title: Reproductive health counseling and practices: a cross-sectional survey of bariatric surgeons.
abstract: BACKGROUND
  Nearly 50% of bariatric surgery patients are women of reproductive age. Both obstetric and gynecology and surgery professional guidelines recommend a delay of fertility 1-2 years postbariatric surgery.
  
  
  METHODS
  We sought to assess bariatric surgeons' perioperative reproductive counseling and contraceptive provision for women of reproductive age. We conducted a cross-sectional, national 32-question mail survey of bariatric surgeons. Survey topics included demographic factors, contraceptive counseling and provision, and method preference. Descriptive statistics were reported and Χ2 tests compared results among respondent demographic characteristics.
  
  
  RESULTS
  A total of 574 of 1,935 physicians returned surveys (30%). After excluding 41 surveys due to missing data, we analyzed 533 (27%) surveys. Mean respondent age was 48.1 years. Most respondents were male (89%), white (78%), and completed residency training ≥10 years ago (72%). The majority of respondents' bariatric surgery patients were female (77%), 63% of which were of reproductive age. Most respondents recommended that their female patients delay pregnancy 12-24 months (87%). Whereas 70% of respondents did not require preoperative contraception, 52% always required postoperative contraceptive use. Although the majority of respondents (64%) referred patients to an obstetrician-gynecologist or primary care physician to obtain contraception, 35% did not know how their female patients obtained contraception. Female respondents were more likely than male respondents to always require a medicine consultation and preoperative contraception, P<.05.
  
  
  CONCLUSIONS
  Despite consistently recommending a delay in pregnancy, bariatric surgeons inconsistently address perioperative contraceptive needs of women of reproductive age. These findings highlight the need for greater collaboration between bariatric surgeons and women's healthcare providers to address the reproductive health needs of women having bariatric surgery.
authors.affiliation: Department of Obstetrics and Gynecology, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois. Electronic address: jchormd@gmail.com.
authors.forename: Julie
authors.initials: J
authors.lastname: Chor
authors.affiliation: Department of Family Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois.
authors.forename: Patricia
authors.initials: P
authors.lastname: Chico
authors.affiliation: Department of Surgery, University of Illinois at Chicago College of Medicine, Chicago, Illinois.
authors.forename: Subhashini
authors.initials: S
authors.lastname: Ayloo
authors.affiliation: Department of Obstetrics and Gynecology, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois.
authors.forename: Alicia
authors.initials: A
authors.lastname: Roston
authors.affiliation: Department of Obstetrics and Gynecology, University of Illinois at Chicago College of Medicine, Chicago, Illinois.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Kominiarek
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D003267:Contraception; D003376:Counseling; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011247:Pregnancy; D066231:Surgeons; D011795:Surveys and Questionnaires
keywords: Bariatric surgery; Contraception; Infertility; Obesity; Perioperative; Pregnancy