the power to create new life, we need
to be responsible in how we use it.
In this educational booklet, we'll explore
human reproduction and how our choices
play a crucial role. It's like being a superhero
—having the power to create life comes with
the responsibility to make good decisions for
ourselves and the new lives we might bring
into the world.
In each chapter of this educational booklet,
you'll discover something fascinating that
will leave you astonished. Rest assured,
each chapter will bring new insights. In
Chapter 1, 'Puberty & Development,' we'll
discuss how our bodies change as we grow
up. Puberty is like a superhero
transformation, and we'll explore what to
expect during this exciting time.
Chapter 2, 'The Menstrual Cycle,' answers
the question: Ever wonder why some people
have periods? We'll explain the menstrual
cycle—a natural process that prepares the
body for making new life.
1
Chapter 3, 'Fertilization & Conception,'
invites you to dive into the magic of making
babies! We'll explore how an egg and sperm
come together, kickstarting the journey of
creating a new human being.
Chapter 4, 'Pregnancy & Embryonic
Development,' is all about the incredible
journey of pregnancy. We'll follow the baby's
development from a tiny cell to a full-fledged
human, exploring the stages along the way.
Chapter 5, 'Birth & Postpartum Period,' is
your guide to welcoming new life! We'll
discuss what happens during childbirth and
what comes after—the postpartum period.
It's like the beginning of a new adventure.
Chapter 6, 'Contraception & Planning,' shifts
focus to planning for babies now that we
know how they are made. We'll explore
ways to make choices about having a family
and being responsible parenting.
Lastly, in Chapter 7, 'Reproductive Health &
Wellness,' we'll discuss how to keep our
bodies healthy. This chapter emphasizes
overall well-being in the journey of human
reproduction.
 Puberty & Development
CHAPTER 1
What Is Puberty? Why Does it Happen?
Puberty is the period when a person develops
into sexual maturity. This means that a boy or girl
undergoes the physical changes that make them
capable of sexual reproduction. While puberty is
known to be a teenage event, in actuality the
internal changes begin much earlier— at about
age 8 for girls and age 11 for boys.
Hormones, which are specialized substances in
our bodies released by glands, signal our bodies
to develop in certain ways. Puberty occurs when
hormones signal the development of organs
related to sexual reproduction. For girls, this
includes the development of ovaries and the
fallopian tube. For boys, hormones signal the
development of gonads and other organs related
to semen production.
While many of the pubertal changes occur
internally, outside indications signal the onset of
sexual maturity. For girls, sexual maturity is
marked by "menarche" or the first menstrual
period (on average, between 10 to 15 years of
age). For boys, sexual maturity is marked by
"spermarche" or the production of viable sperm
and first ejaculation (on average, around the
ages of 11 to 16). For boys, spermarche is often
signaled by nocturnal emissions, otherwise
known as "wet dreams"
2
P hysical changes during
the adolescent years are
dramatic— with teens
seemingly growing inches
overnight, their bodies re-
shaping and voices
changing all at once. This
transformation is complex,
sometimes confusing, and
even anxiety provoking.
Understanding this process
of change, and knowing
what to expect can help
prepare youth and their
parents for the transitions
ahead.
This educational booklet provides readers with
basic facts about the changes that teens go through
during puberty. It also provides parents with
suggestions on how to help their developing
adolescent through this period of physical
transitions.
What is Wet Dreams? Why Does it Happen?
Wet dreams, scientifically known as nocturnal emissions,
occur during sleep when an individual experiences
ejaculation. This phenomenon is more common in males
during puberty and is a result of sexual arousal and
hormonal changes. It happens involuntarily and is a natural
part of sexual development. During a wet dream, the body
releases semen, a mixture of sperm and other fluids, often
accompanied by sexual dreams. Wet dreams are a normal
and healthy aspect of sexual maturation, reflecting the
body's adjustments to hormonal fluctuations and the
awakening of sexual functions.
 3

H ow Will the Body Change?

In addition to sexual maturation, adolescents also

experience physical changes in the following
ways:

1. Maturation of Secondary Sex Traits

Secondary sex characteristics are those that are
related to, but not directly involved in
reproduction. For instance:
• As early as age 8, girls experience "breast
budding" or the emergence of breasts. Hair
growth under the arms and pubic areas also
begin.
• As early as age 11, boys experience growth
in the testicular area, and start facial, underarm
and pubic hair growth
• By the end of puberty, boys have about 1.5
2. The Growth Spurt times as much muscle as girls. The muscle-to-fat
During puberty, hormones signal the body to grow ratio at the end of puberty is 3:1 for boys and 5:4
faster. This hastened growth is called "the growth for girls.
spurt." Some things to note:
• The growth spurt starts at around age 11 for
4. Increase in Strength and Endurance
girls and 13 for boys. Thus, girls become generally Partly because of the increase in muscles,
taller than boys during these years, though boys puberty is a time of increased strength and
often catch up and generally end up taller. endurance.
• At the peak of the spurt, boys can increase • In addition to increased muscle mass, there
their height to an amazing 4 inches in a year, and is maturation of circulatory and respiratory
girls can grow 3.5 inches per year. organs. This results in increased lung and heart
• The growth spurt does not happen evenly capacity.
throughout the body. The head, hands and feet go • Changes are greater for boys and by the end
through the growth spurt first. This is followed by of puberty, they have overall higher
the legs and arms, and lastly by the torso and endurance/strength.
shoulders. Teenagers thus appear
disproportionate in their appearance, at least for a
short period of time.

3. Change in Body Proportions

Another change during puberty happens in how
the body is proportioned. Before puberty, the
bodies of girls and boys are very similar. During
During puberty. muscle and fat tissue increase
and are redistributed in ways that give girls and
boys more adult-like appearances.
In addition to the four main transitions outlined above,
•Both boys and girls have increased fat/muscle
adolescents also experience. a ranee of changes that are
growth.
often related to the hormonal activity in puberty. These
• Boys have a faster increase in muscle tissue,
transitions include the deepening of voice for males, the
and girls have a faster increase in fat tissue.
emergence of acne, emergence of body odor and mood
• For girls, fat moves from the middle to the
changes. These all are related to the maturing body,
upper and lower body, giving them a curvier
particularly to hormones and sexual development
appearance.
 4

Puberty & Development

S trategies to Help Youth
Through Puberty
Several things can help both youth and their
parents suсcessfully deal with the physical
transitions of puberty. First, youth and parents
should learn about the changes. When parents
and youth are educated about the process of
puberty, particularly when they know what to
expect, they are much better prepared for the
changes ahead. Knowing what to expect and
how to deal with those physical changes
alleviates the anxiety and confusion that can
sometimes result from the rapid changes during
this period
Second, parents and youth should understand
that the changes are normal, and that there is no
shame in what is going on. For instance, girls'
first periods and boys' nocturnal ermissions ("wet
dreams") are both normal. While not often.
discussed, this is all a part of the normal process Finally, parents and youth should continue to communicate in
of development. Furthermore, chances are that an open and honest manner, questions and concerns might
that when a teen goes through these events, their arise both from the parents and the youth, and it is important
peers are undergoing them, too. that both sides understand that the other is ready and
available for communication. At the same time, parents should
be willing to give their teen some room if they are not ready to
talk. They should continue to let them know, however, that
they are present and supportive, and willing to discuss issues
and questions when their teen is ready. Parents also should
communicate that they are willing to seek for more information
on their behalf if their children have questions that they do not
have the answers to.

