pregnant woman and her partner talking to a doctor

Weight loss surgery (also called bariatric surgery) is becoming more common, as more women of childbearing age resort to these procedures, and pregnancy after weight loss surgery also becomes more common.

The number of bariatric surgeries in the United States increased slightly from 150,000 in 2011 to more than 250,000 in 2019. More than 80% of bariatric surgeries are performed on women, and about half of them are performed on women of reproductive age.

There are several bariatric procedures, but gastric bypass (or sleeve gastrectomy) is the most common option. The operation is performed laparoscopically, removing about 80% of the stomach. This limits the amount of food you can eat.: Stimulates hormonal changes that help with weight loss.

Facts About Pregnancy Weight Loss After Surgery

How Do Other Bariatric Surgeries Affect Pregnancy? Here are seven important things to know about pregnancy after weight loss surgery.

You can boost fertility

You can get pregnant after weight loss surgery. In fact, bariatric surgery can cause a sudden positive change in your fertility. Obese women with fertility problems who have undergone surgery may begin regular ovulation for the first time in years. (Absence of ovulation is common in obese women).

And if your fertility is affected by polycystic ovary syndrome (PCOS), bariatric surgery may help. This is because surgery improves the hormonal changes associated with PCOS.

5% weight loss was found to counteract the lack of ovulation associated with obesity. In one study, 70 out of 98 women who did not ovulate began normal menstrual cycles within a few months of bariatric surgery. Those who started ovulating lost more weight than those who did not.

Keep in mind that this newly discovered fertility may increase your chances of getting an accidental pregnancy if you do not use contraception, which is a problem if you are in the early 12 months after surgery (see below). There is a concern that oral contraceptives after bariatric surgery may not be as effective due to reduced absorption, so be sure to talk to your doctor about the best option for you. It is a good idea to address this before bariatric surgery to avoid unintended pregnancy as you begin to lose weight.

It is better to wait before getting pregnant

It is safe to get pregnant after bariatric surgery after weight stabilization. After surgery, your body undergoes potentially stressful changes, significant nutritional shocks, and weight loss, which can cause problems for a growing child. Waiting to get pregnant also allows you to maximize your weight loss goals before getting pregnant.

Researchers continue to study the optimal period of pregnancy between bariatric surgery. Some small studies have questioned the need to wait, while some experts suggest waiting 12 months, while others recommend 12 to 24 months.

The largest study looked at more than 1,850 women who underwent bariatric surgery on their newborns. The researchers concluded that women who had children less than two years after bariatric surgery had a preterm birth, neonatal intensive care unit (NICU) փոքր younger children (SGA) than women who waited four years after surgery year: to have their children. (Women in this study had many types of bariatric procedures.)

To protect women և and their children from possible malnutrition, most experts advise women not to become pregnant for at least a year after surgery. This gives your body plenty of time to achieve a stable, desirable weight և reduces the possible problems with nutritional deficiencies that often occur after bariatric surgery.

Talk to your surgeon աբ midwife about the optimal time for you.

You need to watch your diet carefully

After any bariatric surgery, your body does not digest food և does not absorb nutrients as before. Patients should take extra vitamins և minerals throughout their lives to avoid serious medical problems due to low levels of vitamins և minerals.

The most common nutrients after bariatric surgery are protein, B12, iron, folic acid, calcium and vitamin D.

Of course, it is very important that you get enough nutrients during pregnancy. Malnutrition during pregnancy can lead to many complications, including:

Your doctor may check your blood levels for nutrients before or at the beginning of your pregnancy և periodically, at least every trimester. They can recommend the right supplements for you, combined with the supplements you take after your surgery. You can also work with a dietitian who knows about weight loss surgery.

To find a nutrition expert, visit the American Dietetic Association website or ask your midwife who they refer their bariatric patients to. Tell your dietitian what surgery you have had, սննդ your dietary preferences or dislikes. In addition to advice on supplements, your dietitian can help you make good food choices and suggest the best way to improve nutrient absorption.

Nausea and vomiting can make it even harder to get the nutrients you need, so if you have nausea in the morning, you can talk to your provider about anti-nausea medications, including anti-nausea medications, that you can take safely during pregnancy.

You may need a gynecologist who is familiar with bariatric patients

Caring for pregnant women after bariatric surgery requires a special set of knowledge. Your provider should give you regular blood tests for malnutrition և Ultrasound tests to monitor your baby’s growth և Your amniotic fluid level.

As surgeries become more frequent, many midwives have learned what is necessary for women who have undergone special bariatric surgery during pregnancy. While this is definitely something the general obstetrician may feel comfortable with, in some cases you will be referred to an obstetrician (MFM). It may be for consultation only, but depending on your specific health needs, they can take care of you throughout your pregnancy և delivery.

If you’ve had weight loss surgery, are recently pregnant, or want to get pregnant, start rolling the ball by talking to your healthcare provider early. This will allow them to start optimizing their nutritional status early.

The risk of some complications is reduced

When you lose weight as a result of bariatric surgery, the risk of obesity-related complications decreases. (However, many patients remain obese after bariatric surgery, which means they still have risk factors for obesity during pregnancy.)

A large study of perinatal outcomes after bariatric surgery looked at more than 20,000 pregnancies from 2007 to 2018 (the study included more than 1,800 women who had bariatric surgery, և 18,000 who were eligible for bariatric surgery but did not have it) :

The researchers found that bariatric surgery was associated with a reduction in the following:

The same study found that bariatric surgery was associated with a significantly increased risk for young infants (SGA). This may be due to nutritional problems as a result of bariatric surgery.

One review of three studies compared more than 14,800 pregnancies to women who had bariatric surgery; nearly 4 million pregnancies to women who did not. These researchers also found that infants with a history of bariatric surgery (particularly gastric bypass surgery) had a higher risk of developing SGA. They also found that children were at greater risk:

Gaining the right amount of weight can be difficult

If you have had weight loss surgery և you have probably experienced a change in attitude towards your body, it is difficult to see that your abdomen is getting bigger rather than smaller.

Try to feel comfortable with the thought that it will be time for you to gain weight, not lose weight. You can gain the right amount of weight to have the healthiest pregnancy possible.

After bariatric surgery, many women struggle to gain the right amount of weight during pregnancy. In one study, 24 percent of post-bariatric pregnant women were underweight, 20 percent were overweight, and 56 percent were overweight. (32% of women in the general population gain weight within the recommended range for pregnancy.) It is predicted that more women with low birth weight had SGA babies, and those who were overweight had the highest prevalence of pregnancy. age infants.

Find out how much weight you gained during pregnancy based on your prenatal BMI.

You may or may not need a caesarean section

Some studies have found higher rates of cesarean section in pregnant women who have undergone weight loss surgery than in the general population. But this may be due in part to the fact that women undergoing bariatric surgery are often larger and more likely to gain weight than women in the general population. Both are risk factors for cesarean delivery.

Other studies have shown that women who have had bariatric surgery are less likely to need a caesarean section than obese women who have not had weight loss surgery.

Talk to your doctor early about the possibility of a cesarean section. Does your provider consider you at high risk for a caesarean section? If so, why not? Ask your provider’s caesarean section rate և philosophy about caesarean section in general. What might make your provider offer a caesarean section during childbirth?

In addition, you can reduce your chances of having a caesarean section by following your doctor’s recommendations for weight gain, exercising during pregnancy, and taking birth control classes. You can also consider renting a doula for support.

Learn more.

.