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Research article
Contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa: a qualitative study
Jane Harries
University of Cape Town
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7359-8419
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Women's Health.
Background: No known studies have been undertaken in South Africa exploring the contraceptive and fertility needs and preferences of women of reproductive age (18-49) diagnosed with breast cancer. This study set out to understand the contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa.
Methods: Qualitative in-depth interviews were conducted with 24 women diagnosed with breast cancer and 4 health care providers at a tertiary hospital in Cape Town, South Africa. We explored contraceptive use prior to diagnosis; the impact of breast cancer on future fertility intentions and contraceptive use; understanding of suitable contraceptive methods during and after treatment and women’s fertility related counseling needs during their continuum of care. Data were analysed using a thematic analysis approach.
Results: Since being diagnosed with breast cancer, of those women using a contraceptive method, the non-hormonal intrauterine device (IUD) was the most commonly used method. However, women reported receiving limited information from health care providers about contraceptive use and future fertility planning post treatment when fertility desires might change. Many women reported limited information received from healthcare providers about the impact of cancer treatment on their future fertility. Most women did not receive information around fertility preservation options, and few were familiar with the concept. Providers focus was more on preventing pregnancy during treatment and ensuring a patient was on a non-hormonal contraceptive method. Providers supported a more holistic, multidisciplinary approach to breast cancer patient’s contraceptive and future fertility needs.
Conclusions:Limited contraceptive and future fertility counseling were reported by women despite many women being provided with the IUD. There is a need for improved information and counseling regarding the impact of treatment on contraceptive and fertility options. It is important that cancer care providers provide timely information regarding fertility options and communicate with patients about their fertility concerns prior to treatment and throughout the course of survivorship. The development of evidence-based information tools to enhance patient-provider communication and counseling could address knowledge gaps.
Keywords
Breast cancer, contraception, fertility intentions, fertility preservation, South Africa, qualitative methods
This is a list of supplementary files associated with this preprint. Click to download.
- ISSMCOREQChecklistBMWH.pdf
- AdditionalFile1.pdf
Additional File 1 Interview guide: Patients Title: Contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa: a qualitative exploratory study
- AdditionalFile2.pdf
Additional File 2 Interview guide (health care professionals) Title: Contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa: a qualitative exploratory study
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This preprint is under consideration at BMC Women's Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa: a qualitative study
Jane Harries
University of Cape Town
Corresponding Author
ORCiD: https://orcid.org/0000-0001-7359-8419
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 01 Oct, 2020
No comments provided
Editor assigned
On 18 Sep, 2020
Submission checks complete
On 17 Sep, 2020
Editor invited
On 17 Sep, 2020
No comments provided
Editorial decision: Major revision
On 02 Sep, 2020
Review #3 received
Received 29 Aug, 2020
Review #2 received
Received 29 Aug, 2020
Review #1 received
Received 22 Aug, 2020
Reviewer #3 agreed
On 04 Aug, 2020
Reviewers invited
Invitations sent on 03 Aug, 2020
Reviewer #1 agreed
On 03 Aug, 2020
Reviewer #2 agreed
On 03 Aug, 2020
Editor assigned
On 21 Jul, 2020
Submission checks complete
On 20 Jul, 2020
Editor invited
On 20 Jul, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Women's Health.
Background: No known studies have been undertaken in South Africa exploring the contraceptive and fertility needs and preferences of women of reproductive age (18-49) diagnosed with breast cancer. This study set out to understand the contraceptive needs and fertility intentions of women with breast cancer in Cape Town, South Africa.
Methods: Qualitative in-depth interviews were conducted with 24 women diagnosed with breast cancer and 4 health care providers at a tertiary hospital in Cape Town, South Africa. We explored contraceptive use prior to diagnosis; the impact of breast cancer on future fertility intentions and contraceptive use; understanding of suitable contraceptive methods during and after treatment and women’s fertility related counseling needs during their continuum of care. Data were analysed using a thematic analysis approach.
Results: Since being diagnosed with breast cancer, of those women using a contraceptive method, the non-hormonal intrauterine device (IUD) was the most commonly used method. However, women reported receiving limited information from health care providers about contraceptive use and future fertility planning post treatment when fertility desires might change. Many women reported limited information received from healthcare providers about the impact of cancer treatment on their future fertility. Most women did not receive information around fertility preservation options, and few were familiar with the concept. Providers focus was more on preventing pregnancy during treatment and ensuring a patient was on a non-hormonal contraceptive method. Providers supported a more holistic, multidisciplinary approach to breast cancer patient’s contraceptive and future fertility needs.
Conclusions:Limited contraceptive and future fertility counseling were reported by women despite many women being provided with the IUD. There is a need for improved information and counseling regarding the impact of treatment on contraceptive and fertility options. It is important that cancer care providers provide timely information regarding fertility options and communicate with patients about their fertility concerns prior to treatment and throughout the course of survivorship. The development of evidence-based information tools to enhance patient-provider communication and counseling could address knowledge gaps.