RT Journal Article
SR Electronic
T1 Contraceptive counselling in 3 Canadian bariatric surgery clinics: a multicentre qualitative study of the experiences of patients and health care providers
JF CMAJ Open
JO CMAJ
FD Canadian Medical Association
SP E255
OP E261
DO 10.9778/cmajo.20200304
VO 10
IS 1
A1 Dineley, Brigid
A1 Munro, Sarah
A1 Norman, Wendy V.
A1 Zevin, Boris
A1 Hong, Dennis
A1 Katiraee, Babak
A1 Fitzsimmons, Brian
A1 Renner, Regina
YR 2022
UL http://www.cmajopen.ca/content/10/1/E255.abstract
AB Background: Evidence suggests an increase in fertility and unintended pregnancy after bariatric surgery; contraceptive counselling, traditionally defined as a discussion of contraception options, is therefore an important facet of surgical planning. Our aim was to investigate patient experiences of contraceptive counselling, the attitudes of health care providers (HCPs) toward contraceptive counselling, and their perceptions of the facilitators and barriers to contraceptive counselling in bariatric surgery clinics.Methods: We conducted a qualitative study using semistructured interviews with patients and HCPs at publicly funded Canadian bariatric surgery clinics from May 2018 to February 2019. We recruited bariatric HCPs from across Canada using snowball sampling, and recruited patient participants from 3 Canadian bariatric surgery programs. Patient participants had to be at risk of pregnancy in the postoperative period, aged 18–45 years old and have completed all preoperative counselling. We included HCPs who delivered care in a publicly funded, hospital-affiliated bariatric surgery clinic in Canada. Team members analyzed transcripts thematically.Results: We completed 27 interviews (patient n = 16, HCP n = 11). Our analysis identified 3 separate themes: missing information in contraception counselling, making assumptions about who would benefit from counselling and strategies for improving contraception counselling. We found patients and HCPs wanted more resources on the safety and efficacy of contraceptive methods.Interpretation: Our study showed a need for structured contraceptive counselling in bariatric surgery clinics. Information resources that support patients and HCPs who provide counselling are needed.