A Guide to Pregnancy After Bariatric Surgery
If you have had weight loss surgery or bariatric surgery, you may have concerns about the chances of getting, or being pregnant. With the rise of adult obesity increasing, so has the number of bariatric surgery procedures. And as obesity is linked with reduced fertility, women who become pregnant may, naturally, have concerns. But let’s show you what you need to look out for, how to prepare, and how to navigate pregnancy after bariatric surgery safely.
When Is the Best Time To Get Pregnant After Bariatric Surgery?
If you are considering bariatric surgery, you may have to think about putting off getting pregnant. While infertility problems can improve after bariatric surgery, it’s important to remember that because the greatest weight loss occurs between 12 and 18 months after surgery, it’s recommended that you wait at least 12 months before you start conceiving. This is because your body is going through significant changes, and potentially going through a period of malnutrition arising from the surgery. Therefore, having inferior nutrition could result in adverse outcomes, such as low birth weight.
If you have gone through bariatric surgery, contraception and preconception counseling should be a priority. It is important to be aware of the risks of getting pregnant soon after bariatric surgery. Because of the recommended waiting period of 12 to 24 months before conceiving, this gives you the perfect amount of time to go through the preparation stage. Preconception counseling on the use of contraceptives is important and understanding what contraception is best for you. In the 12 months after bariatric surgery, it is recommended that contraception takes the non-oral form, such as injection. This is because oral contraception is not considered to be as effective because of a decreased absorption.
Another reason you should use the 12 months after bariatric surgery to plan the pregnancy effectively is to make sure that you have properly healed from the surgery. After bariatric surgery, it is common to experience abdominal pain and nausea. These are two symptoms closely associated with pregnancy. It can be difficult to tell which are pregnancy symptoms and which are as a result of the surgery.
It’s also important to know that bariatric surgery may produce a change in your fertility. This is for the reason that you could start ovulating regularly for the first time in years. If you have previously experienced Polycystic Ovarian Syndrome, your fertility may get a boost because of bariatric surgery. This is why it’s important to use birth control during the first 12 to 1824 months after bariatric surgery.
What Should You Expect During Your Pregnancy After Bariatric Surgery?
When you become pregnant, you will naturally feel a wave of excitement, but it’s important to remember that there are some things to be aware of when it comes to pregnancy after bariatric surgery.
When you are pregnant after bariatric surgery, the biggest concern is your nutrition. It’s very common for women to experience anemia or an iron deficiency. While nutritional deficiencies are common in pregnancy, bariatric surgery causes a nutritional deficiency. Therefore, it is important to make sure that you look after yourself. Deficiencies are common in pregnancy, but it’s important to note that pregnant women experience deficiencies in the following:
- Vitamin B12
- Folic acid
- Iron
- Calcium
A good quality multivitamin will help with this. But it’s also important to note that you should be taking a high-quality folic acid supplement.
There are also other potential issues associated with being pregnant after bariatric surgery. There could be a decrease in protein. Because bariatric surgery naturally results in people consuming less food, protein deficiency can be a consequence of the restricted food intake. Protein deficiency can result in weakness, hair loss, and fatigue. And this is important to note because while fatigue is common during the first trimester, hair loss is not. Ensuring that you consume good quality protein sources, and aiming for 60 grams of protein a day will ensure you keep your strength up.
There is also the risk of gestational diabetes. Gestational diabetes is high blood sugar that develops during your pregnancy. While this can happen at any stage of the pregnancy, it is more common during the second or third trimester. Because your body cannot produce enough insulin to meet your body’s needs during pregnancy, gestational diabetes can cause issues for you and the baby. The symptoms of gestational diabetes include the following:
- Increased thirst
- A need to urinate more frequently
- Tiredness
- A dry mouth
Gestational diabetes can cause issues such as too many amniotic fluids, which can cause premature labor. Preeclampsia is another condition, where high blood pressure can result in pregnancy complications. Also, your baby may grow larger than usual, which can increase the likelihood of induced labor or cesarean.
