Pregnancy After Gastric Sleeve Surgery

Having a baby can be one of the most exciting times in a woman’s life, but many patients who have undergone a bariatric procedure wonder if pregnancy after gastric sleeve surgery is safe for mom and baby.

The great news is that yes… it is safe for a woman to get pregnant after gastric sleeve surgery.

In fact, it’s safer for both mom and baby if mom were to get pregnant after losing weight versus the potential complications that arise when pregnant while obese. We’re going to tell you everything about gastric sleeve surgery and pregnancy.

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Can you get pregnant after gastric sleeve?

Yes, you can get pregnant after gastric sleeve once your body weight stabilizes. The surgery is an invasive process, which places your body under temporary stress. Gastric sleeve involves the removal of a large part of your stomach tissue, which will trigger certain physiological and hormonal changes. Moreover, you will begin to lose excess weight as your capacity to eat gets restricted.

Therefore, while it is safe to get pregnant after gastric sleeve, you should wait until you have achieved a significant part of your weight loss goals. This time lag will also give your body the time to recover and become fully fit for a pregnancy. Your baby in the womb needs to draw nutrients from your body for growth, so once the nutrition levels in your body have normalized, a pregnancy becomes safer for you and the baby.

READ: Pregnancy and obesity

How long after gastric sleeve can I get pregnant?

Experts have divergent views on how long you should wait after a gastric sleeve surgery for a pregnancy. In general, it may be prudent to wait anywhere from 12 to 24 months after gastric sleeve before you get pregnant.

• Recommended Timeframe: While some people in the medical community are of the opinion that no waiting time is necessary at all, others believe that waiting for 12 to 18 months post-VSG surgery to get pregnant may be the optimal time period. Some medical professionals may also recommend a minimum waiting period of 24 months.
• Risk of a Premature Baby: One of the reasons why some bariatric surgeons and other medical professionals want women to avoid pregnancy for at least one to two years after gastric sleeve is the risk of a premature birth. According to these professionals, the chances of an SGA (small for gestational age) baby may increase if the time lag is insufficient.
• Risk of Complications: Gastric sleeve and pregnancy complications may have a higher correlation when the time gap between the surgery and the pregnancy is sub-optimal. Malnutrition related problems may occur more commonly among mothers and babies when a pregnancy and childbirth occurs in quick succession after a gastric sleeve surgery.

Pregnancy after gastric sleeve: It is safe?

Pregnancy after gastric sleeve is generally considered safe for most women. If you are planning a pregnancy post-surgery, it is best to discuss it with your bariatric surgeon at the initial consultation itself. Your surgeon will explain to you the correlation between gastric sleeve and pregnancy and provide guidance on when you should plan it.

• Best time period: According to the American College of Ob-Gyn (ACOG), the current research on post-bariatric pregnancy outcomes indicates that women should ideally wait for one to two years before conceiving. This will allow her to achieve her weight loss goals, while also protecting the fetus against the risks of rapid maternal weight loss.
• Earlier pregnancy: If a gastric sleeve pregnancy occurs earlier than this recommended waiting period, an increased focus on maintaining nutrition and a closer monitoring of maternal weight will help. For cases of early pregnancy after sleeve surgery, the ob-gyn should consider more frequent ultrasonic evaluation of the fetal development.
• Infant health: Getting pregnant after gastric sleeve does not increase the risk of congenital problems. However, it is possible that in some cases the baby’s birth weight may be slightly lower if the mother has had a pregnancy after gastric sleeve surgery. This could occur because birth weight and maternal weight gain may have a positive correlation.
• Contraception: To lower the dangers of falling pregnant after gastric sleeve without a sufficient gap, bariatric surgeons should provide contraception counseling to female patients of reproductive age. Following the surgery, oral contraceptives may not always work. Therefore, non-oral contraception should be recommended as the first choice.
• Nutrition focus: Gastric sleeve surgery and pregnancy go well in most cases because this procedure is not malabsorptive. It means, nutrient absorption in the body does not change after gastric sleeve. Nevertheless, pregnant women should focus on nutrition post-VSG. Every trimester, the ob-gyn should measure the complete blood count and essential nutrient levels.

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Gastric sleeve and pregnancy complications

As mentioned, the risks associated with being pregnant while obese are far higher than they are after the sleeve surgery, but there are still some potential issues to acknowledge. For one thing, pregnant women who have had gastric sleeve have a higher risk of giving birth prematurely.