It was also found that parents and adolescents encounter

Third, parents and youth should learn how youth
can adapt to the changes. Many of the
experiences are new and teens need to learn
how to properly address the new experiences.
While some information might be available from
school, friends and even the internet, some
things might not be addressed. In particular,
parents and teens should address the practical
concerns that puberty brings, for instance, new
hygiene needs (eg, how to deal with hair growth,
menstrual periods, nocturnal emissions, body
odors), as well as clothing (e.g., undergarments)
and product needs (e.g., deodorant).
difficulties in communicating ranging from lack of knowledge
to discomfort, which they resolve by spending more time with
each other, and using humor in conversations, Arguilla, S.Q.,
& Habitan, J. M., (2014).
The data suggests that discussing sex and reproduction in the
presence of parents is perceived as awkward by the
individual. However, the statistical data indicating a neutral
response may reflect a cultural inclination in Filipino values,
where discussions about taboo topics, including sexuality and
reproduction, are often approached cautiously. In Filipino
culture, respect for authority figures, including parents, might
contribute to a neutral stance in expressing discomfort even if
the topic is considered sensitive or awkward, Alidon J. et. al.,
(2022).
 5
Menstrual
The Cycle

W hat is Menstrual Cycle?

The menstrual cycle is a natural, recurring process that

CHAPTER 2

occurs in the female reproductive system, typically lasting

about 28 days, although variations are common. It
involves a series of hormonal and physiological changes
that prepare the body for the possibility of pregnancy.

First menstrual period or the Menarche:

The menstrual cycle often begins at puberty
between the ages of 8 and 15 (average age
of 12). It usually starts two years after
breasts and pubic hair start to develop.
Phases of the Menstrual Cycle:

1. Menstruation
Menstruation is the elimination of the internal
lining of the uterine wall along with other
secretions from the body through the vagina.
It usually lasts three to seven days but this
could change to more or less days from
month to month and depending on each
woman.
2. The Follicular Phase
The follicular phase starts on the first day of
menstruation and ends with ovulation.
During this phase the pituitary gland The release of estrogen during the follicular phase causes the
(situated at the base of the brain) releases a brain to produce a gonadotrophin-releasing hormone that
follicle (cyst) stimulating hormone. This prompts the pituitary gland to produce raised levels of
hormone produces 10 to 20 follicles in the luteinising hormone (luteotropic hormone). This extracts the
ovary and each follicle houses an immature mature egg from the follicle (cyst) and transports it from the
egg. These follicles produce the hormone ovary to the fallopian tube. If fertilization does not occur during
estrogen, which in turn thickens the lining of this phase, the egg continues. to the uterus and dissolves
the endometrium in preparation to receive a within 6 to 24 hours
fertilized egg. Often, only one follicle keeps
growing and travels to the ovarian surface 4. The Luteal Phase
During this phase, the follicle from which the mature egg burst
while the remaining follicles gradually fade
out (now called the yellow body of the ovary or corpus luteum)
and are absorbed back into the body.
released a large quantity of progesterone and some estrogen.
3. Ovulation The two hormones help thicken the lining of the endometrium
Ovulation occurs 12 to 16 days before the and maintain its thickness. If fertilization does not occur, the
following period but not necessarily in the yellow body degrades and progesterone levels decrease,
middle of the cycle. The term "ovulation" leaving the lining unstable. The lining then falls away and a
indicates the formation of a mature egg by new menstrual cycle period begins.
one of the ovaries.
 6

Common Menstrual Disorders

P eriod problems are known to cause
significant physical and emotional
distress, often negatively affecting
women’s daily lives, social
connections
and fertility.

Premenstrual syndrome (PMS):

Some psychological and physical changes
may occur during the luteal phase. These
include:

Physical changes: Psychological changes:

✧ Breast tenderness and swelling ✧ Aggressive behavior and irritability
✧ Diarrhea or constipation ✧ Trouble sleeping (too much or too little)
✧ Bloating and gas ✧ Changes in appetite
✧ Cramps ✧ Difficulty concentrating and remembering
✧ Headaches of Backaches ✧ Stress and anxiety
✧ Fatigue and Vertigo ✧ Mood swings
✧ Inability to tolerate noise or bright lights ✧ Depression or sadness
✧ Acne ✧ Reduced Libido

PREMENSTRUAL SYNDROME
(PMS)
• Affects 75% of the women
• Causes physical and emotional
symptoms like mood swings,
cramps, irritability, and digestive
problems.

PREMENSTRUAL DYSPHORIC
DISORDER (PMDD)

• Extreme form of PMS

• Affect 3-8% of women
• Severe physical and emotional
symptoms like depression,
apppetite changes, or intense anger.

Individuals with PMS and PMDD should acknowledge the variability in symptoms and seek personalized
medical guidance for effective management. Incorporating self-care strategies, such as maintaining a
healthy lifestyle and managing stress, is crucial. Open communication with those around you and tracking
symptoms can help create a supportive environment during challenging times.
 7
Common Issues Accompanying
the Menstrual Cycle

Cramps
M any women experience stomach
spasms during the first few days of their
cycle. They occur because of chemicals
in the body that cause the uterine
muscles to contract to help shed the
uterine lining.

A girl's body begins to regulate

her menstrual period 2-3 years
Irregular after the cycle starts. During
this time, the body tries to
Periods adjust to the hormonal
changes it is experiencing.

A cycle is considered to be irregular if it is shorter or

longer than usual. However, it is normal for it to be
irregular before menopause. Irregularities general
occur for the following reasons:
✧ Eating disorders
✧ Thyroid disorders
✧ Some medicines (e.g. epilepsy medication)
✧ Polycystic ovary syndrome
Excessive ✧ Premature ovarian failure
Bleeding ✧ Pelvic inflammatory disease
✧ Psychological pressures
✧ Irregular blood sugar levels (diabetes)
✧ Obesity
In older women of reproductive age, heavy
menstrual bleeding is often caused by problems A woman experiences an absence of menstruation,
with the uterus. These include fibroids, polyps or amenorrhea, in the following cases (excluding
and adenomyosis. But other problems also pregnancy and breastfeeding):
could cause heavy menstrual bleeding.
✧ Absence of menstrual blood for over three
consecutive months.
✧ A girl is over 15 years old but hasn't started
her cycle.

✧ Ovulation issues: An imbalance of hormones during ovulation

may lead to the excessive formation of an internal uterine lining,
which in turn increases the amount of blood shed during
menstruation
 8

When to see a Doctor:

Dysmenorrhea
I t is the most common menstruation
problem. The pain varies from one
woman to the other. There are two types
See a doctor if any of
of dysmenorrhea:
the following problems
occurs during puberty:
• If the menstrual cycle begins before the age of 8
• If a girl is 15 years old but hasn't started her cycle
• If the cycle doesn't start within three years of breast
development.
• If the menstrual cycle remains irregular after the first
three years

See a doctor if the following problems occur

during menstruation:

• If the symptoms are severe to the point of

1. Primary dysmenorrhea:
It is a very common condition that occurs because of the
contraction in uterine muscles. It typically occurs during
adolescence and fades away with age. You are more likely
to suffer from primary dysmenorrhea if you:
✧ Started menstruating before the age of 11
✧ Have heavy and long periods
✧ Smoke
✧ Experience psychological pressures
2. Secondary dysmenorrhea:
It is the pain resulting from physical problems. The pain
becomes worse with age and lasts longer than the pain of
primary dysmenorrhea. The most common health issues
that may cause it are:
✧ Endometriosis
✧ Uterine fibroids
✧ Ovarian cysts
hindering daily activities.
• If painkillers don't help relieve menstrual pains
• If large and abnormal clots are discharged with
the blood
• If cramps are felt outside the usual times
(before and during menstruation)
• If menstruation continues for over 8 days
• If you need to change sanitary napkins every
one or two hours.
• If you experience symptoms of iron deficiency
anemia (including: dizziness, weakness, fatigue,
chest pain, difficulty breathing)
• If you experience changes in menstruation
(unusually heavy periods).
See a doctor if the following problems occur
outside menstruation:
• Bleeding after intercourse (more than once)
• Bleeding outside menstrual period
• Bleeding after menopause

