TOWARDS A NEW WORLD OF WOMEN'S SEXUAL AND REPRODUCTIVE LIFE

( Remind Return How Importance  For Girls For More Understand About Sexuality and Rights reproduction )

dr. Made Oka Negara, S.Ked , Biomed, FIAS

“ Very often our listen , read or can so experience problem about health reproduction and sexuality , for example unwanted pregnancy (KTD ) , unsafe abortion , abuse sexual , rape teenager , trading women (trafficking), prostitution children and teenagers girls , and still many what else turned out it is the woman who direct become a victim in it ”.

·         Every year about 500,000 girls die because give birth to

·         More of 65,000 of them is teenager dead girl _ because an abortion that doesn't safe .

·         There are 15 million woman teenager give birth to children , and some from they already To do connection sexual before married .

·         About 42 million population the world when this suffer from HIV/AIDS and almost half from they start suffer from disease the moment still aged teenager and almost half is girl .

Sex , Sexuality and Health Reproduction

We often hear term sex , sexuality and health reproduction . Can so possible terms that delivered in wrong understanding _ or not enough right . Sex have meaning  type sex or sex organs . Whereas sexuality by denotative have meaning  more large because cover all related aspects _ with sex that can cover values , attitudes , orientation and and behavior . In terms of sexuality can sorted again to in dimensions biological , psychosocial , behavioral , clinical , cultural . Dimension biology start from form anatomy of sex organs until function and the biological processes that accompany it . Factor biology this control development sexual from conception until birth and ability reproduce after puberty . Side biology Sexuality also affects encouragement sexual , function sex , and satisfaction sexual . Dimension psychosocial cover factor psychic that is emotions , views and personalities , which collaborate with factor social , that is how man interact with environment by sexual . Talking about dimensions behavior sexual , preferably our avoid self from judge behavior other people 's sex with use value and experience our alone . The term "normal" is often labeled to what are we alone do and feel comfortable , while "abnormal" is defined as what other people do different or feel odd for us . Though sexuality is something natural function , can _ so in line growth and development and in the recreational sexual process experience many obstacle . Problem physique like illness , trauma, or drugs could disturb function reproduction and reaction sexual . Feeling like anxiety , guilt , shame , depression and conflict in connection private can also disturb sexuality . Dimension clinical sexuality give solution to problem these and other problems that hinder achievement happiness sexual . Topics sexual often cause controversy . But controversy often character relatively to time , place , and environment . What the so- called "morals" are different from one culture to culture other , from time to time time. Change behavior Sexual intercourse that occurs everywhere, including in Indonesia, cannot be separated from dimensions cultural . There are several factors that cause change it . First , the more open information sexuality . All form media is reflection change this , and the consequences sex less and less as something that causes taboo , shy and mysterious . Second , change gender roles . By traditional , women treated as passive and unresponsive creatures _ by sexual , moderate Men considered as aggressor sexual . View this now has replaced by a draft participation . Third , the more received sex for destination recreation and relations as opponent from reproduction .

By definition , health reproduction according to WHO and ICPD ( International Conference on Population and Development ) 1994 which was held in Cairo are : comprehensive health , including _ aspect physical , mental, and social , and not just not there disease or disturbance in all related things _ with system reproduction , function as well as the reproductive process that alone . With thereby health reproduction imply that everyone can _ enjoy life safe and enjoyable sex , and they have ability for reproduce , as well have freedom for set when and how much often they want to reproduce . attribution health reproduction with life healthy sex ca n't _ avoided because in humans the reproductive process preceded with connection sex Among men and women . Reproduction process humans ca n't separated from problem life sexual , so it 's impossible our discuss problem health reproduction without discuss life healthy sex . _ So when our speak about right will health reproduction we should too speak about right for undergo life healthy sex . _

Why Women Became Attention ?

Women have characteristic biology ( good anatomical nor different physiological ) with men . With thereby so problem health reproduction and sexual girls are real have different specialty _ with men . During hundreds year attention and study to related problems _ with health reproduction woman often ignored . Whereas number Dead mother , number birth baby always high , cases Infection Infectious Sexuality (STI) in women has also been many , including a number of Thing other related _ with reproduction and sexuality . Just in the middle century to two twenty one problem woman get little attention _ special , especially in study epidemiology about cancer . At the moment that's new talked about problem cancer breast and cancer neck lots of uterus take casualties _ people female . Problem health more girls _ special and the main next start studied by more wide and open especially there are related with function reproduction , that is pregnant , giving birth and breastfeeding . A number of interesting thing _ for understood as problem reproduction and quality for girl at the moment now this is problem as following :

1.      Unwanted pregnancy ( KTD)

Problem unwanted pregnancy _ this always cause deep conflict _ in self women who experience , and every woman will should understand how it's weird take decision for carry on or not continue her pregnancy . Faced with an unwanted pregnancy , a girl who chooses still not married , must decide is he will maintain child out of wedlock _ or To do abortion . In a country that forbids action abortion or in a country where abortion is safe difficult obtained , as a result precisely trigger many woman To do abortion dark and unsafe with caused various the risk like bleeding , infection , infertility until death.And very more more _ many bear as a result good by social nor medical even though more big portion women than men .

