Managing women in pregnancy after bariatric surgery: The midwife as the co-ordinator of care

Abstract

Bariatric surgery is a recommended, cost-effective, evidenced-based intervention to reduce weight and associated comorbidities in severely obese people. People with a BMI of 40 kg/m2 or more, or a BMI between 35-40 kg/m2 with other medical conditions such as diabetes, hypertension, high cholesterol and obstructive sleep apnoea meet the criteria to be considered for bariatric surgery. Over the past 10 years, bariatric surgery in the UK has been more widely accessible and consequently midwives may be required to care for pregnant women who have undergone bariatric surgery such as a gastric band, sleeve gastrectomy and gastric bypass. Midwives are required to work co-operatively, recognising and working within the limits of their competence and providing leadership. The aim of this article is to consider the midwife's role as co-ordinator of care for pregnant women who have undergone bariatric surgery. It outlines the most common bariatric procedures and specific considerations, including nutritional supplementation required when providing care to women in the antenatal and postnatal period.