This may occur due to the following For more information and guidance please
causes: contact the legitimate agency of the Philippines—
Bleeding
✧ Hormonal changes during puberty or Department of Health:
Outside the
before menopause OFFICE ADDRESS:
Menstrual ✧ Endometriosis Department of Health, San Lazaro
Compound, Rizal Avenue, Sta. Cruz
Period ✧ Ovarian cysts Manila, Metro Manila
✧ Malignant tumors (cancerous), such
TELEPHONE NUMBER:
as: Uterine, ovarian or cervical cancer (632) 8651-7800 Local 4203, 4225-
27, 4250-54
 9

Debunking
Menstrual
Myths
MYTH FACT
Myth #1: Fact #1:
Consuming beverages rich in Vitamin C (e.g. This isn't true. They are not harmful and there is
orange juice, lemon, etc.) is harmful during no scientific basis for this idea.
menstruation
Fact #2:
Myth #2: Brown discharge at the start of the menstrual
Brown discharge at the start of menstruation cycle comes from the surface of the
indicates blood remaining from the previous endometrium before the lining is shed from the
cycle and is a sign of a problem. uterine wall. It forms part of the current cycle
and not the previous cycle.
Myth #3:
Bathing during menstruation is harmful. Fact #3:
This isn't true, but it is preferable not to lie down
Myth #4: in a bath to avoid infections.
Irregular periods are a sign of infertility
Fact #4:
Myth #5: Not necessarily, unless the irregularity includes
Period Synchronisation is a thing delays over several months.

Myth #6: Fact #5:

The period stop when you eat mangga. No research evidence supports that this
happens.
Myth #7:
Fact #6:
You shouldn't wash your hair during your
Mangoes do not affect your periods
period.
Fact #7:
Myth #8: There is no reason to follow this idea as bathing
Hot water increases period flow. and regular grooming rituals have no
connection with one's menses.
Myth #9:
Your period stops when you get in the water. Fact #8:
The heat does increase blood circulation.
Myth #10:
You shouldn't use a tampon until you're old Fact #9:
enough. it's not enough to completely stop it

Myth #11: Fact #10:

You can't get pregnant when you're on your There is no age requirement for using tampons
period. Fact #11:
Most likely you will not get pregnant having sex
while on your period.

Fertilization and Conception
W elcome to Chapter 3! This is
where we get into the exciting
world of Fertilization and
Conception. Imagine a tiny egg
meeting a sperm, and that magical
moment starts a brand new life.
We'll explore how this happens,
from the meeting point in the
fallopian tube to the first steps of
creating a new person. Join us as
we uncover the simple yet
amazing process of how babies
begin. Let's dive into Fertilization
CHAPTER 3
and Conception together!
What is Fertilization?
Fertilization is the process by which a sperm
cell from the male fuses with an egg cell from
the female, resulting in the formation of a
zygote. This event typically occurs in the
fallopian tube. The sperm penetrates the
protective layers surrounding the egg, allowing
the fusion of their genetic material. The
resulting zygote carries a unique combination
of chromosomes, marking the beginning of a
new individual's genetic makeup. As the zygote
undergoes rapid cell divisions, it transforms
into a blastocyst, eventually reaching the
uterus for implantation. This foundational
process of fertilization sets the stage for the
subsequent stages of embryonic development.
10
Fertilization and Its Site
Fertilization is the biological process by which a sperm
cell from the male fuses with an egg cell from the female,
resulting in the formation of a zygote—the initial stage of
embryonic development. This critical event typically takes
place in the fallopian tube, a component of the female
reproductive system. The process involves the release of
a mature egg from the ovary, its journey down the
fallopian tube, and the meeting with a sperm cell.
Successful fertilization leads to the formation of a zygote,
which undergoes subsequent cellular divisions before
implanting in the uterus. This orchestrated sequence of
events plays a pivotal role in the establishment of
pregnancy.
What is Conception in Pregnancy?
Conception in pregnancy refers to the specific
moment when a sperm cell fertilizes an egg
cell, resulting in the formation of a zygote. This
marks the beginning of a pregnancy.
Conception typically occurs in the fallopian
tube, where the sperm penetrates the
protective layers surrounding the egg, leading
to the fusion of their genetic material. The
resulting zygote carries a unique set of
chromosomes, representing the initial stage of
embryonic development. This single-cell
structure will undergo rapid divisions,
eventually forming a blastocyst that travels to
the uterus for implantation, initiating the growth
of a new human being.
 11
Understanding the Fertilization
W here Does Fertilization
Normally Occur?
Fertilization typically takes place in the ampulla
of the uterine tube, which is a crucial part of
the female reproductive system. The ampulla
is recognized as the widest segment of the
uterine tube, providing an optimal environment
for the encounter between sperm and egg.
The ampulla's width is essential because it
allows for greater interaction between sperm
and egg, increasing the chances of successful
fertilization. This region provides the necessary
space and conditions for the initial stages of
embryo development. Although the ampulla is
the primary site, fertilization may occur in other
parts of the uterine tube. This flexibility
underscores the dynamic nature of
reproductive processes and ensures that FSH, which causes the release of estrogen from the ovaries, aids
fertilization can still take place if the egg or the cervical mucus in being more hospitable to sperm movement
sperm travel to different regions of the tube. through the vaginal canal and cervix. An LH surge is necessary
for the release of an egg from the ovary out of the follicle and into
the fallopian tube where it can undergo fertilization. Progesterone
produced by the corpus luteum and later by the placenta creates
and maintains a thickened endometrium to allow a nourishing
environment for implantation and growth. Pregnancy tests detect
fertilization by measuring beta-human chorionic gonadotrophin
released by the growing placenta after implantation. Another
important clinical significance is neural tube defects, which are
birth defects of the central nervous system that occurs when the
neural tube fails to close completely.

Chemical Signaling

Mate choice can continue after mating via chemical

Fertilization never occurs in the uterine cavity.
This exclusion is significant because the uterine
cavity is designed to host the implanted embryo
during pregnancy, not for the initial union of sperm
and egg. Understanding this distinction is crucial
for comprehending the stages of reproduction.
Clinical Significance
There are numerous clinical scenarios in which
fertilization comes into play. Fertilization and the
development that follows is a delicate and
complex process that can result in defects.
Hormones are important for preparing the female
body to implant a fertilized egg and to grow and
nourish it.
communication between the female reproductive system and
sperm. Chemical signaling plays a crucial role in fertilization.
Chemical signals released by the follicle cells that surround the
ovulated egg attract the sperm to the egg. Calcium signals are
also crucial for egg activation and initiation of fertilization across
the animal kingdom. In humans, chemical communication
between eggs and sperm is critical for fertilization, and sperm
behavior is influenced by chemical signals from eggs. In plants,
certain chemicals produced by the egg may attract
spermatozoa, and pollen tube guidance is a unique navigating
system that is required for the successful sexual reproduction of
plants. The fertilization of the egg cell by the sperm cell triggers
ethylene signaling, whereas the fertilization of the central cell by
sperm induces fusion between the synergid and endosperm. In
mammals, polyspermy is prevented by an electric change in the
egg plasma membrane and exocytosis of cortical granules. The
finding that fertilin-deficient sperm can still fertilize eggs in a test
tube, albeit inefficiently, suggests that other sperm proteins
normally help to mediate sperm binding and fusion to the egg.
 12
Phases in Fertilization
T he process of fertilization can
be divided into four main stages
1. Passage through Corona Radiata
The sperm begins its journey by navigating through
the protective layer of cells called the corona radiata
surrounding the egg. This movement is facilitated by
the release of hyaluronidase enzyme from the sperm.
The enzyme helps the sperm to penetrate the corona
radiata, allowing it to progress towards the zona
pellucida.