2.      Fertility ( fertility )

Ability for reproduce is element base from health reproduction . By medical not fertile not yet of course indicates existence disturbance health , but by social culture can so people who don't come have child will attempted look for help medical because feel not yet complete if already family not yet have descendants . Part from not fertile occur because existence disturbance health or once experience disturbance health in the reproductive organs . Service medical for prevent or treat happening disturbance the will could reduce happening infertility , more lower the anxiety it causes . Worry that itself is also disturbance health . And more in culture patriarchy , still just occur tendency that when occur infertility so more girls _ often blamed .

3.      Arrangement pregnancy and age Marry

Already become right everyone for _ determine when and how much often he will reproduce , then service for Settings birth is also be part from right will health reproduction . Arrangement birth this now conducted with use various tools and methods contraception . And need also understand the success of the Family program Planning (KB) which was emphasized by the government in the past still many are _ instructive and not willingness , so  often implementation ignore rights health female . Postpone marriage until adolescence _ naturally useful for women , but also make _ they susceptible to risk certain . A procrastinating woman _ marriage possible could continue education , maybe can hold more roles _ big in decide when and with who he will get married , and maybe will have more many influence to what happened _ in marriage and family. But delay age marriage also means open opportunity wide for To do connection sexual possible pre - wedding risk of KTD. While at the age married woman _ age young and pregnant at age young with age not enough of 17 years , of course still in state not yet reach maturity physique will experience very risk _ tall in her birth . Teenager age young , especially those who haven't 15 years old more big possibility experience birth by premature , miscarriage and death baby or baby baby in content and possibilities die consequence pregnancy , thing this estimated quadruple _ _ than more women _ old 20 years old above . After all , baby they more big possibility born with abnormal weight and died _ before age one year than babies born to girls _ mature

4.      Infection Infectious Sexual (STI)

Various there are many kinds of STIs experienced by women . Affected woman disease this generally consequence infected by husband or sexual partners . Disease this can also disturb function reproduction female . And in girls disease this often walk not so _ real or asymptomatic , so do not get optimal care . The girl who did connection sexual prewedding Beside could result in adverse events, he also has the potential infected with STIs. Every year enough big proportion women and men age 15-49 contracted an STI. In part _ big developing country range from 11 to 25%. girls _ young specifically easy get an STI because they not enough have protection antibody than women who are more old , and not ripe neck womb they heighten possibility caught bacteria that cause transmission disease that . In societies where women have no right for make decision about life them , a teenager real girl _ afraid caught infection from partner maybe ca n't reject desire partner for To do connection sex . While the women who are not married contain more risk _ big get an STI, even girl who has marry possible threatened risk , if husbands they have many connection sexual before Marry or Keep going To do connection sex with more from one partner. Symptom beginning for women with STIs often go unnoticed ; _ As a result , women may not notice that they caught an infection that keeps him from trying for treatment . Untreated STI can cause consequence heavy to health including damage fertility , sickness bone hips chronic , cancer mouth uterus , and result in bad to children born to affected women _ _ infection when pregnant . After all, half from those who suffer HIV infection is those aged _ not enough than 25 years . In some Sub-Saharan countries many pregnant teen _ are HIV positive , eg 20-27% in some regions of Botswana, Nigeria and Rwanda.Customs culture certain even something related _ with risk reproduction health among _ female .

5.      Technology Reproduction

Technology Help Reproduction or Assisted Reproductive Technology (ART) is one of the method help for get descendants for those who experience difficulty for get it through the relationship process sex penetrative ordinary . Technology this besides give hope for couple who want have child , also brought various necessary impact _ overcome by law . Technology baby tube is most examples _ inviting controversy from side the law , including regarding handling zygote ( cell eggs that have been fertilized ) remaining , mother surrogate mother , sperm _ or cell egg donations and so on .

6.      Life healthy sex _

What is meant with life healthy sex _ is life sexual done _ by volunteer Among second partner , not accompanied pressure or not cause anxiety free _ from transmission disease infection , and done with way that can enjoyed by both . Healthy reproductive process _ only could achieved through connection healthy sex too . A number of things that don't meet requirements connection healthy sex , for example stress, mental health conditions currently sick , disturbed worry certain , or for example occur affair from his sexual partner , if permanent forcing happening connection sexual will could cause disturbance sexual on the side woman like unwillingness To do connection sexual intercourse ( frigidity ), pain and spasm of the sex organs moment relate sexual intercourse ( dyspareunia and vaginismus ) to to outrageous rejection _ normal to connection sexual ( aversi sexual ).