Having a baby is exciting, and you can rest assured that if you’re considering gastric sleeve or have already had the procedure done, then it’s perfectly safe for you to become pregnant. However, it’s essential to wait for one to two years following the surgery, as this will give you time to get used to your new lifestyle and diet, and that will ensure you’re healthy enough to have the baby. Pregnancy complications after gastric sleeve, although rare, may occur in some women who have higher risk factors. You can minimize the risks by maintaining an optimal waiting time before you get pregnant as well as by following the prescribed gastric sleeve pregnancy diet.

Nevertheless, you should be aware of the following potential pregnancy complications after gastric sleeve.

• Disorders related to micronutrient deficiencies and protein deficiency
• Anemia caused by iron deficiency
• Nerve damage due to prolonged vitamin B12 deficiency
• Dumping syndrome, marked by nausea, vomiting, diarrhea, abdominal cramps, dizziness, and flushing
• Internal hernias or other surgical complications
• SGA baby (small for gestational age) due to maternal malnutrition
• Fetal macrosmia or an abnormally oversized baby
• Altered maternal glucose metabolism
• Pregnancy induced high blood pressure
• Aggravated morning sickness, bloating, or acid reflux
• Poor fetal growth or premature birth
• Higher chances of Caesarean section surgery
• Clinically significant level of hypo-albuminemia with edema
• Increased risk of childhood hypertension
• Increased cardiovascular risk at a later stage or in adulthood

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Dangers of falling pregnant after gastric sleeve

Pregnancy after gastric sleeve may increase the risk of post-operative complications in some women, especially when there is little gap between surgery and conceiving. Your surgeon will inform you about the potential dangers of falling pregnant after gastric sleeve. Using contraception for at least 12 months is the best way for reproductive women to minimize their risk post-VSG.

• Gastrointestinal complications: Pregnant women in general are more prone to abdominal cramps, vomiting and nausea. Gastric sleeve and pregnancy complications may increase the risk of dumping syndrome, hypo-glycemia, tachycardia, diaphoresis, hypertension, and gestational diabetes. Pregnancy symptoms after gastric sleeve should be monitored to diagnose and treat the complications early.
• Medication risks: One of the dangers of falling pregnant after gastric sleeve is poor response to the prescription medications. You and your ob-gyn should keep a track of the drugs you are using during the postpartum phase. NSAIDs use should be used cautiously to minimize the risk of stomach ulcers. Rapid release drugs or oral preparations should be preferred for quicker absorption.
• Delivery risks: Labor and delivery complications are not among the known dangers of falling pregnant after gastric sleeve. However, pregnancy after gastric sleeve may increase your chances of a cesarean section delivery. To mitigate your risks, you should have a pre-labor consultation with your ob-gyn as well as the bariatric surgeon. But in general, labor and deliver management risks are minimal.
• Nutritional deficiencies: Deficiency of vital nutrients, such as protein, vitamin B12, vitamin D, folate, iron and calcium is one of the dangers of falling pregnant after gastric sleeve without adequate gap. To keep a track of your nutrition levels in case of gastric sleeve pregnancy, regular blood tests should be performed to measure your ferritin, iron, vitamin D, and calcium levels.

READ THIS: Pregnancy After Bariatric Surgery: Is it Healthy and Safe?

Pregnant a month after gastric sleeve

Pregnancy after gastric sleeve should ideally be delayed for at least 12 months. However, there are instances where a woman may get pregnant a month after gastric sleeve. This will make it more challenging for her to meet her weight loss goals, but it may not necessarily increase the health risks for the mother and the baby. Here are some of the things to note an early gastric sleeve pregnancy.

• Be alert to the pregnancy symptoms after gastric sleeve so that your post-op diet and weight loss plan can be modified promptly.
• If you have struggled with obesity-related infertility, you may be more anxious to get pregnant a month after gastric sleeve surgery.
• All women of reproductive age should diligently follow their surgeon’s contraception recommendations to avoid early pregnancy after VSG.
• Getting pregnant after gastric sleeve within one month means that your weight loss goals may get extended until after a safe delivery.
• Hormonal changes after a gastric sleeve may interfere with oral contraceptives, increasing the risk of an unplanned pregnancy.
• Early post-op period is the phase of rapid weight loss, so take all precautions to avoid getting pregnant a month after gastric sleeve.

Pregnant 3 months after gastric sleeve

At the time of your initial consultation, your bariatric surgeon will probably advise you to avoid pregnancy after gastric sleeve for at least one year. They will also make recommendations about the type of contraception you should use to delay your gastric sleeve pregnancy. However, despite best efforts, some women may still get pregnant 3 months after gastric sleeve. Here are a few tips to follow in this situation.

