You can do it, but make sure you do your homework first.
If you’re considering having weight loss surgery, and you also want to give birth at some point in your life, you’re probably wondering if those two things are at odds with one another. Here’s the good news: they are not. Getting pregnant and carrying a healthy pregnancy to term after weight loss surgery can be done, but there are definitely some things to keep in mind.
Gastric bypass surgery involves altering the size of your stomach (the colloquialism is “stomach stapling,”) and a rerouting of your intestines, in order to reduce calorie and nutrient absorption. Your recovery time after gastric bypass surgery depends on the size of the incision – some folks can have laparoscopic surgery, which means it’s done via a thin telescope and therefore, the recovery time is shorter. There is also a much more extensive and involved process, called gastric banding, or sleeve gastrectomy, in which part of the stomach is removed and what’s left is connected to the small intestine.
There are risks associated with having gastric bypass, like blood clots, hernias, and ulcers.
In regard to pregnancy, says Dr. Michael Russo, a general surgeon specializing in bariatric surgery at MemorialCare Center for Obesity at Orange Coast Memorial Medical Center in Fountain Valley, CA, the risks come in the first year after surgery.
The period following gastric bypass is rife with changes, including hormonal changes that result in massive weight loss.
“During this time the body is primed for weight loss and actively metabolizing fat very aggressively,” says Russo. “If you become pregnant, it can be dangerous for both you and the developing baby. A developing baby may not get the nutrients he or she needs to grow properly.” A 2016 Reuters article cited a US study suggesting that women should wait a minimum of three years post surgery before trying to conceive, since risks as a result of the surgery diminish over time. Of course, every body is different, so you should check with your doctor before proceeding.
Because women do need to wait for a period of time before trying to get pregnant after gastric bypass, Russo recommends making sure you are using contraceptives. The kind of birth control you choose may be dictated by what kind of surgery you had, since bariatric surgery changes how you absorb food, vitamins, and medication.
“The good news is that once your hormones have leveled out after your weight loss, you are more fertile and most women get pregnant very quickly,” says Russo. This is true even for folks who are living with Polycystic Ovary Syndrome, and other conditions that impact hormones.
It’s also important to keep track of your nutrient intake when pregnant after bariatric surgery, because malabsorption is a concern. Morning sickness can exacerbate this, so seeing a nutritionist while pregnant is also said to be a good idea.Prioritizing finding an OBGYN who has worked with people who have had bariatric surgery before could ensure that you have to do less educating of your provider.
For reasons that remain unclear, people who have had gastric bypass are also more likely to have c-sections, according to a 2004 study published in the American Journal of Obstetrics and Gynecology. If you’re concerned about this, be sure to ask your OBGYN if there’s any reason to not try to for a vaginal birth, especially if you have no outstanding health concerns. (But also, let’s not shame folks for having c-sections.)
According to Dr. Michael Russo, a healthy amount of weight for a post-weight-loss surgery patient to gain during pregnancy is 20 pounds, and more than that might negatively impact the results of the bariatric surgery. Gaining weight, which one will inevitably (and hopefully) do during pregnancy, can be challenging for the self image of someone who just went through a procedure meant to result in weight loss.
“I cried when I told my surgeon I was pregnant…. I was so afraid I would gain fifty pounds,” says C. “The baby is growing and he takes what he needs from me. I take my vitamins and eat fresh fruit and vegetables every day, but I am having to drink protein shakes again.”
For D, who got pregnant only 10 months after her surgery, “the only problem has been myself and fighting that weight gain demon.”
Make sure to surround yourself with a support network – friends, family, and medical professionals – before you find yourself taking negative actions (dieting while pregnant, for example), to help you take the best care possible of yourself and your baby.