7.                  Harassment / violence sex and trafficking

Draft lots of culture happens in society since era before often put woman as unequal and unequal human _ position from men , even often girls _ stigmatized as not having price self or rights . This thing bring up many case harassment and violence sexual to girl , who arrived now permanent happens , which takes advantage of weak position and still not enough breadth effort advocacy and empowerment to female . Including issue  trading women ( trafficking ) who arrive now difficult eradicated because very related close with poverty and problems social economy other .

Internal and External Factors

Internal factors that can influence health reproduction a first girl _ is covers Progression of healthy growth and development processes since from puberty , fine _ by physique as well as mentally. A child women who experience disturbance growth bone pelvis , for example , is impossible could give birth to child through normal delivery . A tall girl _ her body until Step grow flower stop under 150 cm is very risky for pregnant and giving birth , so used help technology medical certain , for example operation sexy cesarean for help him . Likewise for _ a girl , which is because fac

psychodynamic teacher During in formation personality in the family in planting perception occur error then Becomes scared and worried for To do connection sexual (frigid up to aversion sexual ), as a result will difficult for could doing function reproduction by healthy . Another internal factor is pattern life and knowledge about general health _ as well as health reproduction in particular . One who doesn't understand the process pregnancy will easy experience unwanted pregnancy and can not plan her pregnancy alone .

Whereas factor external is in the form of values , culture , environment social , and legal . Concepts and perceptions Public about gender, about score virginity , about rape , about unwanted pregnancy , everyone _ can influence level health reproduction female . ca n't denied that in connection attitude Public this far more take effect to health reproduction woman than to health man because most attitude this of course it doesn't support to fulfillment rights health reproduction and sexuality female . The myths that develop in society are also very need observed because part big also strengthens domination man to woman so that girl always made helpless _ deal with problem health reproduction . Temporary that , factor law actually expected will behave neutralize attitude lame society _ to female . But unfortunately in Indonesia attitude the law is still many are not conducive to problem health reproduction specifically to female .

Women have the right On Her body Own

Life healthy , universally recognized _ as right everyone is fine man or female . By implicit recognized that everyone has _ right on her body alone . With thereby everyone has _ rights , or even encouraged , for strive reach level highest health _ for herself alone . In Thing this all expert ethics and morals agreed that every man must treated equal and appreciated right on herself alone . Assume that everyone has _ right on herself as intervention different liberalism _ with draft east is wrong because in own religion declared that sin-for example , (and of course also the reward ) is Becomes risk from each individual , not other people and not his family .

Crucial issues in Indonesia related to with health reproduction and sexuality woman is problem rape ( including by sexual partners official - dating rape ), prostitution , prevention of HIV/AIDS and KTD problems . In problems the attitude our still ambivalent and tend not to take sides to right health reproduction female . View people who think that wife must ready serve husband when just make wife doesn't have right for reject even though the body is tired or sick and make rape by husband is not considered as rape on right somebody will his health .

In problem prostitution there is attitude general and inclined law _ put worker sex commercial woman as the wrong and sinful party , so that rights they as humans are considered non - existent . Because of work that considered as that job . immoral and illegal , to _ they are not given right protection law and rights for get service adequate health . _ The government doesn't dare do a program for guard health reproduction they because afraid considered legalize prostitution , although on the other hand the government also profit economical from profession this .

About handling unwanted pregnancy , ambivalence _ to action abortion is too look .. In one side action abortion with assertive prohibited because violate law , but on the other hand nothing optimal effort for complete dilemma the weight faced by a women who experience unwanted pregnancy . _ Talks about abortion almost always linked with connection sex outside of marriage or teenagers who do sex by free , even though research data shows not so . Study Center UI Population says that actually only 30% cases abortion performed by a partner who has not married .

To teenager age schools that experience pregnancy we too often behave corner female . Pregnant girl _ issued from school and lost right for follow education , while students who get pregnant are not charged penalty similar . From the problems above , it seems that has occur judgment on women on base moral values held by those who are more power .

