Pregnancy is an exciting time for many women, but it can also bring about unique challenges, especially for those who have undergone bariatric surgery. For women who have had bariatric surgery, it is important to follow specific guidelines to ensure a healthy pregnancy. 

In this blog, we will explore the most important guidelines to provide expectant mothers with information needed to navigate their pregnancies safely and comfortably. 

Regardless of the type of bariatric surgery you have undergone, this guide will offer relevant details on how to maintain proper nutrition and meet essential nutrient requirements while pregnant.

Disclaimer: This article is not intended to replace medical advice provided by your OBGYN or Surgeon.

Recommended Wait Time Before Trying to Conceive

Congratulations on undergoing bariatric surgery and considering expanding your family! It is important to wait until your body has completely healed and adjusted to the changes brought on by the surgery before trying to conceive. 

The recommended wait time is typically 12 to 24 months after the surgery to allow your weight to stabilize, make sure you don’t have any vitamin and mineral deficiencies, and to reduce the risk of pregnancy complications. 

During this waiting period, continue to follow your nutrition and exercise plan, and work closely with your healthcare providers to track your progress. Taking the time to prepare your body will increase the chances of a healthy pregnancy and a successful outcome. 

Remember, patience is key, and there is no need to rush into trying to conceive. Waiting the recommended time will ultimately benefit both you and your future baby.

Complications of Pregnancy After Bariatric Surgery

While pregnancy outcomes after bariatric surgery are generally positive, it's important to note that complications can still arise. 

There is a risk of nutritional deficiencies due to reduced absorption of micronutrients after surgery.  It's important to closely monitor and follow-up with your healthcare provider during and after pregnancy to ensure any complications are caught and treated promptly. 

If you have lost weight, however are still considered obese, you will continue to have a higher risk for gestational hypertension, preeclampsia, gestational diabetes, early delivery, c-section delivery, and a high birth weight baby. However, the risk of these complications decreases after bariatric surgery compared to someone with a higher BMI that has not had bariatric surgery.

Pregnancy after all bariatric surgeries does increase the risk of having a low-birth-weight baby as well. This is why it is important to be closely monitored by your healthcare provider and bariatric surgeon throughout your pregnancy.

Recommended Pregnancy Weight Gain

The Institute of Medicine has guidelines for weight gain based on your prepregnancy BMI, however this is not specifically for people that have had bariatric surgery.

For individuals who have a prepregnancy BMI of 25-29, it is recommended to gain about 15-25 pounds in total throughout the pregnancy.

For individuals who have a prepregnancy BMI of 30 or higher, it is recommended to gain a total of 11-18 pounds while pregnant. 

Although, it is always best to discuss appropriate weight gain with your medical provider. 

Nutrition Advice for Women During and After Pregnancy

• Eat 5-6 small meals or snacks each day
• Eat protein with every meal or snack to reach your protein goal
• Ensure you’re getting enough calcium by having 2, 8 ounce glasses of Fairlife milk or Fortified plant-based milks each day
• Do not drink with meals to avoid getting full from the liquid
• Incorporate a variety of fruits, vegetables and healthy fats with every meal
• Protein supplements may be helpful, especially if you have struggled to consume enough protein each day

Fluid Needs

Staying hydrated is very important throughout pregnancy as well. Try to consume 64-100 ounces of water or sugar-free drinks each day. Avoid alcohol and excessive caffeine during this time as well. 

Protein Needs

Protein recommendations are typically higher during pregnancy as well. The recommendation is 1.2 grams of protein per kilogram of your Ideal Body Weight (IBW). This online calculator will help you determine your IBW. Then change the weight to kilograms with this online calculator. Once you determine your IBW in kilograms, multiply that number by 1.2. This will tell you how many grams of protein you should be consuming each day while pregnant. 

Vitamins

It is important to speak with your OBGYN about vitamin supplements while you are pregnant. While it is important to get the recommended amount of Vitamin A while pregnant, make sure it comes from beta-carotene and avoid retinol sources of Vitamin A. 

If you are struggling with nausea and vomiting related to your pregnancy, speak with your bariatric surgeon directly to be evaluated and monitored for vitamin deficiencies and possibly nutrition support.

Exercise and Activity While Pregnant

Regular exercise can help speed up your recovery and keep you fit throughout your pregnancy. Some great areas to focus on include pelvic floor strengthening, prenatal yoga/pilates, stretching, and walking. However, your healthcare provider can advise you on the best exercises to do, as well as any risks or complications to watch out for. 

Monitoring and Follow Up Visits With Medical Professionals

It is important to note that pregnancy and postpartum periods require closer monitoring and follow-up for women who have undergone bariatric surgery.

As we discussed earlier, there are potential risks and complications during pregnancy and after bariatric surgery that may require extra care and attention. It is important to keep up with regular check-ups and follow the recommendations of your healthcare provider to ensure a healthy pregnancy and postpartum period.

Your doctor may also recommend specific tests and exams to monitor your health and the health of your baby. Remember to stay in close communication with your healthcare team throughout your pregnancy and postpartum period to ensure the best possible outcomes for you and your baby.