• If you notice pregnancy symptoms after gastric sleeve, perform a home test or visit an ob-gyn’s office to confirm your pregnancy.
• Inform your ob-gyn about your medical history as well as the fact that you have become pregnant 3 months after gastric sleeve surgery.
• Do not hide this information from your bariatric surgeon, and give them a call to seek advice on what do’s and don’ts you should follow.
• Getting pregnant 3 months after gastric sleeve is fairly safe for you and your baby, provided you focus on nutrition and fitness as advised.
• Do not be anxious about eliminating obesity immediately, and be assured that your weight loss goals can be achieved post-pregnancy.
• Getting pregnant 3 months after gastric sleeve still means that you would have had rapid weight loss and shed several pounds already.

Pregnant 6 months after gastric sleeve

Six months may be a reasonable period for some women to consider pregnancy after gastric sleeve. Although many researchers are of the view that gastric sleeve and pregnancy should be at least 12 to 18 months apart, there are others who do not prescribe a one-size-fits-all rule for every patient. Keep the following things in mind if you get pregnant 6 months after gastric sleeve surgery.

• If you have had a history of obesity-related infertility, it may not be a bad thing to try for a pregnancy after sleeve surgery within 6 months.
• If you may soon get past the reproductive age, talk to your bariatric surgeon about getting pregnant after gastric sleeve in 6 months.
• Some researchers have found no marked differences in pregnancy outcomes for women who conceived early after bariatric surgery.
• Careful planning in consultation with your surgeon to get pregnant 6 months after gastric sleeve could get you the best of both the worlds.
• The first six months after your surgery is the best time to achieve maximum weight loss, after which you can plan a pregnancy.
• Getting pregnant 6 months after gastric sleeve will lower your risk of gestational diabetes as you would have already lost significant weight.

Twin pregnancy after gastric sleeve

Some women are concerned about the correlation between gastric sleeve and pregnancy with twin gestations. The good news is that a twin pregnancy after gastric sleeve may only be safer when compared to other women with a similar BMI level who did not have the surgery. A research study comparing the data between a group of women who had bariatric surgery and the other who did not confirmed this finding.

• Outcomes for twin pregnancy after gastric sleeve are likely to be more favorable compared to similar women that did not have the surgery.
• Incidence of hypertension and gestational diabetes was lower for women with twin pregnancy after gastric sleeve surgery.
• The surgeon may not make a difference to birth weight, but neonatal weight discordance may be reduced for twin pregnancy after VSG.
• Hemoglobin levels may become slightly lower for some of these women through the pregnancy as well as postpartum phase.
• More research is required to assess the long-term outcomes for the babies in case of a twin pregnancy after gastric sleeve surgery.
• Regular ob-gyn visits and periodic ultrasound monitoring during pregnancy is warranted to increase the predictability of outcomes.

 

It’s important to wait about 2-years after gastric sleeve surgery

Although it is safer and more manageable for a woman to have a child after gastric sleeve, it’s crucial that you give yourself time to adjust to your new lifestyle first.

• Some guidelines recommend waiting 12 to 18 months, while others suggest waiting at least two years before getting pregnant.

This waiting period gives you time to get used to your new stomach and your new diet and ensure you’re eating the right foods in the right quantities to avoid nutrient deficiencies. Moreover, if you don’t wait to get pregnant, you may not lose as much weight as you could have, because most women do gain weight during pregnancy.

READ: Sex after gastric sleeve

Importance of vitamins and supplements during post-gastric sleeve pregnancy

Gastric sleeve surgery encourages weight loss by reducing hunger and limiting the amount of food you can consume, and it’s not uncommon for post-op patients to lack nutrients.

A nutrient deficiency can be exacerbated when you’re pregnant, which is why many gynecologists and dietitians recommend supplements in post-gastric sleeve patients.

This list includes iron, folate, calcium, and B12. These supplements will ensure you get the nutrients you need so that you can provide them to your baby as well.

CHECK: Best bariatric vitamins to take after bariatric surgery

Gastric sleeve pregnancy diet

The risk of gastric sleeve and pregnancy complications can be significantly reduced when you focus on a nutritious and well-balanced post-op diet. Gastric sleeve pregnancy diet will also lower the incidence of morning sickness, vomiting and nausea which commonly occur during pregnancy. Here are some of the useful tips you can follow to maintain an excellent gastric sleeve pregnancy diet.

