- Increased fertility rates
- Decrease in obesity related illness in pregnancy (gestational diabetes, high blood pressure, preeclampsia, eclampsia)
Bariatric surgery is reserved for women who are extremely obese and those who are usually suffering from addition obesity related illnesses. There are many types of surgery that can be done including the gastric banding surgery that creates a small pouch for food. This technique and some others are adjustable. This is important to consider prior to your surgery and intended pregnancy. Since this surgery is relatively new it is difficult to say what the long term effects are on pregnancy, so adjustability may be beneficial if you are a candidate for this type of bariatric surgery.
There are some basic recommendations for pregnant women who have bariatric surgery and are pregnant:
- Wait between 12-24 months after surgery to become pregnant.
This allows your body to stabilize and heal after surgery. It also allows for the rapid weight loss that typically follows surgery to occur without risk to your growing baby. If you get pregnant before this time period is finished, your practitioner may follow you more closely.
- Seek preconception care.
Before you get pregnant talk to both your weight loss surgeon and your obstetrician or midwife. There may be specific tests that they want to run to ensure that your vitamins and minerals are ideal for pregnancy.
- Set up an appointment with a nutritionist during pregnancy.
This will help you ensure that you are eating well enough to maintain the diet needed to sustain a pregnancy. You may need several check ins during your pregnancy and the postpartum period to help you stay healthy for your baby.
- Vitamin supplementation is a must.
Women who have had bariatric surgery are typically deficient in certain vitamins and minerals, pregnancy can exacerbate this issue. The big ones to watch out for include: iron, vitamin B12, calcium and folate.
- Malabsorption and Testing
If you have a problem with malabsorption or dumping syndrome, your practitioner may need to consider alternative routes of testing for gestational diabetes.
- Premature Rupture of Membranes
You may be at an increased risk for premature rupture of membranes after bariatric surgery. Be sure to talk to your practitioner and know the signs of when your water breaks and what to do if this happens.
- Don't ignore abdominal pain in pregnancy.
If you experience abdominal pain, seek the advice of your doctor or midwife. They can help to tell the difference between something pregnancy related and something from your bariatric surgery.
- You can have a vaginal delivery.
Just because you've had bariatric surgery does not mean that you will need to have a c-section. Though some studies say that the c-section rates after surgery are higher than in an average population.
- Be realistic about weight gain in pregnancy.
Most women who have had weight loss surgery are very leery of any weight gain, even that for pregnancy. However, gaining weight in pregnancy is a must for a healthy baby. Talking to your practitioner, surgeon and nutritionist can help you walk that fine line between a healthy and unhealthy weight gain.
ACOG Practice Bulletin No. 105: Bariatric Surgery and Pregnancy. Obstet Gynecol. 2009;113:1405-1413.
Bennett W, et al "Impact of bariatric surgery on hypertensive disorders in pregnancy: retrospective analysis of insurance claims data" BMJ 2010; doi:10.1136/bmj.c1662.
Pregnancy After Weight-Loss Surgery. March of Dimes. December 2005. Last Accessed 4/14/10.