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Pregnancy after weight loss surgery

As the number of people having weight loss surgery grows, more and more women of childbearing age will undergo such operations. Is it safe or even feasible to become pregnant after

weight loss surgery? If so, how long should you wait? Are there any precautions you should take to ensure a healthy pregnancy and delivery after surgery?

Pregnancy after this surgery can be safe and healthy if managed well by you and your Midwife, or Obstetrician. In fact, research suggests that pregnancy after weight-loss surgery might be safer for both mother and baby than pregnancy complicated by obesity.

Women who are overweight may have difficulty becoming pregnant. As you lose weight after surgery, hormones return to more natural levels, and your fertility can increase. This means you may start ovulating regularly, allowing you to become pregnant more easily.

Weight loss may also improve symptoms of polycystic ovarian syndrome (PCOS), increasing your fertility. Your chances of "getting pregnant by accident" are therefore increased, if you are not using birth control.

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Wait 18 months before getting pregnant

Women should wait 18 months after weight loss surgery before becoming pregnant. This is the timeframe when you will experience the biggest amount of weight loss, and it is the most challenging time to meet your own nutritional needs.

If you fall pregnant during this period of rapid weight loss, you will deprive a growing baby of important nutrients, leading to low birth weight, and potential malnutrition for you and your baby.

By 18 months, you should have reached a stable weight and be able to provide your baby with enough nutrition.

Most surgeons advise women of childbearing age to use reliable contraception during this waiting period, as having an unplanned pregnancy is a very real possibility.

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Monitor nutrient intake closely

Even 18 months after your surgery, nutritional deficiencies can be a problem during pregnancy. This may be worsened if you suffer nausea or morning sickness, which may prevent you from eating. If

this is the case you should speak with your Doctor or Midwife about anti-nausea medicines that are safe to take when pregnant.

It is important you pay careful attention to vitamins and minerals both before and during your pregnancy to keep you and your baby well. The most common deficiencies during pregnancy are:


  • Folic acid
  • Vitamin B12
  • Iron
  • Calcium
  • Vitamin D
Although you should already be taking a multivitamin, you should change to a 'prenatal' vitamin even before you get pregnant, as these contain many of the above essential nutrients.

Please make sure your midwife or obstetrician knows you have had weight loss surgery, so they can check your vitamin levels, and advise if additional supplements are necessary. You are also advised to be in touch with your dietitian to help you plan meals,

and ensure you are getting suitable nutrition during your pregnancy. You may benefit from eating several small meals throughout the day, to help improve nutrient absorption.

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Avoid excess weight gain during pregnancy

The best way to avoid excessive weight gain is to eat a healthy diet during your pregnancy. Food cravings, as well as nausea and food dislikes can make this challenging. You may fall into the trap of thinking you need to "eat for two" and eating more than you need. You can discuss any of these issues with a dietitian to help you develop a healthy eating plan, with good food choices.

Regular exercise will also help to avoid excessive weight gain during your pregnancy.

One of the biggest emotional effects of pregnancy after weight loss surgery is that of body image. You have worked hard to lose weight, and will now have to get comfortable with the idea of

gaining weight again. Pregnancy can be a stressful time, and some people also tend to eat more when they are stressed.

Alternatively, dieting while pregnant should be avoided, as this can have serious nutritional consequences for your growing baby as previously discussed (see "You will need to monitor your nutrient intake closely" section).

If you are not gaining weight as expected, your midwife may suggest more frequent ultrasounds to see if your baby is growing normally.

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More likely to need a caesarean

Having weight loss surgery may increase your risk of requiring a caesarean, although it is not clear exactly why this is the case, or what factors are involved.

Talk to your Midwife or Obstetrician about your chances of needing a caesarean delivery, and your preferences for delivering your baby. While a caesarean is relatively safe, it does carry more risks than a normal vaginal delivery.

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Risk of complications

In general, pregnancy and childbirth after weight loss surgery is actually much safer than becoming pregnant while still obese.

Research has shown that weight loss surgery may reduce the risk of some of the obesity-related problems during pregnancy. However, the risks of complications still exist.

Following weight loss surgery, you may be less likely to develop the following:

  • Gestational diabetes, or high blood sugar (glucose) during pregnancy.
  • High blood pressure.
  • Pre-eclampsia (high blood pressure, fluid build-up in the body, and protein in the urine).
  • Large birth weight babies, which increases the risk of Caesarean delivery.
  • More minor complications including headaches and heartburn (reflux).

Women who have had weight loss surgery may also gain less weight during their pregnancy than people who become pregnant while still obese.

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Breastfeeding after weight loss surgery

It is still safe for you to breast feed after weight loss surgery,
Baby-under-blanketin fact it is recommended. However, your nutrition during this time is still very important, so you should continue with nutritional monitoring, and continue to take your supplements. If you have low levels of vitamins in your body, they can also be low in your breast milk, affecting your infant's growth and development.

You may experience a delay in milk coming in. It is important for you to drink enough water so your milk does not dry up. You may wish to talk to your midwife, or a lactation consultant who can support you through breastfeeding and offer advice.

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After baby is born

Most pregnant women have some weight to lose after they have a baby. Women who become pregnant after weight loss surgery are no exception. Working with a dietician and exercising regularly will help shed post-delivery weight and get you back to your pre- pregnancy figure, but it takes time. It is

important you eat a healthy diet and adequate amounts of essential vitamins and minerals, especially if you are breastfeeding.

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Take-home points on pregnancy after weight loss surgery

  • Wait 18 months after surgery before becoming pregnant.
  • Use contraception during this waiting period.
  • Make sure your nutritional needs are being met.
  • Get regular blood tests to look for nutritional deficiencies.
  • See a Dietician to help regulate weight gain during pregnancy.

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Last updated: August 29, 2018