I was recently asked about what my thoughts were on having a baby -- either before or after weight loss surgery. Here is my 2 cents & my personal story.
I had my first child in 1989. I was of normal weight, gained too much weight, and was overweight slightly after her birth. (180's)
My second child was born in 1992. I was more overweight after his birth. (210's)
College....gained even more weight. Hit an all time high. Or so I thought. (280's)
Had my third child in 2003. I was severely overweight at 269 lbs after she born. Ok, heck, I was morbidly obese. Not as bad as what I weighed after college graduation, but still, quite heavy.
All time high - 310 lbs in May 2006. Time to call it quits with traditional weight loss attempts. All it did was make me gain more weight when I would stop dieting. Decided to go for gastric bypass. Lost 50 lbs with dietitian and MD help, with strict diet, and increasing my exercise.
April 2007 - gastric bypass surgery. 260 lbs on day of surgery.
All time low after surgery - Jan 2009 - 137 lbs. Way too low for me. Needed 2nd post op complication surgery this month. Numerous adhesions removed, which were causing severe pain and inability to eat.
Today - Sept 2009 - weight wavers between 148-153 lbs. I'm good with that!
Back to pregnancy and weight loss surgery.
As you can tell, I have three children. I was (and still am) quite content with having 3 children. I have no desire for more children. Would I have done things different? Would I have had gastric bypass surgery before having my third child? I doubt it. I hadn't reached my breaking limit for my weight problems by then. I was definitely getting there though!
Had I not had my last child, and I had reached my breaking point, I probably would not have gone on to attempt a pregnancy after weight loss. Why? For me, personally, I have just too many nutritional issues related to weight loss surgery. I am severely anemic without daily supplementation of a special iron supplement. I deal with fatigue on a daily basis, although it differs from day to day. My GI system is utterly sensitive in what goes through it, and how it handles foods and liquids.
In my opinion, the stress of a pregnancy would put too much onto my already stressed body. I don't know if I would be able to nourish a growing fetus adequately. I had issues with being borderline diabetic before my weight loss (during my last pregnancy, I was borderline gestational diabetic). Would I face those problems in a pregnancy after weight loss? Possibly. Or, I could have issues with hypoglycemia from not being able to take in enough calories to sustain a pregnancy and keep my blood glucose levels stable. I just don't know. I would have to be pregnant to actually find out.
I'm sure it would be very easy for me to conceive post gastric bypass surgery. I was a fertile myrtle before, when I was obese. I conceived my last two children just one to two months after stopping BC pills, each time! Losing weight seems to trigger an increase in fertility in some studies and some women, probably due to blood glucose control being more stable, and less estrogen stores in the body (due to decrease in fat in the body).
After surgery, I had to sign an agreement with my surgeon that I would use birth control methods for at least 1-2 years after getting bypass, due to the increased risk of pregnancy complications post op.
Now, once stability in weight and nutritional deficits are reached post op (about 18-24 months post op), it is probably ok to get the go ahead to try to conceive, if pregnancy is desired. For me - no desire for pregnancy!
Getting pregnant is risky either way: morbid obesity increases risks during pregnancy for preeclampsia, diabetes, soft tissue/shoulder dystocia at birth, etc. Getting pregnant after weight loss is achieved can be risky: nutritional deficiencies, inability to take the glucose tolerance test (it's contraindicated post op), risk for large weight gain and difficulty in losing it again postpartum. This is, by far, not a complete list of risks either.
It comes down to being a personal opinion.
Should a woman conceive before she gets gastric bypass surgery, or should she lose the weight first, wait 2 years, then try to conceive? Only you and your health care providers can decide what is best for YOU.