women are able to have a...

• repsonsible, satifying, and safe sex life
•  autonomy over reproduction and  reproduction frequency
•  capability to reproduce 

1. woman's right to a safe and satifsying sex life
2. right/access to affordable/acceptable health care service
3. right/access to safe, effective and affordable family planning services 
4. freedom to decid frequency of births 

• paradigm shift in RH services from Population Control --> HUMAN RIGHTS
• first comprehensive framework that link rights and SRH health  
• linked women's empowerment to sustainable development 
• promoted women's equality w/ sexual and RH decision making 

Millennium Devel. Goals

UPRIC

• Universal Education 
• Promote gender and women's empow.
• Reducing child mortality
• Improve maternal mortality
• Combat HIV/AIDS

• ectopic pregancy 
• abdominal pregnancy 
• infection of the peritoneum 

Hormonal changes with menstrual cycle

FSH

• rise in FSH causes maturation of ovarian follicles
• FHS signals the ovaries to produce estrogen, which stimulates LH levels around day 14 

Hormonal changes with menstrual cycle

Growth of uterine lining

Hormonal changes with menstrual cycle

Ovulation 

• growth of the Corpus luteum (yellow body)!!
• a surge in LH triggers ovulation
• rise in estrogen 

Hormonal changes with menstrual cycle

Menstruation 

• fall in progesterone (without it the lining sloughed out)
• the corpus luteum stops secreting progesterone and decays after ~14 days 
• the rise in FSH starts a new cycle 

Hormonal changes with menstrual cycle

Menopause 

• fall in estrogen levels
• significant rise in FSH and LH

• puberty
• pre-pregnancy
• pregnancy 

prenatal/fetal,infancy (0-1)

childhood (2-14)

adolescence/Adulthood (15-44)

Middle and Older Adulthood (45+)

life course perspective:

Obesity 

• starts in early life
• genetics, environment, urbanization 
• policy implications:
• prevention vs treatment 

life course perspective:

Cardiovascular

• develops during childbearing years (development of beh. plays a role and genetics)
• early life influences (high BP, abdominal obesity, smoking, diet, inactivity)
• understanding sex differences in risk 

life course perspective:

Cancer

health behs. and risk 

• smoking
• UV rays
• maintaining healthy weight
• physical active lifestyle
• healthy diet
• limit alcohol comsumption 

Leading causes of death realted to RH:

Young Girls

HIV

abortions

pregnancy

childbirth

sexual health 

Leading causes of death realted to RH:

HIV

cancer

childbirth

sexual violence

chronic disease

Leading causes of death realted to RH:

HIV

cervical cancer

hypertension

diabetes

other chornic diseases

differences in incidence, prevalence, mortality and burden of disease

(e.g. breast cancer: by sex: more prev. in women than men due to homormonal/bio influences on the breast)

UNFAIR/UNJUST differences in health which are systemic and avoidable 

(e.g. white women ^ prev. of breast cancer, Black women have ^ BC mortality rate) 

• socially constructed 
• race often patterns health 

intergenerational institutionalized racism over time

-racially mediated stress based on inequities........women's allostatic load.....LBW amongst AA women

• institutionalized racism
• unequal access to helath resources, goods, services, opportunities
• prejudice and discrimination
• racism 
• poverty strains soc. support networks
• residental segregation 
• soc. isolation 
• intersectionality b/n race and gender 

Race/ethnic RH inequalities across the life course:

INFANCY/CHILDHOOD

• LBW
• high infant mortality rate
• unintentional injuries
• sexual abuse 

Race/ethnic RH inequalities across the life course:

ADOLESCENCE

teen pregnancy 

HIV

STIs

Race/ethnic RH inequalities across the life course:

ADULTHOOD

• HIV
• cancer (disparity among AA women)

Life course perspective Lu and Halfon

increased awarness -> screenings -> prevention methods

• more research to eliminate issues
• access to affordable health care for all
• shift in policies that have previously been a hindrance to certain ethnic groups 

3 causes of maternal mortality (Dr. Anderson lecture)

E.H.H

1. ectopic pregnancy 
2. hypertension 
3. hemorrhage

 resulting from obstetric complications of the pregnant state 

(e.g. interventions, omissions, chain of events, incorrect treatment)

maternal deaths PER 100,000 live births 

ratio of life:death

1) Recognition of complications (failure to preceive severity)

2) Delay in deciding to seek care (cost, previous bad exp)

3) Delay in reaching HC facility (lack of transportation, road conditions, proximity/distance)

4) delay in treatment at facility (uncaring attitudes of providers, shortages of supplies/personnel, poor skills of personnel) 

Essential Ob care: basic care that everyone receives when pregnant (family planning, antenatal care, intrapartum and postpartum care)

ER care: when complications arise that require a higher level of training 

NO

lowering MM depdends on long-term care, effective planning, ER care, etc.

it can't change the outcome of the pregnancy 

• family planning
• antenatal care
• essential obstetric care
• clean/safe delivery
• equity for women

Describe the physiology & cycle of sexual/orgasmic repsonse in males and females

DAO model

(doesn't fit majority of people's lives with both straight/gay relationships)

Desire--->Arrousal--->Orgasm--->Resolution

Spontaneous Sex drive

Sexual Stimulation 

Sexual Arrousal 

Arrousal/Sexual desire

Emotion & Physiological Satisfaction 

Emotional intimacy 

• barriers
• use of appropriate language related to sex, gender, partners
• policies relating to insurance coverage
• sense of vulnerability 
• desire to be invisibly different 

why is contraception a basic need?

prevent unintended pregnancy

reduces marternal mortality 

reduces risk of unwanted STIs and HIV

• the pill
• condoms
• hormonal (Depo)
• Least used: IUDs, female condom, implants 

• lack of partner approval
• fear
• low self-efficacy 
• stressful life events and engagement in risky sex beh. 

1. periodice abstinence
2. barrier methods (condoms)
3. pills (birth control)
4. hormone (DepoProvera)

1. implants (Norplant, Implanon)
2. IUD (copper, hormone containing)

how does hormonal contraceptives work?

3 mechanisms 

prevents ovulation, implantation and fertilization

IUD: foreign body reaction 

acne

light periods

decresead risk of ovarian cancer and endometrial cancers 

Plan B

IUDs

irreversible

risk of infection with surgery 

regret

effectiveness varies by age

more protection for the labia and transmission 

higher self-efficacy for women to use protection 

invagination 

misdirection (unprotected sex)

partner disagreement

spillage