Future Fertility Among Pediatric Cancer Patients: Experiences and Perspectives of Health Workers in a Low-Resource Setting.

Purpose:Although fertility preservation for patients with childhood and adolescent cancer is considered standard of care in the high-resource settings, it is rarely offered in low-resource settings. This study explores the experiences and perspectives of oncology health care professionals in Uganda to identify contextual barriers and facilitators to addressing oncofertility in low-resource settings. Methods: Using ground theory, we conducted in-depth face-to-face interviews of health care professionals managing pediatric patients at the Uganda Cancer Institute (UCI). Using a systematic, semi-structured interview guide, participants were asked open-ended questions about their understanding of fertility preservation and their perspectives on implementing this care at their institution. Although all the eligible health care providers were interviewed, interview transcripts were uploaded into NVivo version 12 and openly coded as per theoretical requirements. Codes were refined into categories and later into structured themes. Results: Twelve health care professionals were interviewed. Most participants identified as female (n = 9). Their role in the medical team varied from nurses (n = 6), medical officers (n = 3), pediatric oncologists (n = 2), and pediatric oncology fellow (n = 1). Six themes were noted as follows: (1) importance of information, (2) importance of future fertility, (3) inadequate consideration to future fertility, (4) communication barriers, (5) inadequate knowledge, and (6) resource barriers. Conclusion: Although health care providers at the UCI face contextual barriers to addressing future fertility among patients with pediatric cancer, they value preserving fertility in this population. Future initiatives that aim to introduce oncofertility care in low-resource settings should prioritize educating providers and building capacity to meet the oncofertility needs in this setting.

Abortion needs expressed on Reddit after the Dobbs v. Jackson Women's Health Organization decision in the United States.

CONTEXT: Women, transgender men, and gender non-binary individuals facing unwanted pregnancy use online resources for abortion information. We sought to determine the informational and emotional needs that those seeking abortion information on Reddit expressed immediately following the Dobbs v. Jackson Women's Health Organization (Dobbs) decision in the United States. Furthermore, we aimed to understand how the Reddit community addressed these needs. METHODS: We collected posts on Reddit in the subreddit r/abortion that expressed informational or emotional needs related to the Dobbs decision created between June 24, 2022 and July 24, 2022. We identified posts using keywords including "roe," "rvw," and "trigger law" and then manually reviewed them to ensure relevance. We analyzed posts and their comments using qualitative descriptive analysis. RESULTS: One hundred and ten posts met inclusion criteria. Original posters expressed needs for legal and medical information. Posters also expressed need for logistical support, including help accessing medication abortion, traveling out of state, and financing abortion care, and emotional support in general and resulting from fear of parental disapproval and shame relating to abortion stigma. Although responders to these comments addressed these needs by offering general support, accurate information, and reliable resources, intersecting and emotional needs sometimes went unaddressed. CONCLUSION: The Dobbs decision caused confusion and panic among abortion seekers requesting guidance on r/abortion, resulting in informational and emotional needs. While the r/abortion community actively addressed needs, inherent limitations of an online forum prevented some original posters from receiving the multifaceted support they needed.