Pregnancy Conceptualizations in Women Who Have Had Recent Bariatric Surgery

To describe bariatric surgery patients' perioperative conceptualizations about pregnancy. We performed a secondary analysis of a cross-sectional study performed in 2016, evaluating a nationally recruited convenience sample of U.S. women aged 18-45 years who underwent bariatric surgery within the past 24 months. We assessed four pregnancy constructs: intent, desire, emotional orientation, and importance to avoid. We examined relationships between constructs, with time since surgery, postoperative pregnancy, and contraceptive use using descriptive statistics. We included 363 eligible women (response rate 80%). Participant median age was 36 years, 71% (n = 258) were White, 77% (n = 279) were sexually active at the time of the study, and 39% (n = 140) experienced preoperative infertility. Most reported no desire to become pregnant (59%, n = 175) and that it was important to avoid pregnancy (78%, n = 283) within the first 24 months after surgery. Relationships between constructs were complex. Respondents in their first postoperative year more likely reported they would feel upset about a hypothetical pregnancy (40%, n = 74) than those in their second year (27%, n = 48, p = 0.02). Of those with a postoperative pregnancy, 46% (n = 17) felt it was important to avoid pregnancy compared with 81% (n = 266) of those who did not have a pregnancy (p < 0.001). Most used postoperative contraception (66%, n = 241), and those who felt it was important to avoid pregnancy more likely used contraception (82%, n = 197) than those who did not feel it was important (18%, n = 44, p = 0.01). Women undergoing bariatric surgery have diverse and complex conceptualizations about future pregnancy. These varied based on time from surgery and influenced postoperative contraceptive use.