Since last we spoke on this topic, I had just excitedly informed my unsuspecting husband that his boys could swim and we spent the rest of our fifth anniversary weekend basking in the knowledge that after years of trying, we would finally, in fact, be able to procreate.
No matter how long you've been a post-op, the first thing you do when you figure out you're accidentally (or on purpose) pregnant after gastric bypass surgery is to COMPLETELY FREAK OUT.
About what, you ask?
"O.M.G. I'M GOING TO GAIN WEIGHT AGAIN!"
No matter how much you want to have a baby (in my case it was more than THREE YEARS OVERDUE!), in fact, you're horrified by the idea that you're SUPPOSED to gain weight when at the moment, everything in your life revolves around doing exactly THE OPPOSITE of that.
Go ahead and TRY to have a different reaction and report back to me. It's impossible. It's the NUMBER ONE thing you think about from the moment that second pink line appears. And this reaction makes sense. You've gone through this major life-reforming surgery, you've either lost a bunch of weight or are in the process of doing so and now you worry that getting pregnant will sabotage all those efforts. And the worst thing you can possibly imagine is being fat again. That may sound harsh, but ask any person who has managed to shed a significant chunk of weight what they fear most and they'll likely agree with me.
After I got through the pesky business of informing the old man that he'd gone and knocked me up but good, I called my surgeon's office to see what they had to say. I spoke with the office coordinator, a woman I knew well and who herself was about three years post-op. I said, "I'm six months post op and just found out I'm pregnant, what should I do?" Her reaction was HIDEOUS. She said, "Oh, I'm so sorry," as if I'd just told her someone died.
I wanted to climb through the phone and smack her silly, but all I said was, "Can you ask Dr. Waldrep to fax me a copy of the blood tests I should have my OB order for me?" If you have a good surgeon, he or she will hopefully have seen enough pregnant post-ops to realize that this is no big deal. Again, I repeat:
THIS IS NO BIG DEAL.
In fact, the only study on post-op pregnancy I can find shows that statistically? It's better to have babies AFTER gastric bypass than BEFORE it. Your likelihood of having a healthy pregnancy and a healthy baby is actually GREATER after surgery than it is when you're morbidly obese. Dr. Wittgrove, who has performed over 2000 gastric bypass surgeries, found that:
"With over a 95% follow-up rate on the patients identified as having been pregnant following surgery, we found less risk of gestational diabetes, macrosomia, and cesarean section than associated with obesity. There were no patients with clinically significant anemia.
Conclusion: Since the patients had an operation that restricts their food intake, some basic precautions should be taken when they become pregnant. With this in mind, our patients have done well with their pregnancies. The post-surgical group had fewer pregnancy-related complications than did an internally controlled group that were morbidly obese during their previous pregnancies."
How 'bout them apples?
So to answer one of the first questions people always asked me when they found out I was a pregnant post-op: No, anatomically-speaking, the surgery doesn't interfere with the baby at all. Babies aren't grown in your tummy, they're grown in your uterus, which is further down and way out of the way. The two systems, digestion and reproduction, operate independently and if anything, having gastric bypass surgery gives you MORE space inside your body to make room for a baby. One of the unexpected perks, for me at least? No indigestion or heart burn! You have to actually HAVE a stomach connected to your esophagus for that esophagus to get all burny and pissed off. No Tums for me!
The second question I got asked was whether or not I would be able to gain the necessary weight with the pregnancy. That answer turns out to be a little more complicated, mostly because obese women don't technically need to gain ANY weight AT ALL to have a healthy pregnancy and the recommended amount of weight an individual needs to gain is entirely dependent upon a bazillion factors, most important of which is her starting weight. In my case, I started out the pregnancy at 193 pounds, so my doctor recommended that I gain ONLY 15-20 pounds. He also said that it would be FINE if I never gained ANY weight and that as long as I continued to take my prenatals and kept my vitamin levels up, the number on the scale didn't matter.
[Side note: my own mother had four healthy pregnancies and she never gained weight during ANY of them. All of us weighed over nine pounds at birth and were the very pictures of textbook healthy babies. With her largest baby, my little sister Audrey, who weighed over ten pounds, my mom LOST twenty pounds during the pregnancy.]
It took about six weeks (which is technically four weeks after insemination because of the wonky way due dates are calculated), for me to start getting morning sickness. But then I GOT IT BAD. I lost twenty pounds during the first trimester of my first pregnancy. Part of that I would attribute to simply being post-op and just being in the habit of trying to lose weight. Admittedly, it was hard to break that habit.
But the morning sickness didn't help. I should note for the record that I have not been able to successfully vomit since I was about two or three months post-op. I get queasy, I WANT to barf and I even go through the motions, which involves making the world's most horrendous gagging noises and spitting up mucus. I'm not sure which is worse: actually barfing when you feel sick or constantly wanting to barf and not being able to. Either way, food was often the last thing on my mind.
I ended up having about ten weeks of morning sickness, after which I felt EONS better. During the second trimester of my first pregnancy, I gained back the twenty pounds I'd lost during the first trimester. In the third trimester I gained twenty more pounds, for a total weight gain of twenty pounds.
By the time Alex was one week old, I weighed the same amount I did on the day I got pregnant.
So, to summarize:
1st trimester: -20 pounds
2nd trimester: +20 pounds
3rd trimester: +20 pounds
TOTAL: +20 pounds
After one week: BACK AT MY PRE-PREGNANCY WEIGHT
After I gave birth, I kept losing weight. Rather fast too. In fact, I would say that I had a distinct advantage over all my mommy friends: I lost 100% of my baby weight in a week and then it just kept sloughing off with almost zero effort. By the time Alex was six months old, I got down to my lowest all-time post-op weight of 165 pounds, for a total post-op weight loss of 131 pounds. I was a size ten and I was smaller than I was the day I graduated from high school.
So the idea that getting pregnant ruined my surgery results is a misnomer. It just didn't happen that way for me, in spite of the fact that I got pregnant WAY too early. I will say this, though, I would be a thinner woman TODAY if I had followed doctor's orders and waited the proper two years before getting pregnant. For almost any woman, along with pregnancy comes food inhibition, which is fine and good and normal. But it my case that meant I tried to eat a lot of foods (See's Candy, fast food, junk food, etc) that I would not have even THOUGHT to attempt to eat if I hadn't been pregnant. I'm not saying I would've forever kept myself from trying those foods on my post-op tummy, I just tried them a lot SOONER because of the pregnancy. I stopped trying to lose weight and even though I was lucky and my weight continued to go down, it definitely slowed down my overall weight loss.
Another unexpected perk of having gastric bypass surgery before getting pregnant was that I never got new stretch marks. In fact, even at nine months pregnant, I was several inches smaller in diameter than I had been at 296 pounds. My skin was already ruined.
As for the baby? My pregnancy was textbook perfect. I had my blood drawn every 4-6 weeks to make sure my vitamin levels were normal and they always were. Instead of prenatals, I took gummy bear vitamins and supplemented with extra doses of folic acid. He was perfect and beautiful and eight pounds, 13 ounces of everything I ever wanted my entire life.