Costa Rica prohibits abortion except under narrow circumstances to save the pregnant person\'s life. The country boasts historically strong support for social policy and human rights, while also presenting a complex and restrictive abortion access landscape. From September 2021 to March 2022, we conducted 23 interviews with obstetrician-gynecologist (OB/GYN) physicians, OB/GYN medical residents, and policy stakeholders to explore the socio-ecological influences on abortion access in Costa Rica. We sampled clinicians and policy stakeholders from the Universidad de Ciencias Médicas listserv through snowball sampling and conducted semi-structured in-depth interviews in Spanish. We identified limited access to comprehensive sexual health education, lack of support from interpersonal networks, inadequate provider knowledge and training, financial and migratory status, and both provider and community stigma as substantial barriers to abortion access. This study addresses a gap in published research around the social determinants of abortion in Costa Rica and sheds light on the attitudes and opinions of the medical and policy stakeholder communities about abortion access. The results highlight the need for expanded access to comprehensive sexual health education, abortion-related training for healthcare providers, and increased programming efforts, such as funding, outreach, and implementation, to ensure comprehensive reproductive health services are available and accessible, especially for vulnerable populations in Costa Rica.

This perspective provides an overview of issues needed to bring a testosterone-progestogen combined transdermal male hormonal contraceptive to the market. Large-scale phase 2b trials are near completion and a pivotal trial to confirm efficacy and safety has been designed. We believe we are close to accomplishing the steps necessary to bring the first male-directed effective, safe, and reversible pharmaceutical contraceptive approach to the public. If successful, we believe it will provide a new option for couples to consider in their family planning.

Constituting a valuable resource, youth deserve more attention regarding their rights through increased access to sexual and reproductive health services. Limitations in health service delivery for youth should be overcome, whether pertaining to restrictive legislation and policies or technical approaches. Clear clinical guidelines will improve quality of care thereby complying with national commitments to international legal instruments. It is apt for both decision-makers and service providers to celebrate International Youth Day on Monday 12 August, by paying special consideration to innovative approaches for the delivery of youth-friendly sexual and reproductive health services that are adaptable to local circumstances.
Constituant une ressource précieuse, les jeunes méritent davantage d’attention quant à leurs droits grâce à un accès accru aux services de santé sexuelle et reproductive. Les limites de la prestation de services de santé destinés aux jeunes doivent être surmontées, qu’elles soient liées à des législations et politiques restrictives ou à des approches techniques. Des directives cliniques claires amélioreront la qualité des soins, respectant ainsi les engagements nationaux envers les instruments juridiques internationaux. Il convient que les décideurs et les prestataires de services célèbrent la Journée internationale de la jeunesse le lundi 12 août, en accordant une attention particulière aux approches innovantes pour la fourniture de services de santé sexuelle et reproductive adaptés aux jeunes et adaptables aux circonstances locales.

The medical-legal partnership (MLP) and reproductive justice (RJ) movements both seek to solve complex problems, serve diverse populations with intersectional challenges, and resolve community conditions that impact people\'s ability to reach their highest health potential. Yet MLPs have been overlooked as a strategy to advance reproductive health and justice. MLP has distinct advantages for advancing RJ, and many MLPs might already be doing RJ work without referring to it by name. By intentionally adopting an RJ strategy and explicitly addressing the unmet social and legal needs that limit people\'s ability to plan their reproductive futures, MLPs can better serve their clients and contribute to the movement to combat reproductive oppression.

