Pregnancy after bariatric surgery can have a big impact on a person’s pregnancy outcomes.
Research links obesity during pregnancy to a higher risk of gestational hypertension, preeclampsia, and gestational diabetes. These are conditions that affect a mother’s health and a baby’s growth and development.
Losing weight can reduce the chance of developing these issues. It can also improve pregnancy outcomes.
Getting pregnant too soon after weight loss surgery, though, has its own risks.
When Can I Carry a Pregnancy After Bariatric Surgery?
“Bariatric surgery leads to significant weight loss in the range of about 20% to 30% of starting weight, so it has a big impact on a mother’s weight over time,” says Anita Courcoulas, MD, MPH, FACS, chief of bariatric and general surgery at UPMC.
Experts recommend bariatric surgery patients wait at least a year to a year and a half after surgery to become pregnant, Dr. Courcoulas says.
At this point, patients have usually finished losing most of their weight. It’s important to give your body proper time to recover from the procedure.
“Your body is undergoing rapid weight loss and metabolic changes,” says Dr. Courcoulas.
Becoming pregnant before that 12- to 18-month period may worsen protein, vitamin, and mineral deficiencies. It can also affect your baby’s development.
After weight loss surgery, including gastric bypass and gastric sleeve procedures, doctors prescribe special vitamins and supplements to prevent deficiencies.
Bariatric surgery leads to deficiencies in micronutrients like iron, folate, and vitamin B12, says Dr. Courcoulas, which can cause health issues like anemia.
Anemia happens when your body does not produce enough healthy red blood cells to carry enough oxygen to your tissues. This can cause fatigue, shortness of breath, and dizziness.
“And pregnancy itself is an anemia-inducing state,” says Dr. Courcoulas. “So, there is an increased risk of maternal anemia in pregnancy.”
Patients considering pregnancy after that 12- to 18-month period should still check with their bariatric practice to make sure they’re taking all required supplements.
“Patients have to be monitored for anemia and other micronutrients, and they need to work with their OB-GYN for monitoring throughout their pregnancy, especially the baby’s growth and development.”
Dramatic weight loss can also change the effectiveness of certain birth control methods, so it’s important to talk to your reproductive health specialist to determine what’s right for you before moving forward with weight loss surgery.
What Should I Do When I’m Considering Pregnancy?
When you’ve reached a weight loss plateau, you can discuss pregnancy with your doctors.
Your bariatric team and OB-GYN can make any necessary changes to your diet and supplements before (and during) your pregnancy.
They can also make sure you and your baby stay healthy during the entire pregnancy.
“Meet with your bariatric surgeon and OB-GYN provider and say ‘I’m ready to plan my pregnancy, let’s make sure everything is in good shape,” says Dr. Courcoulas. “This is where to start.”
Weight loss after bariatric surgery can improve obesity-related health conditions like type 2 diabetes, high blood pressure, high cholesterol, and sleep apnea.
Patients who have had these procedures report decreased depression and increased energy levels.
Though weight loss can improve pregnancy outcomes, delaying a pregnancy by as much as two years after surgery is a personal decision.
This is something to discuss with your family and doctors well before the procedure.
“Often, a bariatric practice will see someone in their mid- or late 30s who is considering bariatric surgery,” says Dr. Courcoulas. “They’ll have to weigh with their doctors advancing maternal age and when they plan to have bariatric surgery.”
For more information about UPMC bariatric services, visit upmc.com/services/bariatrics.
Editor's Note: This article was originally published on , and was last reviewed on .