Weight loss surgery has grown in popularity in recent years. There is a whole new generation of women who have had gastric bypass or bariatric weight loss surgery facing new issues regarding pregnancy. Is it possible to still get pregnant after bariatric wright loss surgery? Is pregnancy after weight loss surgery even safe? Learn more about the risks and complications of pregnancy after bariatric surgery below.
So is pregnancy after gastric bypass surgery even possible? The short answer is yes. Many women who have had gastric bypass surgery have found that their fertility increased and getting pregnant was easier and faster post-surgery than it was before they lost weight. Infertility, hormone imbalances, polycystic ovarian syndrome (PCOS) and other obesity-related issues are seemingly “cured” or improved after weight loss surgery. Why? Obesity and morbid obesity can have negative effects on the reproductive system and upset menstruation and ovulation. After significant weight loss, the reproductive system can return to its natural cycle and often experiences a burst of new fertility. For many women, pregnancy is not only possible, it is actually more likely after bariatric surgery.
Pregnancy after gastric bypass surgery is possible, but is it safe? This is a more complicated question. Recent health studies have shown that women who have had gastric bypass weight loss surgery before becoming pregnant often experience fewer negative side effects and complications than obese women. Although researching is ongoing, recent medical studies suggest that bariatric surgery might protect obese women and their babies from obesity-related side effects and complications, including gestational diabetes, high blood pressure and other side effects. However, women who have had gastric bypass surgery still must keep a close eye on their pregnancy.
Pregnancy after gastric bypass surgery can be safe and free of negative side effects, but the amount of recovery time you allow before trying to get pregnant can significantly impact the health and safety of both you and your baby. So how long should you wait – 6 months, a year? Two years? Doctors offer different opinions on the recommended amount of time for recovery after weight loss surgery, usually depending on a woman’s initial size and weight loss goals. Some women have much more weight to lose than others, and most health experts agree that women should wait to get pregnant until their weight has stabilized. As a general guideline, most experts recommend waiting at least 18 months after weight loss surgery before getting pregnant.
Why should you wait so long to get pregnant? There are many cases of women safely getting pregnant just a few weeks after bariatric surgery and giving birth to healthy babies, so is waiting really necessary? Again, every woman is different. Health experts generally recommend waiting for body weight to stabilize before pregnancy. After rapid weight loss of any kind, the body goes through many potentially stressful changes that could pose health risks to a growing baby.
Most health experts will agree that malnutrition and nutritional deficiencies pose the biggest risks to both mother and child after bariatric surgery. During gastric bypass surgery, part of the intestine is removed, resulting in less opportunity for essential vitamins and minerals to be absorbed during digestion. A study in the American Journal of Medical Science found that the most common nutritional complications associated with bariatric surgery are deficiencies in B12, iron, calcium, and vitamin D. In some cases, post-surgery patients can experience protein-calorie malnutrition and fat malabsorption. To prevent malnutrition and its side effects, doctors often prescribe bariatric vitamin supplements to their patients.
While all weight loss surgery patients must maintain proper nutrition, it is especially important for pregnant women. Pregnancy poses even more malnutrition risks because of its common side effects of morning sickness and nausea. After surgery, many women eat as few as 500 calories a day and often have to take extra vitamins to compensate for the ways in which their bodies no longer metabolize nutrients.
By 18 months, the gastric bypass patient should be eating 1200 calories a day. Waiting at least 18 months after bariatric surgery to get pregnant significantly reduces the potential for malnutrition for mother and baby as well as the chance of premature birth, according to a report in a November 2005 issue of the Journal of Obstetric, Gynecologic, and Neonatal Nursing. After 18 months, chances are much greater that a woman has achieved a stable weight and can provide her baby with the necessary nutrition.
Women who have undergone bariatric weight loss surgery can carry 2 babies, but this will mean that the nutritional needs will be even higher. If the mother has waited more than 18 months since gastric bypass surgery, this may not cause any problems. If less than 18 months, however, there will most likely be an increased chance that intravenous nutrition is needed to ensure the health of the babies. Mothers pregnant with twins who have undergone gastric bypass surgery should work closely with their doctors to make sure all nutritional needs are met.
Rest assured, there are many mothers who have had weight loss surgery who continue to lose weight throughout their entire pregnancy and have healthy babies. This is especially true of patients who have become pregnant before the recommended 18 month time frame has lapsed and are still significantly overweight. As long as the nutritional values stay within a healthy level, the body can safely continue to shed excess weight during the pregnancy. As the end of the pregnancy approaches, the weight loss should slow as baby is gaining as much as mom is losing.
To ensure both mother and baby maintain optimal levels of essential vitamins and minerals throughout the pregnancy process, women who have undergone bariatric surgery should consult a gynecologist (OBGYN) who is knowledgeable of the nutritional needs of bariatric patients post-surgery. Pregnancy screenings for mothers who have had gastric bypass surgery will likely include more frequent blood tests, including the glucose tolerance test (GTT). With the increased popularity of gastric bypass surgery, many obstetricians are becoming more familiar with pregnancy protocol in these patients. Ask your doctor about his or her experience with pregnancy after weight loss surgery to protect the health of you and your baby.
Pregnant women who have had bariatric surgery are more likely to end up with a Caesarean birth or C-section, according to a 2004 study published in the American Journal of Obstetrics and Gynecology. While experts are not sure exactly why the odds increase, it may help to discuss the possibility with your doctor.
While your doctor may prefer to perform a C-section to cut down on the risks of complications, you may be able reduce your odds of having a C-section by following your doctor's weight-gain recommendations, exercising during pregnancy and taking childbirth preparation classes.
One of the biggest side effects of pregnancy for women who have had bariatric surgery is actually psychological. Many women who have undergone significant weight loss struggle emotionally with the body image issues of having to gain weight back during pregnancy. Since pregnancy is a stressful process, women may also tend to overeat and revert back to unhealthy eating habits to cope with the stress and hormonal changes associated with being pregnant. Low self-esteem and poor body image can also cause women to “suddenly feel fat again.” The pregnant mom needs to understand that pregnancy weight often sheds off within the first 6 weeks after pregnancy in women of healthy starting weights.
Pregnancy after gastric bypass can be safe and healthy if managed well by you and your health care provider. Women who have had bariatric weight loss surgery should closely monitor their nutritional intake and work closely with an obstetrician knowledgeable of gastric bypass surgery and its potential side effects and complications.
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