Pregnancy And Gastric Sleeve Surgery: All You Need to Know

Weight-Related Infertility

Women who are obese often have a much more difficult time becoming pregnant. Obesity causes hormone disruptions and insulin resistance, which manifests in different ways within the body. In the liver, it shows up as liver disease, in the pancreas it presents itself as diabetes, and in the ovaries, patients can develop polycystic ovary syndrome (PCOS), which is a hormone disorder affecting women of childbearing age and is the leading cause of infertility.

Is It Better To Have Weight Loss Surgery Before or After Pregnancy?

Every individual is different, however, women who become pregnant when they are obese statistically have many more risks and complications with their pregnancy. Studies named complications like hypertension, gestational diabetes, preeclampsia, cesarean section, miscarriage, stillbirth, etc. In the patients who had undergone weight loss surgery and improved their BMI numbers prior to becoming pregnant, there was a significant decrease in risks for maternal complications and much improved neonatal outcomes.

Can You Get Gastric Sleeve Surgery Before Pregnancy?

Yes, you can! Losing weight may have a profound effect on a woman’s ability to conceive, and it will definitely reduce the number of risk factors that contribute to infertility as well as greatly lower potential risks during pregnancy. Beginning a pregnancy with a lower BMI and in a healthier body will be beneficial to both mother and baby.

Consulting with an expert bariatric surgeon can help you determine which procedure would work best for you. In addition to laparoscopic gastric sleeve surgery, there is a non-surgical procedure that may be a good option for you called ESG or endoscopic sleeve gastroplasty. They do not remove any portion of your stomach but use sutures to make it smaller. There is no hospital stay, recovery time is much shorter, and there are fewer associated risks.

How Long Do I Have to Wait After Gastric Sleeve Surgery to Become Pregnant?

Your bariatric surgeon will work with you regarding your pregnancy plans; however, it is usually recommended to wait between 12 and 18 months after your gastric sleeve, and until your weight stabilizes before becoming pregnant. Your doctor may also recommend you to be tested for any nutritional deficiencies before you begin trying to conceive.

The thought is that the healthier the mother, the healthier the reproductive system, the healthier the egg, etc. The first 12-18 months after bariatric surgery is the phase of the most rapid weight loss, which is not the best time to attempt to nurture a growing fetus.

The Benefits of Becoming Pregnant after Gastric Sleeve

There are many benefits gastric sleeve surgery has in relation to pregnancy, and most women will have a successful outcome. Research has determined that starting a pregnancy at a healthy weight reduces risks such as blood pressure irregularities, gestational diabetes, postpartum hemorrhage, larger than normal newborns, and cesarean delivery. 12-18 months after a gastric sleeve procedure, most individuals have lost about 23 – 30 % of their starting weight, have an ongoing exercise routine, and have changed their lifestyle habits to become healthier individuals. Carrying a pregnancy to term without being at an increased risk due to excessive weight should no longer be an issue.

Potential Challenges of Becoming Pregnant after Gastric Sleeve

Nutritional Deficiencies

The size of your stomach is reduced after gastric sleeve surgery and can affect the absorption rate of necessary vitamins and minerals causing deficiencies. During pregnancy, it is especially important to ensure there are enough nutrients for both mother and baby. Doctors will often recommend supplements and/or do periodic testing to make sure nutrient levels are where they should be.
Nutritional deficiencies can contribute to:

• Smaller newborns;
• Intrauterine growth restrictions;
• Preterm labor.

These risks and deficiencies may be avoided with good planning, open communication, a healthy diet, and supplements.

Gaining Weight after Pregnancy

Many women who have had gastric sleeve surgery may be concerned that they will gain weight during pregnancy and undo all their hard work. This scenario can be avoided by working closely with a support team comprised of your OB/GYN, your bariatric surgeon, and a nutritionist. While weight gain is normal during pregnancy, consulting with your support team will help prevent overeating and encourage safe exercise protocols so excessive weight gain is avoided.

Are There Risks Associated With Pregnancy after Gastric Sleeve Surgery?

Some rare risks can occur during pregnancy after bariatric surgery. Because your OB/GYN may not fully understand the effects of gastric sleeve surgery related to pregnancy, it is advised that you confer with both your bariatric surgeon and your OB/GYN during the entire pregnancy. It is also important that you know signs that may indicate possible issues. Risks that are rare but have been reported include:

• Abdominal adhesions after abdominal surgery resulting in scar-like tissue that can cause internal organs to stick together;
• Internal hernias;
• Restricted blood flow to the small intestine;
• Slipping of gastric sleeve.

Breast Feeding after Gastric Sleeve Surgery

You may be wondering if it’s possible to breastfeed after gastric sleeve surgery? Yes! Studies have shown that gastric sleeve surgery does not affect breast milk composition. The main thing to remember during your pregnancy and while you are breastfeeding is to make sure you get the vitamins and nutrients you need.

Vitamins like B12, vitamin D, and Zinc are three components that are important for breast milk production (among others). The human body is “pre-programmed” for survival so be mindful that if you are not consuming enough vitamins or minerals for your milk supply, they will be “stolen” from the stores in your body to help nourish the baby. Following your team of doctors’ nutrition plan and taking your supplements is essential during pregnancy and breastfeeding.