Most women consider having children as a normal part of being a woman. For obese women, this may not be the case. Obesity can make conception very difficult to achieve and it further adds complications to pregnancy if and when it occurs. These additional risks to pregnancy in many cases motivate woman to take action to reduce their weight.
Many obese women have an increased risk of polycystic ovarian syndrome (PCOS) which can make it difficult to conceive and type II diabetes which in many cases cause additional health problems. Obese women who do fall pregnant have an increased risk of miscarriage, pre-eclampsia and gestational diabetes. This is caused by hormonal changes which can reduce blood supply. Gestational diabetes increases the risk of fetal abnormalities due to vessels and hormone changes. Abnormal growth in babies can increase the chance of birth injuries to both parties.
As a result, many obese women are starting to consider bariatric surgery as a precursor to conceiving and, ultimately, delivering a healthy baby after a problem free pregnancy.
Many women have undergone bariatric (weight loss) surgery and gone on to deliver healthy babies. There is clear evidence that gastric bypass surgery significantly reduces type II diabetes. More recently, Australian physicians demonstrated that laparoscopic gastric banding had a similar effect on diabetes. Most women with diabetes or hypertension will see a reduction in requirements for medication and will therefore be better placed to enjoy a healthy pregnancy.
So are there any drawbacks to having bariatric surgery? Toni Russo, Bariatric Nurse Consultant for Streamline Surgical, believes that the benefits outweigh the risks:
"As a midwife in antenatal care, I have looked after many obese women who didn"t enjoy their pregnancies as they were constantly worried about risk to their babies. Even simple tests like ultrasound scans were difficult as it wasn"t always easy to get clear views of developing babies. Eventually I started to meet women who had lost weight after gastric bands or RNY gastric bypass. The results were excellent and pregnancies appeared to be no more risky than for non obese women providing women were responsible and took measures to ensure that they were properly nourished."
In practice, it isn"t difficult for women who have had bariatric surgery to ensure they are properly nourished. As long as they commit to a well balanced diet with adequate protein, calcium and vitamin supplements then they will remain well nourished.
Obviously it is important that women keep in contact with their bariatric team and maternity team throughout their pregnancies. Gastric bands may need partially deflating during the pregnancy especially where there is morning sickness. This is to improve overall nutrition and also to reduce the chance of band related complications such as slippage. Generally the only difference between women that have had bariatric surgery and women that haven"t is that bariatric surgery patients may have the need for more scans to track fetal growth.
Further research has suggested that gastric bypass patients have a slightly increased risk of caesarean section delivery although the reason is not clear.

Ultimately, the improved pregnancy outcomes make bariatric surgery a realistic and practical option for otherwise healthy obese women who wish to expand their families.