Contraceptive Use Before and After Gastric Bypass: a Questionnaire Study.
BACKGROUND
At present, women are recommended to avoid pregnancy 12-18 months after bariatric surgery. Our aim in this study was to describe patterns of contraceptive use before and after gastric bypass in Sweden, and to describe the contraceptive counseling given preoperatively to women undergoing gastric bypass.


METHODS
In October 2012, a questionnaire was sent to 1000 Swedish women who all had undergone gastric bypass during 2010. The women had been included in the Scandinavian Obesity Surgery Register at time of surgery. The main outcome measures were patterns of use of contraception before and after bariatric surgery.


RESULTS
The response rate was 57 %. The most commonly used contraceptive methods were intrauterine devices, 29 % preoperatively and 26 % postoperatively even though there was a postoperative switch from the copper intrauterine device to the levonorgestrel intrauterine system. Thirty percent did not use any contraceptive during the first 12 months after surgery. Sixty percent of the responders were aware of the recommendations to avoid pregnancy after surgery.


CONCLUSIONS
Many women who undergo bariatric surgery are not using any contraceptive method despite the recommendation that they should avoid pregnancy for at least 12 months. There is a great need to improve contraceptive counseling for this growing group of women.
Department of Obstetrics and Gynaecology, University Hospital, Linköping University, 58185, Linköping, Sweden. charlotte.ginstman@regionostergotland.se.|Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden. charlotte.ginstman@regionostergotland.se.
Charlotte
C
Ginstman
Department of Surgery and Department of Clinical and Experimental Medicine, Linköping University, Norrköping, Sweden.
Jessica
J
Frisk
Department of Surgery, Örebro University, Örebro, Sweden.
Johan
J
Ottosson
Department of Obstetrics and Gynaecology, University Hospital, Linköping University, 58185, Linköping, Sweden.|Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Jan
J
Brynhildsen
D000328:Adult; D003267:Contraception / Q000706:statistics & numerical data*; D003270:Contraceptive Agents / Q000008:administration & dosage*; D005260:Female; D015390:Gastric Bypass / Q000534:rehabilitation / Q000706:statistics & numerical data; D006801:Humans; D016912:Levonorgestrel / Q000008:administration & dosage; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D011247:Pregnancy; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
D003270:Contraceptive Agents; D016912:Levonorgestrel
Contraception; Gastric bypass; Obesity; Pregnancy