There is a whole new generation of women facing new issues regarding pregnancy. These women have all undergone gastric bypass surgery in order to lose weight. As the body is less healthy when obese, the fact that these women have chosen gastric bypass is a testament to their desire for good health. When the thought of pregnancy comes to mind, they often have questions regarding their surgery, their pregnancy and the relationship between the two.
Will I be Able to Conceive After Gastric Bypass?
The simple answer to this question is yes. Many women find that they are more fertile after the gastric bypass surgery due to the effect of the weight loss on the body. Obese and morbidly obese women often have trouble conceiving due to menstrual cycle upset and fat deposits around the ovaries. After the weight is lost, these issues are gone and the reproductive system receives a surge of fertility.
How Long Should I Wait to Try Becoming Pregnant?
Each case of gastric bypass is different. Some women have much more weight to lose and others reach their goals within the first 12 months. For the obese woman, losing 100 pounds may make her feel like she is the healthiest she has ever been, but that does not mean her body is ready to take care of a baby. The general guideline for waiting is 18 months after surgery. Successful pregnancies, however, have been carried in women who were as little as 5 to 6 weeks post gastric bypass.
How Will I Eat Enough Calories for Me and Baby?
By the 18 month mark, the gastric bypass patient should be eating 1200 calories a day. After conceiving, this number will increase by 300 to 400 calories. As the patient is used to supplementing their diet with protein supplements, this is often the best way to add in the extra calories. The major obstacle for many gastric bypass patients is keeping the pouch from expanding while they are pregnant thus the use of liquid protein supplementation.
Will My Ob / Gyn Understand My Special Needs?
With the increased popularity of gastric bypass surgery, many obstetricians are becoming more familiar with pregnancy protocol in these patients. Never the less, the obstetrician will be in contact with the gastric bypass doctor during the pregnancy in case of a special circumstance.
I Suddenly Feel Fat All Over Again.
After losing a huge amount of weight, the thought of gaining some of that weight back on purpose can be overpowering for the pregnant gastric bypass patient. The pregnant mom needs to understand that pregnancy weight often sheds off within the first 6 weeks after pregnancy in women of healthy starting weights.
Can I Have a Vaginal Birth?
The choice between a vaginal birth and a C-Section is often one discussed on a patient by patient basis. However, according to a study in 2004, gastric bypass patients were more likely to have a C-Section than other women. There is little reason to why this occurs.
Can I Continue Taking My Bariatric Vitamins?
After a gastric bypass surgery, there are several supplements the patient will be prescribed to ensure overall health. These will often include Vitamin D, Iron, Vitamin B12 and Calcium. While a prenatal vitamin will offer each of these in an amount that is perfect for the traditional pregnant woman, the malabsorption that occurs after gastric bypass can create a need for higher levels of supplementation. This is where blood testing and a strong connection between the gastric bypass surgeon and the obstetrician will be needed.
How Will I Eat Enough for Two?
Nutrition during pregnancy is the major rock to climb. More than 80% of all gastric bypass patients who become pregnant are able to consume enough nutrients to grow a healthy baby. The remaining 20% either cannot eat enough or do not absorb enough nutrients to keep both mom and baby healthy. In these cases, intravenous nutrition will be needed during the pregnancy. This is not to say mom will spend 10 months in the hospital, but supplementation may be needed during the third trimester, especially, as this is the time frame when baby will be growing the fastest.
Are the Pregnancy Screenings the Same?
No, the pregnancy screenings are not the same for gastric bypass expectant mothers and mothers who have not had the surgery. The major difference is in the number of blood tests needed and the GTT. The GTT is the glucose tolerance test. Due to the nature of how gastric bypass is performed, the patient will not be able to drink the fluid needed to perform the test.
The blood tests, on the other hand, will be scheduled more often. These tests will not necessarily pertain to the pregnancy as much as they are offering a look inside the nutritional effects of the pregnancy on the body. If there is a deficiency beginning, the obstetrician will be able to find out early enough to treat the condition.
Can I Breastfeed My Baby After Gastric Bypass?
There is no reason why a mother who has gastric bypass surgery cannot breast feed. The surgery has no effect on the mammary glands. If the mother has undergone post gastric bypass cosmetic surgery, specifically a breast lift or a breast augmentation, there could be problems. The cosmetic surgeon should have discussed these effects on the breast tissue before surgery.
Is it Okay to Lose Weight During Pregnancy?
There are many gastric bypass patients who continue to lose weight through the entire pregnancy and have healthy babies. This is especially true of patients who have become pregnant before the 18 month time frame has lapsed. Weight loss was once thought to have a negative effect on the fetus, but studies have shown otherwise. The obese woman is losing extra weight. As long as the nutritional values stay within a healthy level, there is no reason why the body would stop losing weight during the pregnancy. As the end of the pregnancy approaches, the weight loss should slow as baby is gaining as much as mom is losing.
Will My Gastric Bypass Surgery Lead to Pregnancy Complications?
The opposite is actually true in most cases. Recent studies have shown that women who have undergone gastric bypass before becoming pregnant suffer from fewer complications than obese women. The surgery is intended to improve health and it seems that is what happens on all sides of life.
Can I Take Normal Prenatal Vitamins?
Yes, women who have undergone gastric bypass can take normal prenatal vitamins. The surgery does, however, limit the absorption of these vitamins which is another reason for the continuing blood work. Some gastric bypass clinics offer a bariatric pregnancy kit complete with all the vitamins needed to keep both mom and baby healthy during the pregnancy. The bariatric surgeon will be able to guess how much of the prenatal vitamin will be absorbed and offer insight into whether more than one should be taken every day.
What are the Biggest Risks of Pregnancy After Gastric Bypass?
The biggest risk of all is the nutritional needs of baby and mom. The body is rerouted during the surgery and some of the intestine is removed. This means there is less intestine for the food to travel through and thus less time for absorption. Most of the time, adding more of the same vitamin will solve this problem.
Other complications can include weight gain, anemia, low birth weight baby and increased need for C-Section.
I Am Pregnant With Twins, Can I Carry Two Babies?
Yes, women who have been through gastric bypass surgery can successfully carry more than one fetus to term. However, the nutritional needs will be even higher. If the woman is 18 months plus post surgery, this may not be a problem. If the multiple pregnancy occurs before then, there will be an increased chance that intravenous nutrition is needed to ensure the health of the babies.
I am RH-. Can I Still Have my RhoGam shot?
For Rh- mothers, the RhoGam shot protects mom from baby and baby from mom. In the case of Rh- blood, if the baby is a different blood type than mom, the mixing of the blood during pregnancy and birth could kill mom, baby or both. The RhoGam shot is given in the 26-28th week of the pregnancy via an IM (intramuscular) injection. The gastric bypass surgery will not affect the absorption of the RhoGam.
I Have Hernia From the Gastric Bypass Surgery.
Many women suffer from hernias after having gastric bypass surgery. Most often, the bariatric surgeon will wait until the patient's weight steadies before performing corrective surgery for the hernia. In some cases, the hernia surgery is performed at the same time as cosmetic skin removal. In most cases, the hernia will not be affected by baby but the gastric bypass doctor will need to make the final judgment on a case by case basis. The hernia will not be repaired until after the birth of the baby due to the nature of the repair.