2. Penetration of Zona Pellucida

Acrosine, a substance released from the acrosomal
cap of the sperm, aids in breaking through the zona
pellucida, an outer layer surrounding the egg. This
enzymatic action enables the sperm to overcome
another barrier, bringing it closer to the egg's plasma
membrane.
3. Fusion of Plasma Membranes
Once the sperm reaches the egg's surface, the plasma
membranes of both the oocyte (egg) and the sperm
undergo fusion. This fusion facilitates the transfer of
genetic material from the sperm to the egg, initiating
the process of fertilization.
4. Completion of Second Meiotic Division
As the sperm and egg plasma membranes fuse, the
second meiotic division of the oocyte, previously arrested
at metaphase, is triggered and completed. This results in
the formation of a mature ovum, ready to combine with
the sperm's genetic material.
5. Formation of Female Pronucleus
Following the completion of meiosis, the oocyte's genetic
material forms a distinct nucleus known as the female
pronucleus. This structure contains the genetic information
necessary for the formation of the embryo.
6. Formation of Male Pronucleus:
Simultaneously, the genetic material from the sperm also
undergoes changes, forming the male pronucleus. This
structure contains the genetic contribution from the sperm and
is crucial for the subsequent union of genetic material from
both gametes.
7. Union of Pronuclei
The final phase involves the union of the female and male
pronuclei, marking the completion of fertilization. This merging
of genetic material from both parents forms the zygote, the
initial cell of the developing embryo, containing the complete
set of chromosomes needed for embryonic development.

In summary, the phases of fertilization involve a series of

orchestrated events, starting with sperm passage through the
corona radiata, penetration of the zona pellucida, fusion of
plasma membranes, completion of meiotic division, formation
of pronuclei, and culminating in the union of the genetic
material from both gametes.

Zygote
T he zygote, formed through the fusion of sperm
and egg during fertilization, is indeed a genetically
unique structure. It inherits half of its
chromosomes from the father and the other half
from the mother. This inheritance results in a new
combination of genetic material, distinct from
either parent.
The process of combining genetic material from
both parents is crucial in forming what is known as
biparental inheritance. Each parent contributes a
set of chromosomes, and the zygote receives a
diverse combination of these chromosomes. This
mixing and matching of genetic material contribute
to the genetic diversity and variation within the
human species.
The uniqueness of the zygote's genetic
composition is foundational for the development of
an individual. As cells divide and the organism
grows, this initial combination of paternal and
maternal chromosomes shapes the traits,
characteristics, and genetic identity of the resulting
individual. Therefore, the biparental inheritance
mechanism not only ensures the continuity of
genetic information but also fosters variability
among individuals within a population, contributing
to the diversity of the human species.
Sex of the Embryo
The sex of the embryo is determined at the
moment of fertilization, marking a pivotal event in
early development. This determination is
influenced by the type of sperm, carrying either an
X or Y chromosome, that successfully fertilizes the
oocyte (egg).
13
The two types of sperm, distinguished by their sex
chromosomes, are crucial in determining whether
the resulting embryo will be male or female. If a
sperm carrying an X chromosome fertilizes the
egg, the embryo will develop into a female (XX).
Conversely, if a sperm carrying a Y chromosome
fertilizes the egg, the embryo will develop into a
male (XY).
Therefore, it is indeed the father's gamete that
plays a decisive role in determining the sex of the
embryo. The specific combination of sex
chromosomes inherited from the father's sperm
during fertilization sets the foundation for the
embryo's genetic sex, influencing the entire course
of sexual development in the individual. This
process ensures a degree of variability in the sex
of offspring and is a fundamental aspect of
reproductive biology.
The SRY gene is
responsible for the
initiation of testis
development in the
bipotential gonad.
The testes then produce hormones, particularly
testosterone, which leads to the development of
male reproductive organs and the suppression of
female reproductive structures.
In the absence of the SRY gene, the default
pathway is the development of female
characteristics. Therefore, the presence or
absence of the SRY gene is a key factor in the
determination of the embryonic sex, influencing
the entire trajectory of sexual development.
 14
Birth & Embryonic
Development
W elcome to Chapter 4! We're exploring birth
and development. Learn about babies growing in
Germinal Stage of Prenatal Development
The germinal stage begins at conception when the
the belly and how they come out. Discover the
sperm and egg cell unite in one of the two
special moments when new life begins. Join us for
fallopian tubes. The fertilized egg is called a
an exciting journey into the wonders of birth. Enjoy
zygote. Just a few hours after conception, the
the adventure ahead!
single-celled zygote begins making a journey
down the fallopian tube to the uterus.
CHAPTER 4

Stages of Prenatal
Development
While you might think of child development as
something that begins during infancy, the prenatal
period is also considered an important part of the
developmental process. Prenatal development is a
time of remarkable change that helps set the stage
for future psychological development. The brain
develops over the course of the prenatal period,
but it will continue to go through more changes
during the early years of childhood
Cell division begins approximately 24 to 36 hours
after conception. Through the process of mitosis,
the zygote first divides into two cells, then into
four, eight, sixteen, and so on. A significant
number of zygotes never progress past this early
part of cell division, with as many as half of all
zygotes surviving less than two weeks.
Once the eight-cell point has been reached, the
cells begin to differentiate and take on certain
characteristics that will determine the type of cells
they will eventually become. As the cells multiply,
they will also separate into two distinctive masses:
the outer cells will eventually become the
placenta, while the inner cells form the embryo.

There are three stages of prenatal development:

the germinal, embryonic, and fetal stages.

The first two weeks after conception are known as

the germinal stage, the third through the eighth
week is known as the embryonic period, and the
time from the ninth week until birth is known as the
fetal period.

Let's Dig In!
C ell division continues at a rapid rate during
the approximately week-long journey from
fallopian tube to uterus wall. The cells develop into
what is known as a blastocyst. The blastocyst is
made up of three layers, each of which develops
into different structures in the body.
1. Ectoderm: Skin and nervous system
2. Endoderm: Digestive and respiratory systems
3. Mesoderm: Muscle and skeletal systems
Finally, the blastocyst arrives at the uterus and attaches
to the uterine wall, a process known as implantation.
Implantation occurs when the cells nestle into the
uterine lining and rupture tiny blood vessels. The
connective web of blood vessels and membranes that
form between them will provide nourishment for the
developing being for the next nine months. Implantation
is not always an automatic and sure-fire process.
Researchers estimate that approximately 60%
of all natural conceptions never become
properly implanted in the uterus, which results in
the new life ending before the mother is ever
aware she is pregnant.
When implantation is successful, hormonal changes halt
the normal menstrual cycle and cause a whole host of
physical changes. For some people, activities they
previously enjoyed such as smoking and drinking alcohol
or coffee may become less palatable, possibly part of
nature’s way of protecting the growing life inside them.
Embryonic Stage of Prenatal Development
At this point, the mass of cells is now known as an
embryo. The beginning of the third week after conception
marks the start of the embryonic period, a time when the
mass of cells becomes distinct as a human. The
embryonic stage plays an important role in the
development of the brain.
Approximately four weeks after conception, the neural
tube forms. This tube will later develop into the central
nervous system including the spinal cord and brain.
15
The neural tube begins to form along with an
area known as the neural plate. The earliest
signs of development of the neural tube are
the emergence of two ridges that form along
each side of the neural plate.
Over the next few days, more ridges form and
fold inward until a hollow tube is formed.
Once this tube is fully formed, cells begin to
form near the center. The tube begins to
close and brain vesicles form. These vesicles
will eventually develop into parts of the brain,
including the structures of the forebrain,
midbrain, and hindbrain.​
Around the fourth week, the head begins to
form, quickly followed by the eyes, nose,
ears, and mouth. The blood vessel that will
become the heart start to pulse. During the
fifth week, buds that will form the arms and
legs appear.
By the eighth week of development, the
embryo has all of the basic organs and parts
except those of the sex organs. At this point,
the embryo weighs just one gram and is
about one inch in length.
By the end of the embryonic period, the basic
structures of the brain and central nervous
system have been established. At this point,
the basic structure of the peripheral nervous
system is also defined.
As neurons form, they migrate to different
areas of the brain. Once they have reached
the correct location, they begin to form
connections with other neural cells,
establishing rudimentary neural networks.
 16
Fetal Stage of Prenatal Development

O nce cell differentiation is mostly complete, the

embryo enters the next stage and becomes known as
a fetus. The fetal period of prenatal develop marks
more important changes in the brain. This period of
development begins during the ninth week and lasts
until birth. This stage is marked by amazing change
and growth.