BACKGROUND: Nepal is one of the most vulnerable countries to climate change. The drivers of climate risk include its topography, ecological diversity, climatic variability, natural resource dependency, under-development, and socioeconomic vulnerabilities. Climate change affects women and girls in unique ways. Research conducted in Asia Pacific region highlight negative sexual and reproductive health outcomes from climate change-related stressors such as droughts, floods, and air pollution, factors also linked to decreased SRH services utilization, increased maternal mortality rates, and repercussions on women\'s mental health.
METHODS: This is a mixed methods study conducted in two river basins including household surveys with 384 females ages 18-49, 12 focus group discussions, and 22 key informant interviews. We conducted descriptive and thematic analysis.
RESULTS: More than half relied on agriculture for income (66%). Despite one-third being heads of households, land ownership was low (13%). Climate change perceptions included rising temperatures (88%), increased heat wave (70%), drying water source (99%), and delayed monsoons (83%), impacting agriculture and increasing women\'s workload (61%) due to displacement and male migration. 64% reported disturbances in antenatal and postnatal care visits . Inaccessible healthcare facilities during the rainy season increased maternal mortality risks. Heavy river flooding hindered female community health volunteers access leading to childbirth complications. 82% of women feared being unable to protect their children post-climate events. Moreover, 21% of women faced gender-based violence during or after climate disasters.
CONCLUSIONS: Our findings suggest clear impacts of climate change on women and the communities. Thus, climate adaptation efforts must be designed to address the unique impacts of the crisis on women and girls, making space for their increased participation and leadership.

OBJECTIVE: Training in cardiothoracic surgery coincides with a time when many plan their families. Many choose to delay childbearing until the end of training, 33% of women and 20% of men reported using assisted reproductive technology (ART). States have varying laws regarding abortion and ART, which can impact these decisions. Our purpose was to elucidate the intersection of such laws and the training positions available in cardiothoracic surgery.
METHODS: We identified abortion laws, abortion laws regarding insurance coverage, personhood laws that potentially impact ART, and insurance coverage of ART using publicly available data. We created choropleth maps with cardiothoracic surgery training positions identified using the National Resident Matching Program Match data for 2024.
RESULTS: 29.4% of cardiothoracic surgery programs (47 out of 160) are situated in states with abortion restrictions. Of 48 integrated training positions, 10 are in states with abortion restrictions. Similarly, 32 of 95 traditional thoracic positions and 5 of 17 congenital positions are in states abortion restrictions. 25.6% of cardiothoracic training programs reside in states that grant personhood before birth, potentially impacting ART. Insurance coverage for abortion and ART are variable. See Figure 7 for a graphical abstract of the study.
CONCLUSIONS: Valuing reproductive rights like access to abortion, insurance coverage and ART can potentially impact training opportunities in cardiothoracic surgery.

The article reports on a roundtable dialogue on Donor Funding for SRHR Advocacy and Movement Building, organised by Sexual and Reproductive Health Matters (SRHM) in collaboration with AmplifyChange on 14-15 September 2022. It explores the current scenario about the changing landscape for advocacy and movement building for SRHR and presents some key takeaways from the discussion. The roundtable examined the current funding architecture, drawing on the diverse perspectives of participants, including funders, and raises critical questions on whether current funding patterns are geared to help or hinder advancing a transformative SRHR advocacy agenda that can effectively counter opposition to and rollback of SRHR gains. It provides insights into current approaches to monitoring success and impact that, in turn, shape future funding strategies and priorities and offers preliminary suggestions and solutions for a way forward. The article ends with a call to infuse the SRHR advocacy and movement-building funding landscape with a new set of mutually agreed values, principles and strategies that are embedded in people and movement-centred approaches as a way to ensure not just more but better funding.

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France\'s landmark constitutional amendment in 2024 enshrines abortion freedom in its supreme legal framework, representing a profound milestone against the backdrop of shifting global political and social attitudes toward abortion. This decision, influenced by disruptive events such as the COVID-19 pandemic and the overturning of constitutional abortion rights in the United States, places France to the forefront of protecting abortion access. Despite ongoing challenges in accessing services in certain areas and circumstances, this amendment sets a precedent for other nations considering similar protections. We offer key insights into this case and reflect on how it can potentially shape legislative trends in abortion rights worldwide.

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