• Eat in small portions and ensure a balanced food intake.
• Include lean proteins, veggies, fruits, and small quantity of carbs in your daily diet.
• Choose healthy snacks in measured quantity if you feel hungry between meals.
• Increase the intake of protein shakes or other nutritious drinks to fulfill your daily nutrient requirements if necessary.
• Avoid nausea inducing foods
• Keep away from cooking smells and avoid foods with strong odors
• Do not wait for nausea to occur and take your prescribed anti-emetics on time.
• Use ginger tea or other complementary home remedies to fight nausea.
• As your taste may undergo changes, experiment with changes in food choices as part of your gastric sleeve pregnancy diet.
• Eat in small bites, chew your food thoroughly, and listen to your body when you are feeling full to stop eating.
• Avoid or minimize your intake of caffeinated beverages, alcohol, and smoking.
• Develop the habit of going for short walks before (not after) your meals.
• In the final trimester of pregnancy, increase your daily energy intake by about 200 calories in consultation with your physician.

C-section after gastric sleeve

The likelihood of a c-section after gastric sleeve seems to be higher, even though researchers have not been able to pinpoint any specific reasons for it. One study in Sweden found that the chances of a cesarean delivery are as much as six times higher for women who have had a weight loss surgery compared to similar other women who did not. However, it is important to remember that c-section rates are anyway going up in general worldwide.

If you are concerned about a c-section after gastric sleeve or wish to increase your chances of a non-surgical delivery, be prepared to follow your bariatric surgeon’s guidelines for post-op weight loss. Consult a physical therapist to perform specific exercises during your pregnancy. It may also be a perspicacious idea to join childbirth preparatory classes. Stay cheerful and allow pregnancy after gastric sleeve be the most memorable phase of your life.

Gastric sleeve while breastfeeding

Many women have concerns related to gastric sleeve while breastfeeding. The good news is that healthy mothers can breastfeed even if they have undergone a gastric sleeve surgery. The stored nutrients in your body will first go to your breast milk, and then get utilized for the sustenance of your own body. Make sure you are following the appropriate gastric sleeve pregnancy diet as advised by your nutritionist or obstetrician.

• Watch for Symptoms: Malnutrition is one of the possible pregnancy complications after gastric sleeve. Therefore, watch out for the deficiency of iron, calcium, folate, proteins, and vitamins and take your prescribed nutritional supplements. Watch out for symptoms of PCOS, thyroid conditions, or insulin resistance, which may reduce your milk production.
• Focus on Vitamin B12: Deficiency of vitamin B12 is a notable concern for women who want to understand the risks of gastric sleeve while breastfeeding. If the mother is vitamin B12 deficient, she will have low levels of it in her breast milk. This could result in vitamin B12 deficiency in your breastfed infant, posing developmental risks.
• Breast Skin Concerns: One of challenges some mothers may face with gastric sleeve while breastfeeding is sagging breast skin. You may have loose skin in the breasts and nipples after a massive weight loss following your VSG surgery. This could result in problematic positioning and latch. Seek medical advice well in time to address this concern.

Irregular periods after gastric sleeve

Have you struggled with irregular menstrual cycles while you suffered from obesity? Well, there is good news for you. Your problem of irregular periods after gastric sleeve is likely to get resolved, and any other associated obesity-related hormonal abnormalities that adversely impact your menstrual cycle may also improve.

Research Study 1

Researchers analyzed the data of 515 pre-menopausal women who underwent different types of weight loss surgery over a period of eight years from 1999 to 2017. Based on their post-operative experience, researchers found that the incidence of irregular periods after surgery had reduced from 38.6% to 25%. This cross-sectional study indicates the resolution of irregular periods after gastric sleeve for many women.

Research Study 2

Researchers at Stanford University School of Medicine conducted a study, which also indicates that bariatric surgery contributes to the regulation of menstrual cycles. The study authors reported fairly dramatic results. Within a year after the surgery, almost all the women (99%) who earlier had irregular periods started having regular menses. Nearly 82% of the women who earlier had no periods also began having regular periods.

Gastric sleeve and birth control

Is there a connection between gastric sleeve and birth control options you may want to use? According to some researchers, gastric sleeve is not a malabsorptive procedure, which means it will not affect your ability to absorb drugs, including birth control medications. Therefore, you may confidently utilize any method of birth control you want.

However, according to the ASMBS, following weight loss surgery women should use additional birth control solutions along with oral contraceptives. These may include spermicide, condoms, and intrauterine devices (IUDs). Some other hormonal methods, such as the implant, the shot, the patch, or the ring can be used normal after gastric sleeve for birth control.