The early body systems and structures established in

the embryonic stage continue to develop. The neural
tube develops into the brain and spinal cord and
neurons continue to form. Once these neurons have
formed, they begin to migrate to their correct locations.
Synapses, or the connections between neurons, also
begin to develop.

Between the ninth and twelfth week of gestation (at the

earliest), reflexes begin to emerge. The fetus begins to While development usually
make reflexive motions with its arms and legs.
follows this normal pattern,
During the third month of gestation, the sex organs there are times when problems
begin to differentiate. By the end of the month, all parts
of the body will be formed. At this point, the fetus
with prenatal development
weighs around three ounces. The fetus continues to occur. Disease, malnutrition,
grow in both weight and length, although the majority and other prenatal influences
of the physical growth occurs in the later stages of
pregnancy. can have a powerful impact on
how the brain develops during
The end of the third month also marks the end of the
first trimester of pregnancy. During the second
this critical period.
trimester, or months four through six, the heartbeat
grows stronger and other body systems become
further developed. Fingernails, hair, eyelashes, and
toenails form. Perhaps most noticeably, the fetus
increases about six times in size.

So what's going on inside the brain during this

important period of prenatal development? The brain
and central nervous system also become more
responsive during the second trimester. Around 28
weeks, the brain starts to mature faster, with an activity
that greatly resembles that of a sleeping newborn.

During the period from seven

months until birth, the fetus
continues to develop, put on
weight, and prepare for life
outside the womb. The lungs
begin to expand and contract,
preparing the muscles for
breathing.

Frequently Asked Questions
W hat are the most critical
weeks of fetal development?
The first 13 weeks of pregnancy
are considered the most critical in
prenatal development. It is during
this period that the embryo forms
organs. It is also the period when
most miscarriages occur.
What are the stages of embryonic
development in order?
The main stages of the embryonic
period encompass gastrulation
(the ectoderm, mesoderm, and
endoderm form), neurulation
(formation of neural tissue),
organogenesis (development of
the organs).
What are the major milestones in fetal
development?
Important fetal development milestones
at each stage of prenatal development
include:
Germinal stage: The division of cells
and implantation of the blastocyst.
Embryonic stage: The development of
the neural tube and organs.
Fetal stage: Continued growth of
organs and physical development in
preparation for birth.
17
What is the germinal stage in
prenatal development?
The germinal stage is the first
stage, spanning from
conception to about two
weeks, where the fertilized
egg undergoes rapid cell
division. At what point does the fetal
stage begin in prenatal
development?
Answer: The fetal stage
begins at approximately eight
weeks and extends until birth,
focusing on the growth and
refinement of existing
structures rather than organ
formation.
When does the embryonic
stage occur in prenatal
development?
The embryonic stage occurs
from around two to eight
weeks after conception,
involving the formation of
major organs and the basic
body plan.
 18
Birth &
Postpartum
Period
C hapter 5 is all about having babies and what
happens after. Learn about how babies are born and
what moms go through after having a baby. Find out how
bodies heal and change in the weeks after giving birth.
CHAPTER 5

Understand why taking care of moms during and after

pregnancy is super important. This chapter is like a
guide to the beginning of being a mom and dad. Come
and explore the exciting journey in Chapter 5

The postpartum period begins soon after the delivery of

the baby and usually lasts six to eight weeks and ends
when the mother's body has nearly returned to its pre-
pregnant state. The postpartum period for a woman and
her newborn is very important for both short-term and
long-term health and well being This activity should help
the interprofessional team on how to provide
comprehensive postpartum care for the new mother.
The postpartum period begins soon after the baby's
delivery and usually lasts six to eight weeks and ends
when the mother's body has nearly returned to its pre-
pregnant state. The weeks following birth lay the
foundation of long-term health and well-being for both
the woman and her infant. Therefore, it is critical to
establish a reliable postpartum (afterbirth) period that
should be tailored into on-going, continuous,
comprehensive care. Most maternal and infant deaths
occur in the first month after birth. Hence effective
postpartum care is mandatory to improve both short-term
and long term health consequences of mother and
newborn.
Timing of Postnatal Visits
In April 2018, The American College of Obstetrics and
Gynecology (ACOG) recommends12 weeks of support,
rather than a single six-week postpartum visit. ACOG
also recommends postpartum evaluation within the first 3
weeks after delivery in person or by phone, which later is
followed up with ongoing care as needed, concluding
with a comprehensive postpartum visit no later than 12
weeks
Components of Postpartum Care
1. Vaginal pain: Genital tract trauma is obvious
with spontaneous vaginal delivery. Mild vaginal
tears occur during delivery and take a few
weeks. to heal, whereas extensive tears might
take longer to heal. Advice women to take
over-the-counter medications such as
ibuprofen or acetaminophen for pain, sit on a
padded ring, or cool the area with an ice pack
to relieve the pain. Health care providers
should inform women about the signs of
infection such as fever and encourage them to
seek medical attention for persistent, severe
pain.
2. Vaginal bleeding/discharge: Bloody vaginal
discharge (lochia rubra) is heavy for the first 3-
4 days, and slowly it becomes watery in
consistency and color changes to pinkish-
brown (lochia serosa). After the next 10-12
days, it changes to yellowish-white (lochia
alba). Advise women to seek medical attention
if heavy vaginal bleeding persists (soaking a
pad or more in less than an hour). Women with
heavy, persistent postpartum bleeding should
be evaluated for complications such as
retained placenta, uterine atony, rarely
invasive placenta, or coagulation disorders.
Endometritis may also occur, presenting as
fever with no source, maybe accompanied by
uterine tenderness and vaginal discharge. This
usually requires intravenous antibiotics. This
also should be explained and advise the
mother to seek immediate medical attention.

