I perform gastric sleeve on patients from teens to seniors, and their questions run the gamut from how soon they can return to football practice to whether Medicare covers the procedure. But among women of childbearing years, questions about pregnancy are standard. The good news-bad news situation: Pregnancy is not only possible afterward, but it’s much easier. How could this possibly be bad news for women who may have struggled to have a baby? Because it’s so much easier that some women get pregnant before they want to! Here are some fast facts about babies and the gastric sleeve procedure.
Fact #1: If PCOS is the problem, the sleeve can be the answer
I can’t tell you the number of female patients who contact me about being sleeved because their OB/GYN has suggested it. Gastric sleeve isn’t an across-the-board solution to infertility, but if you’ve had trouble conceiving because of PCOS (polycystic ovarian syndrome), the procedure can be something of a miracle. Weight loss boosts fertility in overweight women, but PCOS can make it nearly impossible to lose a significant amount of weight. But when you add a sleeve to the equation, it can be a huge difference-maker.
Fact #2: It’s best to wait at least a year to try for a baby
The number of “oops” babies among happily married, previously infertile women is pretty high around here. Because as much as we try to tell patients that their fertility will likely skyrocket after the procedure, they don’t really believe it. And I don’t blame them; they’ve been trying for years to have a baby, so the notion that it might be pretty easy afterward doesn’t always click. And then darn if that stick doesn’t turn blue within a few months. You can still carry on a healthy pregnancy this early in your weight-loss journey, but I don’t recommend it simply because, well, you’re still early in your weight loss journey. Losing a lot of weight is stressful on your body. So is pregnancy. Putting those things together is less than ideal. So bring out the birth control and focus on shedding pounds for at least a year—then think about decorating a nursery.
Fact #3: Your prenatal risks will likely decrease
Even if obese women manage to get pregnant, both they and their babies can face significant risks during gestation. The healthier your weight (say, after losing weight with gastric sleeve), the healthier your pregnancy and baby are likely to be. The risk of gestational diabetes and pregnancy-induced hypertension is much lower in healthy weight women than in those who are overweight, and a 2005 study suggested that being overweight previously doesn’t have an impact on those risks. That’s very good news!
Fact #4: Nutrition is an even bigger deal for pregnant sleevers
Though the sleeve doesn’t cause the malabsorption problems that other bariatric surgeries can, it’s still smart to take a vitamin supplement to cover your bases. That becomes even more important during pregnancy—yet another reason to plan your pregnancy—and getting those prenatal vitamins in your system before conception is crucial. Another potential issue is your caloric intake. Depending on how many you’re consuming, you may need to work your physician to up those numbers. Some sleevers are satisfied on 800 calories a day, especially early on. Most doctors won’t be happy with that amount, though, when you’re also growing a baby.
Fact #5: Your changing body can mess with your head
Pregnancy means gaining weight. And when all you’ve been trying to do is lose weight, it can be difficult to see the scale go back up. It may be helpful to put a box around your pregnancy and classify it as “the time to gain weight.” It’s not forever, and it’s for a very good cause. But if you’re struggling with this idea more than you’re comfortable with, please speak to your OB/GYN about it. Some sessions with a counselor trained in these issues can be very beneficial. And the good news is that, in my experience, sleevers drop that baby weight pretty easily. After all, you have a tool to help with that—pus experience in shedding extra pounds.
Happy and healthy pregnancy wishes to all of our hopeful mommies!
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