Family planning knowledge, attitudes and practices among bariatric healthcare providers

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• 作者：Tara C. Jatlaoui ; ^{tjatlaoui@cdc.gov" class="auth_mail" title="E-mail the corresponding author} ; Sarah Cordes ; Peggy Goedken ; Denise J. Jamieson ; Carrie Cwiak
• 关键词：Family planning ; Bariatric surgery ; Contraception ; Weight loss surgery
• 刊名：Contraception
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：93
• 期：5
• 页码：455-462
• 全文大小：182 K

文摘

This survey aimed to identify the family planning knowledge, attitudes and practices of bariatric providers in the perioperative period.

Study design

We developed a quantitative survey based on semistructured interviews with six bariatric providers. We mailed the survey to the American Society of Metabolic and Bariatric Surgery members with plans to use data from the first 275 responders to assess knowledge, attitudes and practices regarding family planning.

Results

Over 70% of 272 respondents recommended that women avoid pregnancy for 12–24 months after bariatric procedures. Most (73.0%) considered female reproductive health discussions very important, and most feel comfortable (70.4%) with these discussions. The majority considered the most effective contraceptive methods to be safe for women after gastric bypass; only a minority (35.3%) provided contraceptive services or referrals, and few (4.9%) have accurate knowledge of contraceptive effectiveness. Respondents most frequently preferred the patient's own gynecologist (80.9%) or bariatric surgeon (71.0%) discuss contraception. Discussing contraception was associated with provider age 40–49 years, training region in southeast or midwest and degrees of physician assistant or nurse practitioner with adjusted odds ratios exceeding 2.0.

Conclusion

Bariatric providers consider reproductive health very important, and while most are comfortable having these conversations, few have accurate knowledge of contraceptive safety and effectiveness. Most would prefer patients see their gynecologists to discuss contraception. These findings suggest an opportunity for gynecologists to educate themselves and bariatric colleagues about contraception recommendations after bariatric surgery and collaborate with bariatric centers in their area to meet the needs of these patients.

Implications

Gynecologists must become educated and involved in the care of female bariatric patients to discuss reproductive health concerns and to counsel effectively regarding contraception after bariatric surgery.