3. B reastfeeding: Breastfeeding is
beneficial for the mother and the
newborn. Breastfeeding women are less
likely to get breast cancer, ovarian
cancer, and type 2 DM. Providers should
evaluate latch, swallow, nipple type and
condition, and hold of infants for any
problems. Interventions include
professional support, peer support, and
formal education. Health care providers
should strongly encourage women to
breastfeed the newborn unless it is
contraindicated. The World Health
Organization (WHO) recommends at
least four to six months, every three to
four hours daily. Breastfeeding reduces
the newborn's risk for gastrointestinal
tract infections, pediatric cancers, and
atopic eczema. Breastfeeding should be
evaluated at each postnatal visit.
4. Nutrition and exercise: Women at
higher risk for postpartum weight
retention are those with higher
gestational weight gain, black race, and
lower socioeconomic status, which at the
same time increase their risk of future
obesity and type 2 diabetes. Advise
women to take a variety of healthy
balanced diets and resume their normal
dietary habits. All breast- feeding
mothers need to take extra 500 calories
per day. Avoid strenuous activities in the
early postpartum period and take plenty
of rest for the first 2-3 weeks and slowly
start with non-impact activities such as
walking and a gradual return to previous
activities is recommended.
5. Breast engorgement: Women may
experience full, firm, and tender breasts.
after the delivery. Frequent
breastfeeding on both breasts is
recommended to avoid engorgement.
Advise women to use warm washcloths
or warm showers or place cold
washcloths between feedings to relieve
the pain. For women who are not going
to breastfeed, encourage them to use
cold packs, using firm support of the
breasts, take analgesics as needed, and
mechanical extraction of milk.
6. Bladder and bowel function: Voiding
must be encouraged and monitored to
prevent asymptomatic bladder overfilling.
Women are encouraged to use mild
laxatives such as docusate, psyllium,
bisacodyl if defecation has not. occurred
within 3 days of delivery. Another
consideration is Osmotic laxatives as
polyethylene glycol and lactulose.
7. Sexual relations: Libido may decrease
after the delivery because of decreased
estrogen levels. This may not return for
as long as 1 year postpartum,
particularly in women who are
breastfeeding Reassurance is usually
appropriate.
Advice women to wait for their perineal
area to heal before resuming sexual
activity, and it may take 4-6 weeks for
the perineal tears to heal completely.
Health care providers should be more
comfortable discussing women about
sexuality during the early postpartum
period. Address earlier return of sexual
activity with contraception to avoid
unintended, closely spaced pregnancy
8. Contraception: The prenatal period is
the best time to discuss postpartum
contraception. In adolescents begin
motivational interviewing, discussion of
long-acting reversible contraception during
pregnancy. For breastfeeding women,
nonhormonal modalities are usually
preferred. The American College of
Obstetrics and Gynecologists (ACOG)
recommend progestin only contraceptives
are the best hormonal contraceptive
modality for breastfeeding women.
19
Breastfeeding mothers should not use
combination estrogen progestin
contraceptives as it can interfere with
breast milk production. Among
hormonal methods, combined
estrogen- progestin vaginal rings can
be used after 4 weeks postpartum.
Hormonal methods such as progestin-
only oral contraceptives, depot
medroxyprogesterone acetate
injections, and progestin implants are
preferred, as they do not affect milk
production. A vaginal diaphragm and
cervical cap should be fitted only after
complete involution of the uterus, at 6
to 8 weeks after delivery.
9. Education: Health care providers
should provide essential education.
regarding newborn care, such as
umbilical cord care, bathing,
breastfeeding, and the importance of
immunizations.
10. Miscarriage, stillbirth, or neonatal
death: For mothers who experience
any pregnancy loss, it is essential to
ensure follow-up. Key elements are to
provide emotional support and
bereavement counseling; referral, if
appropriate, to counselor and support
groups. Also review of any laboratory
or pathology studies related to the
loss and counseling regarding
recurrent risk and future pregnancy
planning.
 20
Common Postpartum Concerns
1. Postpartum blues: Transient depression (baby blues) is very
common. during the first week after delivery. Women may notice feeling
down, anxious, mood swings, crying spells, irritability, and difficulty
sleeping. Postpartum blues typically resolve within 2 weeks. Health care
providers should advise them to seek medical attention if depressive
symptoms. continue beyond 2 weeks and having difficulty taking care of
themselves or taking care of the newborn or having thoughts of harming
themselves or the newborn baby. All women should be screened for
mood and anxiety disorders using a validated tool (Edinburgh Postnatal
Depression Scale).
The American Academy of Pediatrics recommends screening at the
one-, two, four-and six-month well visit. Encourage the partner and
family. members at least for the first week of the postnatal period to
provide emotional support and to take care of the newborn. The
National Institute for Health and Care Excellence recommends
screening all postpartum women for resolution of the postpartum
blues at 10 to 14 days after delivery.

2. Intimate partner violence: Use HARK (humiliation,

afraid, rape, kick) or HITS (hurt, insult, threaten,
scream) tools to evaluate for intimate partner violence
Prioritize patient safety, consider referral to intimate
partner violence prevention organizations

3. Incontinence: Stress incontinence occurs due to

extensive stretch or injury to pelvic floor muscles
during labor. Risk factors for urinary incontinence
three months postpartum include obesity, parity,
smoking, longer duration. of breastfeeding, and use of
forceps during vaginal delivery. Advise women to do
Kegel's exercises regularly to strengthen pelvic floor
muscles. Other considerations also are bladder
training and weight loss as part of first-line treatment.
It is important to let the new mother know that more
than 4 of women experience moderate or severe B. Basic Care Procedures
urinary incontinence in the first year postpartum. After giving birth, basic care procedures are implemented to
take care of both the mother and the newborn. This includes
checking vital signs, providing pain relief, assisting with
4. Hemorrhoids: Caused by constipation and/or by
breastfeeding, and meeting the baby's health and hygiene
pushing during the second stage of labor. The first line
needs. These procedures aim to aid in the recovery and well-
of treatment includes an increase in water and fiber
being of both the mother and baby during the period after
intake and stool softeners. Some may need excision
childbirth.
or ligation of refractory hemorrhoids or grade III or
higher. C. Adjusting to Parenthood
Adjusting to parenthood involves adapting to the new roles and
responsibilities that come with having a baby. This can involve
experiencing emotional changes, dealing with lack of sleep,
learning how to care for the baby, and forming a bond with the
Basic Aspects of Postpartum Care new addition to the family. It is a time of significant adjustment
and learning for both parents as they navigate the challenges
A. Labor and Delivery and joys of being parents.
The stages of labor and delivery refer to the different
phases a woman experiences during childbirth. These
stages involve the opening of the cervix, the pushing
and birth of the baby, and the delivery of the placenta.
Medical professionals closely monitor these stages to
ensure a safe delivery.
 Care of the Mother
and
Newborn After Birth
S ome women will give birth in the
home with a skilled attendant; others
may not have a skilled attendant
present.
Some women who give birth in the
facility will spend time there following
childbirth. WHO recommends that a
women not be discharged before 24
hours after birth. Regardless of the
place of birth, it is important that
someone accompanies the woman and
newborn for the first 24 hours after birth
to respond to any changes in her or her
baby's condition. Many complications
can occur in the first 24 hours.
Following childbirth at home, it is
important that the mother and baby
receive a postnatal examination as
early as possible, preferably within 24
hours of birth. If the birth was at a
facility, mother and baby should receive
a postnatal examination before
discharge.
There are a number of important points
to discuss with the woman and her
family following birth to ensure that the
woman has adequate care. See the
WHO PCPNC for additional
information.
IMPORTANT ISSUES TO DISCUSS WITH
WOMEN AND THEIR FAMILIES,
IMMEDIATELY FOLLOWING BIRTH:
• The importance of having someone
nearby for the first 24 hours.
• The importance and recommended
timing of postnatal visits.
• The importance of rest and sleep and the
need to avoid hard physical labour.
• The importance of the new mother
eating more and healthier foods – discuss
in the context of local practices and taboos
to ensure women have access to good
nutrition. The new mother should also
drink plenty of clean, safe water.
• Discussion of normal postpartum bleeding
and lochia – discuss with women how
much blood loss they can expect, for how
long. When bleeding is more than normal,
they should seek care urgently.
• Personal hygiene in the context of local
practices and the environment. Discuss
with women the type of pads they will use
and their disposal, and care of episiotomy
in the context of home conditions.
• Talk to them about when they can resume
sexual relations and the importance of
condom use to prevent STI and HIV
transmission.
• Discuss the importance of the home
environment for promoting the health of the
baby and recovery of the mother. For
example, discuss the need for warmth,
good ventilation and hygiene for both
mother and baby.
How to Provide Information and Support
for the Care of the Mother After Birth:
Explain the reasons behind the tasks you
are carrying out and discuss with the
woman any advice or recommendations
you have for her to ensure appropriate care
in the home during the postnatal period
(refer to the points above). Encourage her
to ask questions during the examination
and use your active listening skills to reflect
on and clarify what she is telling you.
21
Help her to think of ways she can
implement your advice. Sometimes, when
women are unsure or hesitant they voice
concerns in an indirect manner rather than
directly raising an issue. Be aware of her
body language and the non-verbal signs
she may be showing you. Repeat back to
her in different words what you think she is
saying to see if you have understood. At
the end of the postnatal examination,
remind her that she can come to the health
facility at any time if she has questions,
reassure her and make sure she feels
supported.
Note to Remember:
If the mother suffers most of the time and
cannot function normally, neglects herself
and/or the baby, you need to refer her to
more specialized help. Health workers or
counsellors trained to treat depression can
offer more advanced psychosocial
treatments or if this does not work, they can
prescribe some medication, or refer to
mental health specialists.
If there is a risk of self harm, or the mother
is having thoughts about suicide it is
important that she gets urgent help and
support and is not left alone. Remove
means of self harm and assign someone to
ensure her safety while you arrange
specialist mental health care.
 22
Contraception & Family Planning
CHAPTER 6

