Assessment of contraceptive needs in women undergoing bariatric surgery

Abstract

Objective: To evaluate documentation of contraception and counseling in women planning to undergo bariatric surgery.

Study design: Chart review of 1012 women ages 18-45years presenting for bariatric surgery evaluation. Data on socio-demographic variables, documented contraceptive method, preconception counseling, gynecology referrals and postoperative pregnancies were collected.

Results: The charts of only 272 women (26.9%) contained documentation of a contraceptive method; the most common was oral contraceptives (n=132, 48.5%). Sixteen pregnancies were identified in the first 18months postoperatively.

Conclusions: Currently, the documentation of contraceptive counseling is lacking in clinical practice. Measures to enhance provider and patient awareness of these issues will improve patient care.

Implications: Pregnancy planning and documentation of perioperative contraceptive use in women undergoing bariatric surgery are suboptimal, placing these women at risk of unintended pregnancies. Future research should delineate the best practices in contraceptive provision in this high-risk population of women.

Keywords: Bariatric surgery; Contraception; Obesity; Preconception care; Pregnancy interval; Weight loss.