Pelvic Organ Prolapse (POP) occurs when one or more pelvic organs descend into or through the vaginal opening, significantly impacting physical and mental health. POP affects the female reproductive tract and, overwhelmingly, people who identify as women. However, little research has examined the impact of gendered expectations on women’s treatment-seeking for POP and their decision-making around surgery for POP. To address this gap, we conducted semi-structured interviews with 26 women seeking surgery for POP in Alberta, Canada. Data were analyzed from a gender-based lens, using the Framework Method. Participants reported the need to balance their identities as women, partners, and mothers in their pursuit of treatment and faced many barriers to treatment related to their gendered responsibilities. Findings highlight the gendered experiences of prolapse in the context of healthcare needs and can inform policies and practices which promote more equitable access to prolapse treatment.

Background: Given the prevalence of women seeking surgical treatment for pelvic organ prolapse (POP), there is a need to understand women’s decision-making regarding uterine-preserving versus hysterectomy-based surgeries. Historically, hysterectomy-based surgeries have been the preferred treatment for pelvic organ prolapse; however, contemporary evidence supports uterine-preserving surgeries as equivalent. At present, the lack of information available to the general public and limited options presented at surgical consultation for pelvic organ prolapse may hinder women’s autonomy as they navigate surgical treatment. Objectives: To examine the factors affecting women’s decision-making processes regarding uterine-preserving or hysterectomy-based surgery for pelvic organ prolapse. Design: This is a qualitative study. Methods: We conducted semi-structured, qualitative interviews with women seeking surgery for pelvic organ prolapse to explore the factors affecting women’s decision-making between hysterectomy-based and uterine-preserving surgeries. Results: Women (n = 26) used clinical and personal factors to determine which surgery was best. Women noted that the lack of evidence (clinical and/or anecdotal) available to them hindered their decision-making, causing them to rely more on their own interpretations of the evidence, what they perceived to be “normal,” and what their surgeon recommended. Even with standardized discussion regarding the existing clinical equipoise between surgeries at the clinical consultation, some women still had misperceptions that hysterectomy-based surgery would convey the lowest risk of prolapse recurrence and be best for severe prolapse. Conclusion: There is a need for more transparency in discussions about prolapse and the factors affecting women’s decision-making for surgical repair of pelvic organ prolapse. Clinicians should be prepared to offer the option of hysterectomy-based or uterine-preserving surgeries and to clearly explain the clinical equipoise between these procedures.

Background: Housing is a critical determinant of health and a basic human right. Historically, Canada’s housing policies have not been grounded in a human rights-based approach. In the 1990s, a policy shift prioritized efficiency in government spending and deficit reductions over the provision of many social programs including affordable housing. With various levels of government now acknowledging and recognizing the need for more affordable housing, it is important to understand tenant experiences, perspectives, and needs to ensure policies and practices are supporting individuals appropriately. Methods: In total, 161 individuals participated in this study by completing online or in-person questionnaires. Results: Exploratory analysis of results revealed that although there were some positive benefits to affordable housing, many tenants continued to struggle financially, physically, mentally, and emotionally without adequate supports in place. Conclusions: These findings highlight the need for affordable housing to be part of a system of care that provides supports along a continuum. The results further reiterate that placing a person or family in affordable housing does not guarantee that their lives have improved. Without robust affordable housing models that prioritize the empowerment of individuals and families, housing policies may fail to fulfil the right to safe and affordable housing for Canadians, especially when considering historically marginalized populations.