Culture is shared patterns of behaviour, interactions, cognitive contracts and understandings that are learned through socialisation. Culture can also be defined as a collection of learned and easily identified beliefs and practices shared by groups of people, which guides their decisions, thinking and actions in a patterned way.  

Culture is a set of customs, traditions and values of a society or community such as ethnic group or nation. Culture also includes religion, social habits, beliefs, music and the arts.

Common Cultural Practices that may play a role in sexual and reproductive behavior worldwide are indicated as follows:-

• Motherhood sexual abstinence: Culture recommends husbands not to have intercourse with their wives during pregnancy and breastfeeding where men end up having extramarital affairs.

• Virgin myth: a belief that sex with a young girl including children and babies cures HIV/AIDS

• Polygamy: This is still practiced in many countries which plays a role in the spread of STI and HIV.

• Practice of never looking at adults in the face or saying no to an adult: In many African countries this culture allows the male adults to molest young women because she’s unable to say no.

These and many other cultures that are still practised in different parts of the world play a major role on SRH and also put a negative impact on women.

A birth defect is something abnormal about your newborn baby’s body. 

It can be one of the following:

• Visibly obvious, like a missing arm or a birthmark.
• Internal (inside the body), like a kidney that hasn’t formed right or a ventricular septal defect (a hole between the lower chambers of your baby’s heart).
• A chemical imbalance, like phenylketonuria (a defect in a chemical reaction that results in developmental delay).

Your baby can be born with one birth defect such as a cleft lip (a gap in their upper lip) or multiple birth defects such as a cleft lip and cleft palate (a hole in the roof of their mouth) together, or even a cleft lip and cleft palate with defects of the brain, heart and kidneys.

Birth defects are common. Between 2% and 3% of infants have one or more defects at birth. That number increases to 5% by age one (not all defects are discovered directly after your child’s birth)

Experts don’t know the exact cause of most birth defects, but there are some identifiable causes:

• Genetic or hereditary factors.
• Infection during pregnancy.
• Drug exposure during pregnancy.

Environmental factors can increase the risk of miscarriage, birth defects, or they might have no effect on your baby at all, depending on at what point during the pregnancy the exposure occurs.

Diabetes and obesity can possibly increase your child’s risk of birth defects. Your healthcare provider may suggest that you do your best to manage these conditions before you get pregnant

Alcohol is the most commonly used drug that causes birth defects. Foetal alcohol syndrome is a term used to describe the typical birth defects caused by the mother’s alcohol use:

• Learning disabilities.
• Developmental delay.
• Hyperactivity.
• Poor coordination.
• Abnormalities of facial features

Can birth defects be prevented? How?

Most birth defects cannot be prevented. There are certain important steps to promote a healthy pregnancy, however. 

These tips include:

• See your healthcare provider consistently.
• If you are trying to conceive, or if you are sexually active and not using contraception, take a prenatal vitamin with 400 mcg of folic acid.
• Contact your healthcare provider immediately if you think you’re pregnant.
• Don’t drink alcohol.
• Don’t smoke.
• Talk to your healthcare provider about any medications and supplements you’re taking.
• Avoid marijuana and illegal drugs.

Family planning is a crucial issue for all women of reproductive age, but in women with severe mental illness, there may be particular challenges and concerns. As primary care-based mental health services are expanding in low- and middle-income countries, there is an opportunity to improve family planning services for women with severe mental illness.

Women with severe mental illness also have increased risks of pregnancy, birth and neonatal complications. Mental illness is a risk factor for poor obstetric outcome, including perinatal mortality and congenital malformations. Some of these complications may be directly related to mental illness.

Family planning is particularly important for these women due to the perinatal effects of psychotropic medication. The risk of teratogenicity from some psychotropic medications is highest during the first trimester of pregnancy, with the critical period of exposure often occurring before pregnancy is detected or disclosed. Moreover, discontinuation of the medication during pregnancy increases the risk of relapse. Psychotropic medications may also cross into breast milk, which adds an important consideration in settings with high levels of exclusive breastfeeding and no realistic option to bottle feed

Taking the challenges and complexities faced by women with mental illness in relation to pregnancy and childbearing, family planning and education about future pregnancy is of critical importance in a woman living with mental illness during childbearing years. It is recommended that information about family planning should be incorporated into regular health care services.

At present, no studies have explored reasons for low access to family planning in women with mental illness in Ethiopia. There is also no published evidence on how these women prefer family planning services to be rendered. The plans to scale up mental health care by integrating into primary care services in Ethiopia provide a potential opportunity to deliver more holistic care to women with mental illness and improve their access to family planning advice.

Premenstrual syndrome (PMS) is a combination of many cognitive and emotional symptoms affecting women in menstruating age. 

PMS and it’s more severe form, premenstrual dysphoric disorder (PMDD) are commonly associated with other mood-related disorders such as major depressive disorder and causes significant life impairment with mood swings, tension and anxiety, but their relationship with personality disorders is less clear.

Many psychological, physical and social behavioural factors have an impact on occurrences of PMS. According to the Diagnostic and Statistical Manual of Mental Disorders, PMS and its more severe form, premenstrual dysphoric disorder (PMDD) is regarded as a type of depressive disorder (DD). The psychiatric markers of PMDD are characterised not only by mood symptoms but also by those for anxiety. Most women with PMS suffer with a lifetime history of anxiety disorder in addition to a prolonged depressive disorder.