Bariatric Surgery
Ebariatric Surgery

Pregnancy After Bariatric Surgery

In 1998 - 2005, bariatric surgeries for women aged 18 - 45 increased 800%. Women accounted for 83% of weight loss surgeries. Women who undergo bariatric surgery during child-bearing years are advised to use contraception for 12 to 24 months after having bariatric surgery.

It is recommended for women who want to become pregnant to wait at least one to two years after bariatric surgery for weight loss to stabilize.

Contraceptive methods

Women are advised to wait at least 12 to 24 months after bariatric surgery before becoming pregnant; therefore, reliable birth control should be used for sexually active women following bariatric surgery. Oral contraceptives are unreliable after bariatric surgery because they are metabolized through the digestive system. Rapid weight loss and shifting hormone levels can also affect the reliability of the pill. Women should consult with their family physician, OB-GYN, or bariatric surgeon to find an appropriate birth control method for them.

Maternal risks

Women who get pregnant after having weight-loss surgery have a lower risk of maternal and newborn complications than pregnant women who are obese. Being obese and pregnant carries a far greater risk than having bariatric surgery and getting pregnant at a safer weight. Non-obese women have lower maternal complication rates than obese women, including lower rates of gestational diabetes and preeclampsia. Most current studies do not show any increased risk to the mother or fetus as a result of bariatric surgery.

Am I obese?

Weight gain during pregnancy

A woman who has had bariatric surgery, becomes pregnant, and gains little or no weight creates an increased risk of fetal abnormality or retardation. This risk is present for all woman, even those who have not undergone bariatric surgery, who do not gain weight during pregnancy. Normal weight gain during pregnancy, especially for the bariatric patient, is required for a healthy fetus. Bariatric patients should remain under the care and supervision of both your bariatric surgeon and obstetrician so that you gain the proper amount of weight during your pregnancy.

Nutrition and vitamins

Women who have undergone bariatric surgery before pregnancy may need to take chewable or liquid prenatal vitamins because many bariatric patients experience a low tolerance of prenatal vitamins in pill form. Heartburn and ulcers can occur in the esophagus because of the inability to swallow vitamins.

Nutritional deficiencies during pregnancy can have severe and long-term consequences. You must alert your obstetrician during the initial obstetrical visit about the type of bariatric surgery you have had and what other complications you may have experienced post-surgery, nutritional or otherwise, so that a careful assessment of metabolic and nutritional status is monitored during your pregnancy. Nutritional supplements and vitamins, especially iron, must be taken during pregnancy.

Common vitamins to take during pregnancy after bariatric surgery:

  • Folate
  • Vitamin B12
  • Iron
  • Calcium
  • Vitamin D

Breastfeeding

Nutrition impacts the quality of the breast milk produced. Infant nutrition problems may be avoided after bariatric surgery if the patient maintains sufficient caloric intake and continue to take vitamin supplements during lactation. A continuation of nutritional monitoring and supplementation by your obstetrician, bariatric surgeon, or dietician is important to ensure quality milk production. You must also drink plenty of water, though not during meals.

Summary

With proper oversight and management of your pregnancy following bariatric surgery, you can expect a healthy and uncomplicated outcome.

  • Use non-oral contraception after surgery if you are woman of child-bearing age for 12-24 months.
  • Talk to your bariatric surgeon about adjusting your gastric band if you had adjustable gastric banding surgery.
  • Ensure that your nutritional needs are being met.
  • Get regular blood tests to look for nutritional deficiencies.
  • See a dietician to regulate weight gain during pregnancy.

Find out more about bariatric surgery

For more information on bariatric surgery, see the links to the left. To find a bariatric surgeon near you, use our bariatric surgeon locator.

Find out if you are a candidate for bariatric surgery.

References

Preidt, R. 2008. "Bariatric Surgery Before Pregnancy Benefits Mom, Babies." Health Day News. November. Consumer Health Complete. Ebscohost. University of Houston-Downtown. (accessed July 7, 2009).

Raymond, R. 2005. "Hormonal Status, Fertility, and Pregnancy Before and After Bariatric Surgery." Critical Care Nursing Quarterly. July-September:28.3 Consumer Health Complete. Ebscohost. University of Houston-Downtown. (accessed July 7, 2009).

Woodard, C. 2004. "Pregnancy Following Bariatric Surgery." Journal of Perinatal & Neonatal Nursing. October-December:18.4. Consumer Health Complete. Ebscohost. University of Houston-Downtown. (accessed July 7, 2009).

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