Reproductive Health in Female Bariatric Patients: A National Survey of Bariatric Professionals

Abstract

Abstract Background A significant proportion of bariatric patients are women of childbearing age. Bariatric patients may be at risk of nutritional and surgical complications that can be impacted by and can impact pregnancy. Aims We aimed to investigate perioperative reproductive health practices, knowledge and recommendations of bariatric professionals regarding reproductive health counseling, contraception and pregnancy in female bariatric patients of reproductive age. Methods We conducted a national, online survey among bariatric professionals. Survey topics included demographic factors, perioperative reproductive health practices, attitudes and knowledge about contraception and recommendations regarding pregnancy. Results A total of 72 healthcare professionals participated. The majority of participants responded that female patients of reproductive age are more than the half of the referred bariatric patients. Only 23 respondents (31.9%) referred always female patients of reproductive age to a gynecologist prior to a bariatric procedure, but 75% always discuss family planning. 51.4% of the participants do not recommend a certain type of bariatric operation in women of reproductive age, but 19 (26.4%) and 9 (12.5%) participants recommend Roux-en-Y gastric bypass and sleeve gastrectomy, respectively. There was a strong variance regarding the recommendations about contraception after surgery. Only 51.4% inform the patients about possible surgical, bariatric surgery-related complications during future pregnancies. More than half of the participants reported inadequate knowledge regarding absorption and safety of contraception pills after bariatric surgery. Although most professionals routinely follow- up and provide counselling on maternal and fetal risks in pregnant women with previous bariatric surgery, 65% have no standardized protocol for such patients who present with acute abdominal pain in their practice. Conclusions Despite acknowledging the importance of reproductive health counseling, bariatric professionals address perioperative and contraception issues inconsistently and mostly reported lack of adequate knowledge in the latter. Therefore, a stronger collaboration between bariatric professionals and women`s healthcare providers is needed to improve care of female bariatric patients in reproductive age.