What does reproductive health include?

When many people mention reproductive health, their first reaction is "gynecological diseases, andrological diseases, and pregnancy preparation." In fact, this is only a small part. It is a complete concept that covers the entire life cycle and covers the three dimensions of physiology, psychology, and society. The core is that everyone can have a healthy body and the right to make independent choices in all matters related to reproduction, and will not be discriminated against or harmed due to related issues.

I have been doing reproductive health science popularization in the community for almost five years, and I have seen too many people with an absurdly narrow understanding of this concept. The last time the community organized a free physical examination, 62-year-old Aunt Zhang waved her hand directly after getting the "Reproductive Health Screening" form and said, "I have been menopausal for more than ten years. Isn't it a waste of resources to check this?" In fact, she privately talked to her older sisters several times about how she always leaked urine after menopause and had pain during intercourse, but was too embarrassed to look at it. She thought this was a normal phenomenon of old age. Little did she know that this was a typical reproductive health problem for older women, and intervention could significantly improve her quality of life. Not only elderly women, but also middle-aged and elderly men who have abnormal urination and decreased sexual function caused by prostatic hyperplasia are also covered by reproductive health and are not minor problems that "cannot be brought to the forefront" at all.

In addition to disease prevention and condition maintenance at the physiological level, reproductive health also hides many soft needs that are invisible to everyone. Two years ago, I treated a little girl who had just entered college. She didn’t dare to tell her parents about her unexpected pregnancy. She searched for home remedies on the Internet and bought her own medicine to have an abortion. When she was sent to the emergency room for heavy bleeding, her face was as white as paper. Later, during the follow-up examination, she cried and said that she was afraid of going to a public hospital and being looked down upon by the nurse. She was also afraid that her classmates would find out and say that she was not doing well, and that she had no place to learn formal contraceptive knowledge. You see, whether you can obtain accurate reproductive health knowledge conveniently and without shame, whether you can independently decide on your own fertility wishes and sexual behavior, and whether you can receive assistance when you encounter reproductive-related harm (such as forced childbirth, sexual violence), these seemingly unrelated contents are all core components of reproductive health.

There is now a lot of discussion about the coverage of reproductive health, such as whether to provide reproductive health education that includes sexual knowledge for young children. There are quite big differences among different groups. Some parents think that clarifying body boundaries, sexual assault prevention, and developmental common sense in advance can prevent their children from being harmed. Others worry that too detailed content will induce children to try sexual behavior prematurely. At present, various places are adjusting the scale of science popularization based on actual conditions, but the core direction is to enable everyone to obtain scientific and non-discriminatory knowledge at the appropriate age. This is not controversial.

To put it bluntly, from the confusion of your first menstruation/nocturnal emission in adolescence, to the need to choose contraceptive methods and prepare for pregnancy and childbirth during the childbearing age, to the various discomforts faced by the decline of the reproductive system in old age, and even your right to choose whether to get married or have children, they are all linked to reproductive health. It is never a private topic that is ashamed to be mentioned, but is closely related to everyone's quality of life.