Pregnancy and Bariatric Surgery: Part One

Katie Chapmon

August 11, 2020

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Pregnancy after Bariatric Surgery

 

Blog Series on prenatal nutrition and weight loss surgery

 

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Part One: When pregnancy is recommended after bariatric surgery

Hello! You’re getting a new face to The Bariatric Food Coach Blog 👋. My name is Katie and I’ve teamed up with Steph to bring you a series of posts about pregnancy after bariatric surgery. Like Steph, I’m a registered dietitian that has worked in the bariatric surgery realm since 2008. During my years of working with patients after bariatric surgery, one of my biggest enjoyments have been helping women regulate their hormones and become pregnant.

With pregnancy after bariatric surgery comes a time of excitement and usually MANY questions. How do I make sure I’m taking care of myself and my baby? Do I need to take different vitamins because of my pregnancy and having a surgery? Do I need to have more appointments with my doctors? Can I breastfeed? In this series, I hope to answer these questions plus many more as I take a deep dive with you on this subject.

Why is it easier to get pregnant after bariatric surgery?

Many of my clients decide to get bariatric surgery in order to get pregnant. Some wonder (especially if they have been struggling for years)… how does this happen?

Yes, it has something to do with a change in body weight, but it’s a little bit more than that. Let’s geek out for a second, shall we? Bariatric surgery makes a huge shift in hormones, how they function and how the body uses them. This is seen in our digestive hormones that indicate hunger (ghrelin) and fullness (leptin). Changes are also seen in reproductive hormones – estrogen, progesterone and testosterone.

Women become more fertile after bariatric surgery due to the reproductive hormones becoming better regulated in our bodies. This shift can actually even happen within the first month postoperatively!

I suggest for my clients to speak with their OBGYN about birth control options prior to surgery. Some surgeons may ask patients to stop oral contraceptives before surgery to reduce complications. In addition, depending upon the type of bariatric surgery, the body may not be able to absorb oral contraceptives as well and they may be unreliable. Since regulation of reproductive hormones and fertility can improve quickly, you’ll want to discuss the options with your doctor.

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How Long Do I Need to Wait after bariatric surgery to get pregnant?

This answer may vary slightly, but The Academy of Nutrition and Dietetics, The American College of Obstetricians and Gynecologists and The American Society for Metabolic and Bariatric Surgery recommend waiting at least 12 months post operatively until becoming pregnant with encouragement to extend that time period even longer. The surgeons that I’ve worked with over the years typically recommended at least 18 months post surgery.

Of course, I have seen many early post op pregnancies in my time, but that first year after surgery can be a vulnerable time period for pregnancy to occur.

But what if I get pregnant before 12 months after surgery?

An early pregnancy before the 12 month mark can come as a surprise. First, I want anyone in these shoes to take a breath and relax. I’ve definitely seen early post op pregnancies that are healthy and safe. You’ll then want to make sure you reach out to your OBGYN and your bariatric team as soon as possible. Get all of the support on board to ensure you and your baby are getting adequate nourishment and monitoring along the way.

I would highly recommend making an appointment with your Bariatric Dietitian. (I *just may be a little bit biased). Ideally you have a Bariatric Dietitian available to you in your area and someone that is experienced with pregnancy and weight-loss surgery. If not, email Steph at Steph@bariatricfoodcoach.com and should would be happy to help get you taken care of.

Up next in our series, I’ll be talking protein, carbohydrates and fats – what’s needed and what may be too much for pregnancy after bariatric surgery. Click here to read part two!

 

 

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