I mpact
There are many different types of
contraception, but not all types are appropriate
for all situations. The most appropriate method
of birth control depends on an individual’s
overall health, age, frequency of sexual
activity, number of sexual partners, desire to
have children in the future, and family history of
certain diseases. Ensuring access for all
people to their preferred contraceptive
methods advances several human rights
including the right to life and liberty, freedom of
opinion, expression and choice and the right to
work and education, as well as bringing
significant health and other benefits
It offers a range of potential non-health benefits
that encompass expanded education
opportunities and empowerment for women,
and sustainable population growth and
economic development for countries.
The number of women desiring to use family
planning has increased markedly over the past
two decades, from 900 million in 2000 to nearly
1.1 billion in 2021 (1).

In 2022, global contraceptive prevalence of any

method was estimated at 65% and of modern
methods at 58.7% for married or in a union
women.

Among current users, 9.6 percent rely on

traditional methods, while 36.9 percent use a
modern method. Female sterilization is the
most widely used modern method (10.3
percent), followed closely by pills

Use of contraception prevents pregnancy-

related health risks for women, especially for
adolescent girls, and when expressed in terms
of interbirth intervals, children born within 2
years of an elder sibling have a 60% increased
risk of infant death, and those born within 2–3
years a 10% increased risk, compared with
those born after an interval of 3 years or longer
(4).

• A hormonal IUD or IUS releases a progestin hormone
(levonorgestrel) into the uterus.3 The released hormone
causes thickening of the cervical mucus, inhibits sperm
from reaching or fertilizing the egg, thins the uterine lining,
and may prevent the ovaries from releasing eggs.
• A copper IUD prevents sperm from reaching and
fertilizing the egg, and it may prevent the egg from
attaching in the womb.3 If fertilization of the egg does
occur, the physical presence of the device prevents the
fertilized egg from implanting into the lining of the uterus.
Implants
Implants are implantable rods. Each rod is matchstick-
sized, flexible, and plastic. The method has a failure rate
of less than 1%.3 A physician surgically inserts the rod
under the skin of the woman's upper arm.
Short-Acting Hormonal Methods
Hormonal methods of birth control use hormones to
regulate or stop ovulation and prevent pregnancy.
Ovulation is the biological process in which the ovary
releases an egg, making it available for fertilization.
Hormones can be introduced into the body through
various methods, including pills, injections, skin patches,
transdermal gels,
23
T here are many different types of contraception,
but not all types are appropriate for all situations.
The most appropriate method of birth control
depends on an individual's overall health, age,
frequency of sexual activity, number of sexual
partners, desire to have children in the future, and
family history of certain diseases.
Long-Acting Reversible
Contraception (LARC)
Intrauterine Methods
An intrauterine device (IUD), also known as an
intrauterine system (IUS), is a small, T-shaped
device that is inserted into the uterus to prevent
pregnancy. A health care provider inserts the device.
An IUD can remain in place and function effectively
for many years at a time. After the recommended
length of time, or when the woman no longer needs
or desires contraception, a health care provider
removes or replaces the device.
vaginal rings, intrauterine systems, and implantable
rods. Depending on the types of hormones that are
used, these methods can prevent ovulation; thicken
cervical mucus, which helps block sperm from
reaching the egg; or thin the lining of the uterus.
Health care providers prescribe and monitor
hormonal contraceptives.
Short-acting hormonal methods (e.g., injectables,
pills, patches, rings) are highly effective if used
perfectly, but in typical use, they have a range of
failure rates.
• Injectable birth control. This method involves
injection of a progestin, Depo-Provera® (depot
medroxyprogesterone acetate [DMPA]), given in the
arm or buttocks once every 3 months.5 This method
of birth control can cause a temporary loss of bone
density, particularly in adolescents.
 24

• P rogestin-only pills (POPs). A woman takes

one pill daily, preferably at the same time each day.
Types of barrier methods that do not require a health care provider
visit include the following:
POPs may interfere with ovulation or with sperm
function. POPs thicken cervical mucus, making it • Male condoms. This condom is a thin sheath that covers the
difficult for sperm to swim into the uterus or to enter penis to collect sperm and prevent it from entering the woman's
the fallopian tube. body. Male condoms are generally made of latex or polyurethane,
but a natural alternative is lambskin (made from the intestinal
Combined Hormonal Methods membrane of lambs).
Combined hormonal methods contain a synthetic • Female condoms. These are thin, flexible plastic pouches. A
estrogen (ethinyl estradiol) and one of the many portion of the condom is inserted into a woman's vagina before
progestins approved in the United States. All of the intercourse to prevent sperm from entering the uterus.
products work by inhibiting ovulation and thickening
cervical mucus. The combined estrogen/progestin
drugs can be delivered by pills, a patch, or a vaginal
ring. The combined hormonal methods have some
medical risks, such as blood clots, that are
associated with the synthetic estrogen in the
product. These risks have not been observed with
progestin-only hormonal methods such as injectable
birth control, POPs, or hormonal LARCs. Your health
care provider can discuss your risk factors and help
you select the most appropriate contraceptive
method for you.

Emergency Contraception
Emergency contraception can be used after unprotected
intercourse or if a condom breaks.

• Vaginal ring. The ring is thin, flexible, and
approximately 2 inches in diameter. It delivers a
combination of ethinyl estradiol and a progestin. The
ring is inserted into the vagina, where it continually
releases hormones for 3 weeks. The woman
removes it for the fourth week and reinserts a new
ring 7 days later. Risks for this method of
contraception are similar to those for the combined
oral contraceptive pills.
Sterilization
• A sterilization implant is a nonsurgical method for
permanently blocking the fallopian (pronounced fuh-LOH-
pee-uhn) tubes.
• Tubal ligation (pronounced TOO-buhl lahy-GEY-shuhn) is
a surgical procedure in which a doctor cuts, ties, or seals
the fallopian tubes. This procedure blocks the path between
the ovaries and the uterus.
• Vasectomy (va-SEK-tuh-mee) is a surgical procedure that
cuts, closes, or blocks the vas deferens (pronounced vas
DEF-uh-renz). This procedure blocks the path between the
testes and the urethra (yoo-REE-thruh). The sperm cannot
leave the testes and cannot reach the egg.

Barrier Methods
Designed to prevent sperm from entering the uterus,
barrier methods are removable and may be an
option for women who cannot use hormonal
methods of contraception. Failure rates for barrier
methods differ depending on the method.

