Most women who get pregnant after bariatric surgery have an uncomplicated pregnancy and birth. The risks to you and your baby are lower after surgery than if you kept a very high body mass index (BMI).
Pregnancy after bariatric surgery can be safe and healthy if managed well by you and your doctor. In fact, research suggests that pregnancy after weight-loss surgery might be safer for both mother and baby than pregnancy complicated by obesity.
If you become pregnant after weight-loss surgery, your pregnancy will depend on how long it has been since the operation and what type of surgery you had. It’s best to wait to get pregnant for at least 12 to 18 months after surgery and once your weight has stabilised . However many women have babies safely before 12 months.
Is pregnancy safe after bariatric surgery?
Yes, for most women pregnancy following weight-loss surgery can be safer than before due to the weight loss. Complications such as gestational diabetes, high blood pressure and larger birth weights that are linked to being overweight can be reduced.
It is essential that you get the right advice however. Talking to your doctor is important as soon as you know you’re pregnant.
Will my post-surgery diet be enough for my baby and I?
Eating well during pregnancy is very important for you and your baby. The way you eat is probably quite different from before you had surgery. You may be quite used to taking vitamin and mineral supplements every day now.
If you’re planning to get pregnant or have just found out you’re pregnant, talking to your weight loss surgery centre about your diet and supplement use is a good idea. This way you can be sure they are suitable for your pregnancy needs.
You may worry that if you eat less as a result of surgery, you won’t be getting enough food to support your baby’s development. This is unlikely, because your baby takes what they need for growth from you. You don’t need any extra calories until the third trimester.
‘I worked so hard to lose weight that, although I was thrilled to be pregnant, I was also scared that my body would be out of control again. But I talked to Dr. Jaime Ponce de Leon and it’s been fine.’ Katy, mum of one, 5 months post-birth
Supplements needed for different types of surgery
Depending on the type of weight-loss surgery and your specific nutritional needs, your doctor also might recommend certain nutritional supplements — such as folic acid, vitamin B-12, vitamin D, iron and calcium — in addition to a daily prenatal vitamin before and during pregnancy.
Gastric bypass
- Pregnancy-specific vitamin and mineral supplements. In addition you may need vitamin D, calcium and possibly iron supplements
- Your levels of Vitamin B12, iron (ferritin), calcium, folate and fat-soluble vitamins should be checked at the start of pregnancy.
- You may need regular blood tests to check nutrient levels in each trimester.
Gastric sleeve
- You will need pregnancy-specific vitamin and mineral supplements.
- Your levels of Vitamin B12, iron, calcium and folate and fat-soluble vitamins should be checked at the start of pregnancy.
- You may need regular blood tests to check nutrient levels each trimester.
Duodenal switch
- You will need pregnancy-specific vitamin and mineral supplements. You may also need vitamin D, calcium and possibly iron supplements.
- Your levels of Vitamin B12, iron, calcium, folate and fat-soluble vitamins should be checked at the start of pregnancy.
- You may need regular blood tests to check nutrient levels each trimester.
- Your levels of vitamin A may need to be adjusted and monitored. Your levels of vitamin E and K may also need to be assessed.
Bilopancreatic Diversion (BPD)
- You will need pregnancy-specific vitamin and mineral supplements. You may also need vitamin D, calcium and possibly iron supplements.
- Your levels of Vitamin B12, iron, calcium, folate and fat-soluble vitamins should be checked at the start of pregnancy.
- You may need regular blood tests to check nutrient levels each trimester.
- Your levels of vitamin A may need to be adjusted and monitored. Your levels of vitamin E and K may also need to be assessed.
Gastric band
- You will need pregnancy-specific vitamin and mineral supplements.
- Your levels of Vitamin B12, iron, calcium, folate and fat-soluble vitamins should be checked at the start of pregnancy.
- Some centres may suggest fluid is removed from your band while you’re pregnant.
Am I going to put all the weight back on?
This is unlikely, although during pregnancy it is likely that you may gain some weight. Your size and shape will have changed a lot after your surgery, and you’ll be adjusting to the new you. Weight gain is different for everyone during pregnancy, and it is something many women worry about, whether they had weight-loss surgery or not.
Pregnancy itself will make you gain weight. Your baby is growing and surrounded by amniotic fluid and placenta. Your body is producing more blood, your breasts are getting bigger, and so are your muscles and bone mass.
However, if you are still losing weight after your surgery, you may not notice these changes on the scales. Changes to your weight will depend on a number of factors, including:
- How long it has been since your surgery. You may continue to lose weight if it hasn’t been long since your operation. If this is the case, ask your doctor for advice. If it has been 18 months or more since your surgery and your weight is now stable, you may need to look after your weight as you normally would during pregnancy.
- The type of surgery you had. Some weight loss surgery centres may remove fluid from a gastric band if you’re pregnant, and you may experience some weight gain as a result. This can be managed as normal through healthy eating and exercise.