Globally, obesity is on the rise, and an estimated 41% of women ages 20-39 are considered obese in the United States. This age range is when most women become pregnant. To combat obesity, many women turn to bariatric procedures to help them achieve a healthier weight and reduce their comorbidities, such as diabetes and osteoarthritis.

Weight loss is especially significant for women who are intending to become pregnant, as obesity can cause infertility and may lead to several complications during pregnancy. When lifestyle measures like diet and exercise fail, many women try lap band to help them shed the pounds. Here is what you need to know about a lap band and pregnancy.

What is a lap band?

Also known as gastric banding, a lap band is a medical device that helps people lose weight. A gastric band is a silicone band placed around the upper portion of the stomach to create a small pouch. Decreasing your stomach size helps you limit your food intake, which reduces the number of calories you can consume at one time. Lap band also makes you feel full more quickly by sending signals to your brain that your stomach is full capacity.

Lap band is usually placed laparoscopic, which means a bariatric surgeon places the band through small incisions in your abdomen. Your surgeon will also place a port outside your body so that your band is adjustable without surgery. For example, if you are struggling to meet your weight loss goals, your surgeon can conveniently tighten the band to further limit your food intake. Because the band is adjustable and removable, gastric banding has become a popular choice among people seeking significant weight loss.

You can expect to lose a significant amount of weight with a lap band, and most surgeons will recommend you keep the band in place, even when you meet your ideal weight. More often than not, band removal will increase your appetite, and you will be able to eat more. Usually, people who have their band removed regain the weight they initially lost.

How does excessive weight affect pregnancy and childbirth?

Being at a healthy weight is vital to having healthy outcomes for both the mother and baby.

Women who are overweight and obese have a higher risk of complications in pregnancy. Pregnancy complications related to excessive weight gain and obesity include:

• Gestational diabetes
• High blood pressure
• Blood clots
• Higher risk for cesarean section
• Longer labor
• Difficulty assessing baby’s progress during labor with fetal heart monitoring
• High birth weight in infant
• Stillbirth
• Maternal infection
• Postpartum hemorrhage
• Maternal death

Infertility and difficulty conceiving is common in women who are overweight and obese. Fortunately, significant weight loss often resolves issues related to infertility.

How is Lap Band Managed During Pregnancy?

Currently, there is no specific guidance on how best to manage lap band pregnancy. Most providers recommend deflating the lap band during pregnancy because the mother may not be able to take in enough essential nutrients for her growing baby. There may also be a higher risk for nausea, vomiting, gastric reflux, and band slippage due to heightened abdominal pressure from the developing baby. Some providers prefer to leave the balloon inflated throughout the pregnancy, however, it can limit essentiall nutrients for the baby.

Some studies have found that women with a history of weight loss surgery are at risk for higher complications in pregnancy, and their babies are more likely to be born prematurely. If you plan to become pregnant, talk with your bariatric surgeon to see how they manage a lap band and pregnancy.

Is Pregnancy After Lap Band Safe?

A gastric band may be a good option for women with obesity who wish to become pregnant. However, there is still much to be learned about the implications of having a lap band pregnancy.

Generally, most women should wait for one to two years before pregnancy after lap band surgery. People usually experience significant weight loss in the first year of having their lap band, so it is essential to wait until your weight stabilizes. Once you are at a steady weight, a lap band pregnancy is generally safe and can improve your outcomes because your risk for obesity-related complications goes down with weight loss.

There are very few known cases of complications due to a lap band and pregnancy. One documented case of a woman who was six weeks pregnant found early signs of a small bowel obstruction. Her surgeon removed the lap band via laparoscopic surgery to prevent complete blockage of her intestine, and she was able to deliver a healthy child at full term.

What Steps Can I Take to Have a Healthy Pregnancy After Lap Band Surgery?

It is never too soon to start preparing for pregnancy once you are interested in having a baby. Taking these steps can help you have a healthy pregnancy and a healthy baby.

1.Begin your weight loss journey as soon as possible. If lifestyle measures, such as diet and exercise, do not give you the results you need, some bariatric procedures, like lap band, may be safe and increase your likelihood of a healthy pregnancy.

2. If you are not yet ready to become pregnant, talk to your doctor about using a reliable form of birth control, like pills or an intrauterine device. Significant changes in your weight may affect how birth control pills are absorbed. Therefore, it is essential to check your weight regularly and stay in touch with your doctor.

3. If you do become pregnant, make sure to attend all of your prenatal visits. Your doctor will check your weight, urine, vital signs, baby’s size, and heartbeat. At certain check-ups, you may also have ultrasounds and blood work. Regular visits with your OB/GYN will improve outcomes for both you and your baby.

4. Start healthy dietary habits as early as possible. Your bariatric surgeon should help you identify healthy foods to eat to maximize your intake of essential nutrients while decreasing calories. You will want to focus on eating vegetables, some fruits, and foods high in protein, such as lean meat and protein shakes. Working with a nutritionist can be quite helpful, but there are also online resources, including choosemyplate.gov.

5. All women who wish to become pregnant should start taking a prenatal vitamin, even before conceiving. This is because the ingredients in a prenatal vitamin, such as folic acid and iron, are essential for a developing baby.

6. People who undergo bariatric surgery must take supplements to ensure they do not develop a nutritional deficiency. Meet with your bariatric surgeon to develop a personalized vitamin regimen to keep you healthy after lap band surgery and during pregnancy.

7. Develop a regular exercise regimen. Physical activity is important throughout our lives and is especially vital during pregnancy. Make sure to incorporate different types of exercise, including aerobics, strength training, and stretching. If exercise is new to you, or you are not sure where to begin, meeting with an exercise therapist can give you lifelong tools.

8. Take prenatal classes with a person who will support you during childbirth. Prenatal classes can help you prepare for labor, delivery, and postpartum.