Approximately 60% of women in Australia are overweight, and most of these are of childbearing age[i]. More and more women are having bariatric surgery to lose weight. For many, this is to improve their chances of conceiving and maintaining a healthy pregnancy.
Obesity has been associated with infertility and poor pregnancy outcomes.
We know that bariatric surgery procedures, such as lap band or gastric bypass surgeries, limit the amount of food a woman can eat. They can also alter the way nutrients are absorbed, leading to nutritional deficiencies. As a result, if a woman becomes pregnant too soon after undergoing bariatric surgery the growth and development of the foetus may be impacted.
Because of this, it is recommended that women wait at least 12 months after undergoing bariatric surgery before attempting to become pregnant. This is to ensure that the rapid weight loss phase following surgery is complete and any nutritional deficiencies can be identified and addressed before pregnancy.
Although women are supported with preparation for surgery and some post-operative follow-up, there is a lack of evidence regarding how women who have bariatric surgery are supported through pregnancy planning and beyond. It is also unclear how these women experience pregnancy and lactation following bariatric surgery.
To improve our understanding, we conducted a scoping review to synthesise the available evidence regarding women’s experiences of pregnancy and lactation following bariatric surgery. The review showed that very little has been written on women’s experiences, with only one full paper and 4 conference abstracts written on the topic.
Of the literature available, findings suggested that women did not understand how bariatric surgery might impact pregnancy. They also felt conflicted about eating well for supporting a healthy pregnancy and maintaining the weight loss achieved through surgery. Breastfeeding was a reported challenge with women wanting tailored advice and support for lactation after bariatric surgery. It is of note that the research available was low in detail, limiting the conclusions that could be drawn.
The outcomes of the scoping review highlights that more work needs to be done to understand these women’s experiences. Such information can be used to develop tailored advice and resources for women to meet their needs and improve pregnancy outcomes.
Our team was awarded a Western Health Foundation grant to commence a body of work exploring women’s experiences of pregnancy and lactation following bariatric surgery. The study is now complete with findings due to be published soon.
Findings from the study have been published in the academic journal Midwifery.
[i] Australian Bureau of Statistics. (2018). National Health Survey: First results, 2017-18 Retrieved from Canberra: https://www.abs.gov.au/ausstats/abs@.nsf/mf/4364.0.55.001