Obesity in an expectant
mother can cause problems in her pregnancy. This can begin
even before she gets pregnant since infertility is a frequent
problem associated with excess weight. Pregnancy in an obese
woman carries more risks than for others of normal weight
for problems such as diabetes, high blood pressure and exercise
since her ability to move may be limited.
Weight loss surgery
is a good option for women who are seriously obese (about
100 lbs. overweight), resulting in excellent long-term results.
But, it is important to know the risks involved as they
relate to pregnancy.
When a person has major
surgery such as this the body needs time to heal. The surgeon
changes the stomach and/or intestines and the patient is
able to achieve rapid weight loss. The nutritional status
of the woman during this weight loss stage may not be enough
to support a growing baby, so it is not a healthy way to
begin a pregnancy. There could be problems with preterm
delivery or miscarriage. For this reason it is recommended
that a woman wait until her weight and health have stabilized
before she gets pregnant. Eighteen months has been determined
to be a good minimum period of time between weight loss
surgery and the time she becomes pregnant. Healthy babies
have been born to mothers who became pregnant within the
first year following their surgery, but waiting can help
to give her the best chance for a successful pregnancy.
If infertility was a
problem before surgery, the woman may believe she still
cannot become pregnant and may not be careful about using
birth control during the recommended eighteen month waiting
period following weight loss surgery. But, the significant
weight loss that occurs may result in improved fertility,
so a surprise pregnancy could occur. Even if birth control
was not needed before weight loss, it should be used faithfully
after the surgery until weight loss goals are achieved and
the woman’s body has healed completely. Many doctors
recommend using two reliable forms of birth control at this
The woman needs enough
iron in her body and this is sometimes a problem following
the weight loss surgery. Sometimes special forms of iron
are needed. It is especially important to take a good prenatal
vitamin faithfully beginning before you even become pregnant.
It would be a good idea to see your doctor before you start
trying to have a baby to make sure you are in good health.
You should discuss your surgery with your doctor at this
Once you are pregnant
it is important to keep all your prenatal appointments.
To be sure you are getting the best nutrition and necessary
adjustments for your situation you may also need to talk
with your weight loss surgeon and a dietician. Help your
family doctor, obstetrician, or midwife to know your special
nutritional needs. This may include eating smaller, frequent
meals with more protein and even making adjustments in the
routine glucose screening to avoid dumping syndrome, a common
long-term effect following gastric bypass surgery. This
can be triggered by sweet foods or drinks such as might
be used in the glucose testing.
Do plan to breastfeed
your baby but be alert that extra care should be given to
adequate nutrient intake. You should continue your vitamin
supplements faithfully while nursing your baby. It is recommended
that the baby receive breast milk for the first year of
life and the baby’s weight should be monitored for
normal growth patterns through regular well-baby visits
with the pediatrician. Be sure to discuss any concerns relating
to your health history and nutritional status with your
Once the body is healthy
again following weight loss, pregnancy is just as safe as
it is in a normal weight mother-to-be and there will be
fewer risks than she would have had in her obese, pre-surgery
state. So, get healthy, then get pregnant!