Family Planning
in the Philippines
T he Philippines has adopted reproductive
health education (RHE) in schools with the
passing of the Responsible Parenthood and
Reproductive Health Law in 2012 which
promised multidimensional support on
reproductive health (RH) including RHE.
Although there is urgent need for RH policy to
enhance family planning and to reduce high
teenage pregnancy, this law continues to be
extremely controversial, conflicting with
Filipino socio-cultural norms, mainly based on
Catholic beliefs. Family planning holds
immense importance in the context of the
Philippines, shaping the lives of families and
influencing the overall well-being of our
society. It serves as a guiding light for families,
allowing them to make thoughtful decisions
about the size and timing of their households.
In a country where economic challenges are
part of many families' stories, family planning
becomes a tool of empowerment. It empowers
parents to determine the number of children
they want and when it is most opportune to
welcome them into the world. This choice, like
a compass, helps navigate the intricate terrain
of family life.
A critical facet of family planning lies in the
promotion of health and well-being. When
parents can plan their families, it paves the
way for healthier pregnancies. Mothers can
receive proper care and attention, ensuring
the well-being of both themselves and their
babies. It's a foundation for creating stronger,
healthier families.
25
Education plays a pivotal role in this journey,
teaching us that family planning is not just
about numbers; it's about quality of life.
Managing resources wisely, family planning
becomes a financial compass, guiding families
toward stability. It aids in ensuring there's
enough for everyone, be it food on the table or
funds for education and housing.
Beyond the practical aspects, family planning
is a catalyst for dreams. It allows individuals to
pursue their aspirations, unburdened by
unplanned responsibilities. When young
people can witness the positive impact of
family planning, it shapes their understanding
of responsible decision-making and fosters a
culture of empowerment.
In the Philippines, family planning is not
merely a concept; it's a narrative of
empowerment, health, and dreams. Learning
about family planning is an essential aspect of
our education, equipping us with the
knowledge to navigate life's journey
responsibly.
It's about recognizing the
power of choice and
contributing to a future
where families can thrive,
and dreams can flourish.
 26
Reproductive Health & Wellness
C ongratulations on reaching the
last chapte, Chapter 7: Reproductive
Health and Wellness! We've taken a
journey through the essentials of
keeping our bodies healthy and
understanding the amazing things they
can do. From learning about our
reproductive systems to discovering
how to make choices that keep us in
good shape, this chapter has been a
guide to a healthier, happier life. As we
wrap up, remember that your well-
CHAPTER 7

being is important, and the knowledge

you've gained here is a powerful tool.
So, here's to a future filled with good
health, smart choices, and the well-
being you deserve. Keep thriving!

Healthy Sexual Life as a Teenager

Before you decide to have sex, or if you are already
having sexual intercourse (oral, vaginal-penile, or penile-
anal), you need to know how to stay healthy. Even if you
think you know everything you need to know about sex,
take a few minutes and read on. Your doctor wants to
make sure you know the facts

Are you ready for sex?
Sex can change your life and relationships.
Having sex may affect the way you feel
about yourself or how others feel about you.
Many teens believe that waiting until they
are ready to have sex is important. The right
time is different for each teen. For example,
some teens may want to wait until they are
adults or married, or they may want to wait
until they feel their relationship is ready.
Signs that your Relationship is ready
when:
• You can be completely honest and trust
the other person, and the other person can
trust you. A good idea is to talk about sex
with the lights on and clothes on!
• You can be responsible, by protecting
yourself and your partner against STIs and
pregnancy with condoms and birth control.
Important Reminders:
• No one should be forced or pressured to have sex! If
you are ever forced or pressured to have sex, it's
important to never blame yourself and to tell an adult you
trust as soon as possible. Medical and counseling
supports are available to help someone who has been
forced or pressured to have sex.
• Using alcohol and drugs can affect your choices about
sex. Too many teens have sex without meaning to when
they drink alcohol or use drugs.
• You can talk with the person about difficult topics such as
feelings, other relationships, whether the person has had a
sexually transmitted infection (STI), or condoms or
pregnancy prevention.
• You can respect the other person's decisions about not
having sex and about using protection. Consent is the KEY!
• You can have sex in a private place.
"Abstinence is the key to unlocking
your full potential and living
your best life."
- Unknown
 27
H ere are signs that your
relationship is not ready for sex:
• Your partner is jealous or possessive.
For example, your partner prevents you
from spending time with your family or
other friends, texts or instant messages
you constantly, or checks your cell phone
to read your texts.
• Your partner pressures you to have sex and
doesn't respect your reasons for not wanting
to have sex.
• Your partner controls you by bullying you or • Sex can lead to emotional pain and distractions.
by threatening to hurt himself or herself if you You may feel sad or angry if you let someone
end the relationship. pressure you into having sex when you're not ready.
• Your partner doesn't respect your desire to You may also feel sad or angry if you choose to have
use condoms or birth control. sex but your partner breaks up with you. Your
partner may tell other people you both had sex even
if it was supposed to be private.
Why wait to have sex?
There's nothing wrong if you decide to wait.
Not everyone is having sex.
About half of all teens in the Philippines have
never had sex. If you decide to wait, plan how
you are going to say no so you are clearly
understood. Stay away from situations that
can lead to sex, such as being alone with
someone who has been pressuring you or
using alcohol or drugs. If your partner doesn't
support your decision to wait, he or she may
be the wrong person for you. How can you prevent getting a
sexually transmitted infection?
You can't tell by looking at or talking with someone
3 reasons why waiting to have sex whether they have an STI since many STIs don't
makes sense cause symptoms. Nothing works perfectly to prevent
STIs except for not having sex (abstinence); however,
• Sex can lead to pregnancy. Are you ready to if you're going to have sex, here are tips to keep in
be pregnant? If you become pregnant, you mind.
have to make difficult decisions such as
becoming a teen parent, placing a child for • Using a barrier method, such as a condom or dental
adoption, or ending the pregnancy. Are you dam, is the best way to reduce the risk of getting STIs.
ready to make these sorts of decisions? What • Remember to use a barrier method every time you
will be the effect of a pregnancy on your have sex, no matter what other type of birth control
health, finances, education, relationships, or you and your partner might also use.
family? • To make sure you stay healthy, get regular medical
checkups. You can also get a vaccine to protect
• Sex has health risks. A lot of infections can against HPV.
be spread during sex. STIs include chlamydia, • If you have had sex in the past, or are having sex, it's
gonorrhea, "trich" (trichomoniasis), hepatitis B, important to get tested for STIs.
herpes, HIV (the virus causing AIDS) infection,
human papillomavirus (HPV) infection, or
syphilis. Some infections are treatable, but
"Curiosity killed
some persist throughout a lifetime.
the cat"
 28
What do you need to know about
barrier protection (condoms)?
External (male) condoms have about a 98% chance
of preventing pregnancy, and internal (female)
condoms have a 95% chance, but they must be used
each time you have sex and used correctly.

External condoms are available to

purchase without any age restrictions at
stores, including convenience stores, and
pharmacies. Internal condoms may
require a prescription. Most teens use
latex external condoms.

What to keep in mind if you use

condoms:
• Never use external and internal condoms at the
same time; they might tear.
• Follow the instructions on the package to make
sure you are using condoms in the right way. To
learn more about how to use condoms and other
barriers, visit the Centers for Disease Control and
Prevention Condom Effectiveness web page.
• Check the expiration date on the package. Don't
buy or use expired condoms.
• You can carry condoms with you at all times, but
do not store them where they will get hot or
damaged (such as in the glove compartment of a car
or in a wallet). Heat can damage a condom, and the
condom may then tear or break more easily.

What types of birth control are

effective?
Talk with your doctor about birth control or
contraception. Your doctor can answer questions
about safe and effective methods, side effects, and
costs. Most contraception is covered by insurance.

Here are some forms of birth control, from the most

effective forms at preventing pregnancy to the least.
None of these methods prevent STIs, so it's
important to also use barrier protection.

Remember
If you decide to have sex, it's important you know the
facts about birth control, infections, and emotions.
Deciding when to become sexually active, how to
protect yourself from STIs, and how to prevent
pregnancy can be confusing. These are important
decisions and are worth talking about with adults
who care about you, including your doctor.
 Booklet
Booklet
Contributors
Contributors

Teacher Alidon, J. Teacher Bausin, D. S.

BSEd-Filipino BEEd

Teacher De Leon, A. A. Teacher Misperos, M. L.

BSEd-English BSEd-ECE

Teacher Pedroso, M. Teacher Salinas, S. J.

BSEd-English BEEd

Teacher Serondo, J. C. Teacher Sumambot, N.

BSEd-Math BEEd
Reproductive Health, Productive Life

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