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Back to Gynecology Articles
 Article
author: Debbie Miller, RN; specialized in maternal/child health,
bariatric surgery, psychiatry, communicable diseases.
Tuesday 20th November, 2007
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Advice for overweight moms: Lose weight before
getting pregnant.
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It has been documented that obesity in an expectant mother
negatively affects her pregnancy. This can begin even before
conception since infertility is a frequent problem associated
with excess weight. In addition, pregnancy in an obese woman
tends to place her at higher risk than others of normal weight
for problems such as diabetes, high blood pressure and mobility
limitations.
Weight loss surgery is a good option for the morbidly 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.
Because it is major surgery the body needs time to heal. The
procedure often results in gastric and/or intestinal alterations
and puts the patient into a controlled starvation mode to
facilitate rapid weight loss. The nutritional status of the
woman may be compromised during the weight loss stage. This is
not a healthy state to support a pregnancy and risks include
malnutrition of the mother, preterm delivery, and miscarriage.
For this reason it is recommended that a woman wait until her
weight and health have stabilized before conceiving a child.
Eighteen months has been determined to be the ideal minimum
period of time between weight loss surgery and conception.
Healthy babies have been born to mothers who became pregnant
within the first year following their surgery, but waiting can
help to ensure 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 diligent
in using birth control during the recommended eighteen month
period following weight loss surgery. But, the significant
weight loss that occurs with this surgery often results in
increased or normal fertility in the woman so a surprise
pregnancy could occur. Even if birth control was not needed
prior to weight loss, it should be used faithfully until weight
loss has stabilized and the woman’s body has healed, including
adequate iron stores, which are sometimes compromised. Many
doctors recommend using two reliable forms of birth control.
After becoming pregnant it is important to communicate well with
your obstetrician to be sure you are getting the best nutrition
and necessary adjustments for your situation. Your doctor may
need to be educated in your special needs. Work with your
surgeon and dietician to get information about your nutritional
needs to your provider. 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. You
may also do better with a vitamin that is specific to your
situation rather than the standard prenatal. Sometimes special
forms of iron are needed as well.
Once the body is healthy again, following weight loss, pregnancy
carries no increased risks than for a normal weight mother-to-be
and significantly less risk than she would have had in her
obese, pre-surgery state. So, get healthy, then get pregnant!
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