Pregnant women's experiences of nutrition care after previous bariatric surgery

The rate of pregnancy following bariatric surgery is rising globally and is associated with health benefits but also increased risk of micronutrient deficiency, preterm birth and small for gestational age offspring. Bariatric surgery may limit women's ability to meet the nutrient demands of pregnancy, necessitating individualised nutrition therapy. However, little is known about women's experiences of, and preferences for nutrition-related care during pregnancy after bariatric surgery. To describe women's experiences of pregnancy after bariatric surgery, focussing on nutrition-related care. This qualitative study interviewed women across Australia with a history of any bariatric surgery. Semi-structured telephone interviews were conducted after 36-weeks gestation and before childbirth. Data were analysed using reflexive thematic analysis. Thirteen women aged 26-37 participated. Three themes were generated: navigating healthcare, the personal toll of pregnancy after bariatric surgery, and women's agency. Despite a strong desire for specialised nutrition care, women encountered several barriers to accessing this. When care was available, it often did not meet women's needs due to healthcare professionals' limited understanding of the nutrition challenges faced in pregnancies following bariatric surgery. This compelled women to seek information outside their maternity care team and advocate for themselves during care. These findings highlight the need to address barriers to accessing nutrition care for pregnant women following bariatric surgery. Improved understanding of pregnancy and post-operative symptoms may enable enhanced woman-centred care. Greater awareness of bariatric surgery among all maternity care professionals is needed to improve opportunities for informed, shared decision-making with pregnant women.