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What is this information about?
This information is about fertility and pregnancy after your bariatric surgery (your weight loss operation). It is aimed at people who are planning to have a baby after having bariatric surgery.
It includes information about:
- contraception
- how long after your bariatric surgery you should try to wait before having a baby
- what you should tell your midwife at the start of your NHS pregnancy care
- what vitamin and mineral supplements you should take when you are trying for a baby and when you are pregnant
- what you should eat so that you have a healthy diet while you are pregnant
- changes to your weight that can happen when you are pregnant.
Why have I been given this information?
You have been given this information so that you know what changes to expect in your fertility after your bariatric surgery. If you are trying for a baby or are pregnant, following the advice in this information will help to make sure that you and your baby get the nutrition you need to be as healthy as possible.
How does having bariatric surgery change my fertility (how easy it is for me to become pregnant)?
Having bariatric surgery improves your fertility and makes it more likely that you will become pregnant.
What must I do if I am losing weight quickly after my bariatric surgery and I am not trying to get pregnant?
Do use contraceptive methods other than oral contraceptives (‘the pill’). This is because after you have had bariatric surgery your body may not take in (absorb) oral contraceptive medicines as well. You may not get enough of the hormones in them to stop you from getting pregnant.
If for any reason you need to continue to take an oral contraceptive do use another contraceptive method as well if you are trying to avoid getting pregnant.
How soon after my bariatric surgery can I start trying for a baby?
Do wait 12 to 18 months after your surgery before you start trying for a baby.
What should I be doing and how should my health be before I start trying for a baby?
You should be:
- eating a balanced, high protein healthy diet
- drinking at least 2 litres (8 cups) of water every day
- physically active every day
- taking your vitamin and mineral supplements every day
- a stable weight (you are not losing or gaining too much weight)
- within the expected ranges for blood test results (have normal blood test results).
Visit the NHS Website for further information
What should I do if I find out that I am pregnant?
Do
- refer yourself for NHS pregnancy care. To refer yourself for maternity care with University Hospitals Sussex (UHSX) please visit https://www.uhsussex.nhs.uk/services/maternity/pregnancy/book/
- tell your midwife that you have had bariatric surgery when you have your first appointment with them. This is because you may need extra checks and tests during your pregnancy.
What advice about taking supplements should I follow if I am pregnant or trying for a baby?
- Multivitamin and mineral supplements.
Do not
- continue to take your usual multivitamin and mineral supplement. These are not suitable for when you are pregnant.
Do
- switch to a multivitamin and mineral supplement which has been designed to be right for when you are pregnant. For example, Sanatogen Mother To Be or Pregnacare.
- Folic acid supplements
Do
- take a folic acid supplement when you are trying for a baby and for the first 12 weeks of your pregnancy. You should take a tablet containing 400 micrograms of folic acid each day.
Be aware,
if you have diabetes or are obese (you have a BMI (Body Mass Index) greater than 30kg/m2) you will need a higher dose.
Ask your GP surgery to prescribe you with a higher dose of 5mg. You cannot get this higher dose without a prescription.
- Vitamin A
Do not
- take Vitamin A supplements or any tablet that contains too much Vitamin A (retinol). Too much can harm your baby. This includes cod liver oil tablets.
- Vitamin D
You can continue to take your vitamin D supplement. This should be at least 1,000 IU or 25 mcg every day. If you have been advised to take a higher dose of Vitamin D due to low levels in your blood, continue with this advice.
- Calcium
You can continue to take your calcium tablet providing 500mg of calcium every day. If your calcium intake from food like milk, cheese and yoghurt is low, you may need two tablets every day.
- Iron supplement
You can continue with your iron supplement.
- Vitamin B12 injections
You can continue with your B12 injections every 3 months.
Where can I find general advice about having a healthy diet while I am pregnant?
What other advice should I follow because I have had bariatric surgery?
- Eat at least 60g of protein every day. This can be from meat, fish, eggs, milk, cheese, yoghurt, beans, peas, nuts or pulses.
- Remember to check food labels for sugar content. This will help you to avoid empty calories and dumping syndrome. Aim for less than 5g of sugar per 100g of portion
- If you keep getting constipation and your iron levels in your blood are normal, stop taking your iron supplements for 2 weeks (take an ‘iron holiday’). After this reintroduce your supplements slowly. You can continue to eat iron rich foods. These will not give you constipation.
- If you have a gastric band and you are being sick (vomiting) every day or not eating and drinking enough do book an urgent appointment at your bariatric surgery centre
- If you are offered a test for gestational diabetes, please inform your midwife that you have had bariatric surgery. The test requires you to drink a sugary liquid. This is likely to cause you to be ill with ‘dumping syndrome’. Your midwife may be able to offer you a different test.
- If you have severe tummy pain that comes and goes, and you feel sick (are nauseous) or are sick (vomit) contact your GP or your bariatric surgery team. They will need to check that you do not have an internal hernia. There is an increased that you may get an internal hernia when you have had a gastric bypass operation.
What do I need to know about gaining or losing weight while I am pregnant?
Try not to lose weight while you are pregnant. If you become pregnant within the first 12 months after your surgery, you may find that you do lose weight while you are pregnant.
It is usual to gain weight when you are pregnant but gaining a lot of weight could be harmful to you and your baby.
Some women who have recently lost a lot of weight after bariatric surgery find that the change in their body shape when they are pregnant is hard to adjust to and deal with. If this happens to you, do talk about how you are feeling. Ask the bariatric team for advice and support.
Where can I find advice that will help me to stay active while I am pregnant?
Who can I contact if I need further information or support after I have read this information?
Bariatric Surgery Service
St Richard’s Hospital
Spitalfield Lane
Chichester
West Sussex
PO19 6SE
This leaflet is intended for patients receiving care in St Richard’s Hospital.
The information in this leaflet is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.
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