Right Reproduction Very Need Known by Women and Teenagers

Beijing Declaration is a document phenomenal results from Fourth World Conference about women 's event which was held in China on September 4-15 1995. And of course just because Indonesia itself join process in birth declaration this so morally bound _ for run it . By Specific The Beijing Declaration provides serious attention _ to women , especially teenager , with mandated fulfilled education and service health reproduction so that allow teenager handle her sexuality by responsible answer . Factor the main cause of non - fulfillment right reproduction girls and teens is because level lack of knowledge about sexuality , limited information about health reproduction and inaccessibility to access service health reproduction , beside inadequate service , and _ attitude negative to child girls and of course just action discriminatory to them . One fact that is not indisputable , often information about sexuality and reproduction obtained precisely originated from irresponsible source _ answer , incomplete information _ in the mass media , as well as in books , which sometimes information it ca n't confirmed the truth . Whereas right get information and access to service is right health primary reproduction . _ Because needs will information about reproductive functions , systems and processes _ related close with self girls , and will have impact enough social _ means in socialize among _ society in general . Abandonment to information and services health reproduction for woman since age teenager , really is form violation rights _ real reproduction . _ Not fulfilled rights health reproduction since adolescence , not only result in they experience difficulty in handle sexuality them , but also become very factor _ weak in against the offenders rights reproduction . For KTD cases , for example , in a number of case , often caused because myths and misinformation , for example _ To do connection sexual just one time , wo n't cause pregnancy . By chain , case this usually will followed with another suffering for teenager female , that is unsafe abortion that will _ can snatch life them . Another risk , they must undergo Marry young , often more meant for the interests of parents and families , who feel embarrassed because child teenager To do connection sex and cause pregnancy . With Thus , abandonment to rights reproduction teenager girl , will very limit opportunity they in life social and private , including opportunity in get education and empowerment economy — especially for teenagers who have must work , because it is not possible again continue more education _ high .

What to do Conducted

By independent , women moment this already it's time for enrich and empower always herself for knowing more many about what that sexuality and health reproduction . Besides accept assumptions and information about originating sexuality _ from source public our could broaden and deepen definition about sexuality from perspective biological , psychosocial , behavioral , clinical , and cultural based on what are we believe with confirm it from trusted sources _ can accountable or the expert when if find problem or self complaint _ alone nor environment around us . So in review sexuality from corner different views _ this actually our learn about man with all its complexity . Learn sexuality with Correct give a number of benefits , namely could give information and education true sex , can _ prevent and overcome various problem sexual as well as more sensitive and aware in connection between human . Knowledge true sex _ could lead to direction behavior rational and responsible sexual _ answer and get help make decision important personal _ about sexuality .

In more context _ wide , necessary is known that Indonesia as one of the participant in Fourth World Conference about girl , really bound with 1995 Beijing Declaration . With understanding this , Indonesia must operate mandated actions _ in declaration . About problem right reproduction women , the state must give attention by special needs teenager for advance healthy behavior , including _ activity physical . The state must also ensure circle woman will get access by Keep going continuously to information and services health . For all this , the state must review return various policy related public _ with fulfillment rights reproduction , so it doesn't happen again abandonment by continously to rights reproduction . Elites _ ruler , already it's time realize , change a law , not humiliating act _ self them , but must seen as effort to more front _ fine , because limitations formula the law already there is in respond developments _ new knowledge and technology . _ Besides that , the State should also by active and on continuously To do efforts deletion behavior and harmful practices _ life youth , including marriage _ _ _ age youth and children , exploitation sexual abuse _ possible sexual _ HIV /AIDS and infection Infectious Other Sexual (STI) including abuse _ narcotics . In question this , the state must review repeat rule existing law . _ Intense education to device enforcer law , be also important , such as judges, police , prosecutors , and lawyers , because issues rights reproduction , must recognized as issue new need _ understanding and awareness new too. Country must designing affordable information programs , through _ campaign health public , media, open consulting and developing system education with enter education health reproduction to in curriculum . everyone that for could ensure to all party good women and men , especially teenager , inside get knowledge about health them , especially information about sexuality and reproduction . For children and youth , fulfillment information and services health reproduction conducted with notice rights they in get enlightenment , freedom privacy , confidentiality , as mandated _ in Convention Children 's Rights and Conventions Removal All Form Discrimination Against Women. Educational program health reproduction , directed to consciousness about specific needs , for example , education and information about disturbance health reproduction and infection Infectious Sexual (STI) that can arise consequence connection sex , including HIV/AIDS. For teenagers _ woman alone , already it's time for follow together build a organization strong teenager _ in effort urge fulfillment rights reproduction them . Organization this will also have meaning  for urge the country to leave return whole existing policies that do not provide attention to rights and health reproduction , mainly teenager female . With organization this too can ensure yourself to join involved in design and formulation as well as taking related policies _ with interests health and rights reproduction they alone . Participation is Thing important already _ it's time for built in health program planning reproduction and fulfillment rights health reproduction . Development participation like this , will very help takers _ policy , so that the policies they take truly in accordance with needs Specific teenagers and girls .Because when now this everything need very understood , especially by teenagers candidate successor nation this , more special again is girls so that observing problem health reproduction and sex , so that you know and it's not easy robbed or not fulfilled rights health reproduction because moment this our all currently to the new world life sexual and reproductive female .