Pregnancy After Sleeve Gastrectomy: What You Need to Know

During a sleve gastrectomy up to 85% of the stomach is removed reducing it roughly to the size and shape of a banana. The procedure is typically carried out by way of several small, strategically placed incisions which are used to insert a camera and any necessary surgical instruments. 

After surgery the stomach continues to function normally, just at a greatly reduced capacity. Because the person can no longer eat anywhere near as much as they did previously weight loss – often dramatic weight loss – ensues. When it comes to gastric sleeve surgery and pregnancy women often wonder whether pregnancy will disturb the newly refashioned stomach or indeed if they will be able to provide all the nutrients both they and their developing baby will need. Below we’ll look at this issue.

Is Pregnancy after Sleeve Gastrectomy Possible?

The question of pregnancy after gastric sleeve surgery is one that has been on the minds of women since the surgery first became widely accepted and practiced some 25 years ago. But while the concerns about adequate nutrition and possible complications with the surgically altered stomach are understandable the fact is there is no reason to be alarmed. All that’s really required is proper guidance and common sense. Let’s start with the guidance.

When is it Safe to Become Pregnant after Sleeve Gastrectomy?

Most health professionals and specialists in this type of surgery recommend waiting 12 to 18 months after the procedure before becoming pregnant. That’s because it will usually take about a year for a patient to achieve optimal weight loss following gastric sleeve surgery. During this time the body is going through numerous changes and adjustments. The last thing you need is to add another layer of physiological adjustments and complications on top of what you’re already dealing with. Patience is the key.

Another important thing to keep in mind with gastric sleeve surgery and pregnancy is that fertility rates typically increase after this type of surgery. This is sometimes the result of oral contraceptives simply not being absorbed thoroughly by the new stomach. So it is recommended that you augment any birth control efforts in the period after surgery with non-oral contraceptives.

Will the Baby be Healthy?

This is usually the most common fear women have when it comes to vertical sleeve gastrectomy and pregnancy. They fear their baby will not get enough in the way of nutrients during pregnancy because of the reduced size of their stomach. Rest assured, however, that the vast majority of post gastric sleeve pregnancies have successful outcomes. In fact there is evidence to suggest that the weight loss resulting from sleeve gastrectomy can have a positive impact on the health of the baby when compared to what might have happened if the expectant mother was obese. Still, it is crucial that you don’t go it alone. Consult closely with your dietitian and follow their dietary and supplemental recommendations to the letter. Also, make sure your OB/GYN is familiar with the details of your weight loss surgery so that they are able to make appropriate recommendations and offer timely advice. It is also a good idea to put your dietitian and OB/GYN in contact with one another so they can coordinate their efforts on your behalf.

Will I Need to Take Supplements?

In all likelihood yes. Your dietitian will probably have you taking a multivitamin anyway in the wake of your gastrectomy but they may suggest a more comprehensive and targeted regime of vitamin and mineral supplements should you become pregnant. It’s probably a good idea to have a complete blood work up prior to getting pregnant as well. This will reveal whether you have any nutrient deficiencies that will need to be addressed prior to becoming pregnant. Vitamin D, iron, folic acid and more are all important to the developmental process of your baby. Therefore it’s important to know ahead of time whether you need to add any of these to your supplemental routine.

Are There Specific Things I Should Eat?

This is something you’ll need to determine in consultation with your dietitian. As a general rule however the following dietary guidelines will apply with sleeve gastrectomy and pregnancy:

• Make sure you are getting enough protein. A typical amount would be 70-90 grams per day.
• Avoid refined sugars and foods that are highly processed. Concentrate instead on whole grains, vegetables and fruit.
• Avoid saturated fats and trans fats. But make sure you’re getting adequate levels of unsaturated fats in your diet as this will aid your baby’s development and also provide needed energy for you. The exact amounts and sources will be determined by your dietitian.
• Don’t overeat. Now is no time to undo all the hard work you’ve put into building good eating habits in the months following your gastric sleeve surgery.
• Remember to drink plenty of water. At least 1.5 to 2 litres per day if possible to avoid dehydration.

Will I Pack on the Pounds During Pregnancy?

It is natural for your weight to increase some during pregnancy. This should not be of concern as long as you are maintaining healthy eating habits and following the advice of your dietitian. Chances are you will only gain a small amount of weight, or you may gain none as a result of your sleeve gastrectomy. The crucial thing is to focus on nutrition rather than panicking over a pound here or there. Keep in mind that one of the major benefits of gastric sleeve surgery is that you will be able to live a more “normal” life. Putting on a few pounds during pregnancy is the very definition of “normal”. So don’t sweat it. After you’ve had your baby you can discuss steps to take off any pregnancy related weight with your dietitian.

Conclusion

Sleeve gastrectomy and pregnancy do not have to be mutually exclusive. The most important things to keep in mind if you are planning a pregnancy after sleeve gastrectomy is not to rush it and to concentrate on nutrition during the pregnancy.