Contraceptive knowledge, attitudes and practices among women with a history of bariatric surgery
Awarded 2011
Complex Family Planning Fellowship Research
Tara Jatlaoui, MD, MPH
Emory University

Introduction: Over 100,000 bariatric procedures are performed yearly in the US. Women account for the majority of cases. Current clinical guidelines recommend women avoid pregnancy preoperatively and 12 to 18 months after surgery. This survey aimed to identify the family planning knowledge, attitudes, and practices of bariatric providers in the perioperative period.
Methods: We conducted semi-structured interviews with six bariatric providers. From these qualitative data, we developed a quantitative survey, which was mailed to the American Society of Metabolic and Bariatric Surgery (ASMBS) members. We collected data from a convenience sample of the first 275 responders.
Results: Over 70% of 272 respondents recommended women avoid pregnancy for 12-24 months after bariatric procedures. The majority considered the most effective contraceptive methods to be safe for women after gastric bypass, however a minority (35.3%) provided contraceptive services or referrals. While most (73.0%) considered female reproductive health discussions very important, the majority (70.4%) never or almost never felt comfortable with these discussions. Respondents most frequently preferred the patient’s own gynecologist (80.9%) or bariatric surgeon (71.0%) discuss contraception.
Conclusion: Bariatric providers consider reproductive health very important, however most are not comfortable having these conversations and would prefer patients see their gynecologists to discuss contraception. This is an opportunity for gynecologists to educate themselves and colleagues about contraception recommendations after bariatric surgery and collaborate with bariatric centers in their area to meet the needs of these patients.