What Are the Best Ways To Look After Yourself When You’re Pregnant After Bariatric Surgery?
Looking after yourself while you are pregnant is of the utmost importance. And this is even more so after bariatric surgery. Because of the potential for vitamin deficiencies such as B12, as well as mineral deficiencies such as iron, prioritizing your nutrition is crucial. Taking a folic acid supplement, as well as a good quality multivitamin, can ensure that you keep on top of your nutrition. However, you must remember that a vitamin is not a replacement for a good diet. You will need to make sure you have your nutrition dialed in, and ensure that you have good quality meals with the right balance of vitamins and minerals for your needs.
For anybody experiencing pregnancy, it is a time of immense highs and lows. With all of the hormones surging through your body, as well as the lingering thought in the back of your mind as to the state of the pregnancy, it’s important to reach out to professionals. The best thing you can do is to work with your healthcare providers and ensure you provide as much information to them as possible. If you don’t feel supported by your healthcare professionals, it might be worth referring to your bariatric surgeon and ask for a referral or additional advice. The best approach is a multidisciplinary effort, to ensure that your pregnancy is as healthy and safe as possible.
In addition to these, you have to be aware of nausea during pregnancy. As it can be difficult to get the nutrients you need, if you start to suffer morning sickness, nausea can get worse. Nausea is a common complication after surgery, and morning sickness can exacerbate it. You might feel that you don’t have an appetite, but it’s important to speak to your healthcare professional about anti-nausea drugs that you can take safely during your pregnancy.
You should also remember the importance of being active in pregnancy. Individuals who have had bariatric surgery may not necessarily feel so active. But it’s important to slowly work up to being more active. The best way to become more active is to start swimming and walking more. But you have to remember to build up slowly and listen to your body. Whenever you need to rest, do so.
What Are Your Birth Options After Bariatric Surgery?
There is no reason why you cannot have a natural birth. But women who have had bariatric surgery can be more likely to end up with a cesarean. Cesarean deliveries are more common in women with bariatric surgery, but it is on a patient by patient basis. If someone has had surgery as a result of losing weight, consulting with a bariatric surgeon, even virtually, may be essential if it was complicated.
It is important to speak to your healthcare provider to know your options. If you have any concerns about your delivery, you should speak to your doctor and you may be able to reduce the likelihood of having a cesarean by following medical advice, exercising, and also taking childbirth preparation classes.
Life After the Baby Is Born
You may have concerns about the baby and have various questions. Some mothers are concerned that the baby will have any side effects because they’ve had bariatric surgery. But bariatric surgery does not cause any development problems. It’s important to remember that pregnancy is the time for you to give your baby the nutrients they need so they can grow healthier. As long as you keep to a diet with adequate nutrition, there will be no problems.
Some mothers have concerns about breastfeeding. Breastfeeding is always recommended because it has more nutrients for the baby. When you are breastfeeding, you should ask your doctor to check your blood so you are absorbing enough vitamins. Many women can still be overweight after bariatric surgery, which can delay lactogenesis (where the milk comes in). Some mothers also have concerns about weight gain in pregnancy, but it’s important to remember that this is the baby’s way of storing up nutrients, and most of the baby weight is not you.
Naturally, pregnancy after bariatric surgery causes many concerns. But pregnancy is incredibly common after bariatric surgery and is well understood. The important thing to remember is that you follow medical advice. And remember that this baby was all worth it!
DR. GABRIELA RODRIGUEZ RUIZ MD Ph.D. FACS
Dr. Gabriela Rodriguez specializes in General and Laparoscopic Bariatric Surgery. She brings to VIDA Wellness and Beauty a wealth of experience in bariatrics. Dr. Rodriguez is a founding associate of the Mexican College of General Surgeons. A world-class bariatric surgeon with double certification in the US and Mexico.