Contraceptive use after bariatric surgery

Abstract

Background Bariatric surgery is an effective intervention for morbid obesity with established short-term efficacy for weight reduction and long-term efficacy in improving health outcomes. Pregnancy is contraindicated in the first year after bariatric surgery and therefore necessitates careful contraceptive planning to reduce pregnancy complications. This study aimed to assess contraceptive use and counseling among women with obesity before and after bariatric surgery at King Chulalongkorn Memorial Hospital. Methods This descriptive study, including a retrospective group with data from records and a prospective group followed over time, was conducted from July 31, 2023, to May 26, 2024.The study included 90 reproductive-aged women who underwent bariatric surgery between January 1, 2018, and October 31, 2023. Participants were surveyed on contraceptive use, counseling, and related factors. Data were collected from medical records and through questionnaires. Results In this study, 85.7% of sexually active participants used contraception 6–12 months after surgery, with male condoms being the most common method. Only 31.4% of the participants used effective contraception (including male and female sterilization, contraceptive implants, intrauterine devices, and depot medroxyprogesterone acetate). Contraceptive counseling was most frequent before surgery and 3 months after surgery; however, seven participants did not receive adequate information about the appropriate contraception for their condition. Conclusion Although the contraceptive prevalence among participants was relatively high, the use of effective contraception was low. The study highlights the need for improved contraceptive counseling and education in patients who have undergone bariatric surgery. Enhanced counseling can help in selecting safe and effective contraceptive methods and reducing the risk of unintended pregnancies during the first year after surgery, a period considered unsafe for pregnancy.