Why This Matters to Us
Before our surgeries, we had already been through four late miscarriages, each between 20 and 23 weeks. It has been one of the most painful parts of our story and not something we share lightly. When we decided to pursue gastric sleeve surgery, one of the reasons was the hope that improving our health would give us a better chance at a successful pregnancy in the future. Obesity is a known risk factor for miscarriage, gestational complications, and adverse pregnancy outcomes. Getting to a healthier weight felt like something concrete we could do.
Two years on from surgery, we are still in the planning stage rather than actively trying. This article explains the clinical reasoning behind that, what the recommendations actually are, and what we have learned along the way.
What the Clinical Guidance Says
The consistent recommendation from bariatric teams, RCOG (Royal College of Obstetricians and Gynaecologists), and specialist literature is to wait at least 12 to 18 months after bariatric surgery before attempting to conceive. Some guidelines suggest waiting up to 24 months. The reasons are clinical and specific.
In the first 12 to 18 months after surgery, the body is in a period of rapid and significant change: weight is dropping quickly, nutritional intake is restricted, hormonal balance is shifting, and the metabolic state is essentially one of managed stress. A developing baby needs a nutritionally stable environment. The period immediately after bariatric surgery is the opposite of that.
The specific risks associated with conceiving too soon after gastric sleeve surgery include increased likelihood of miscarriage, preterm birth, small-for-gestational-age babies, and nutritional deficiencies in both mother and child. These are not rare edge cases – they are documented outcomes in the published literature on bariatric surgery and pregnancy.
Our Specific Situation
Given our history of late miscarriages, the standard advice to wait has felt not just sensible but essential. We were not going to try to accelerate a timeline that was already conservative for the general population, especially given that our losses occurred at weeks when the pregnancies appeared to be progressing.
Kirsten also has Crohn’s disease, which creates additional complexity. Inflammatory bowel disease can affect nutrient absorption independently of the sleeve, and during a flare it reduces the body’s ability to absorb the folate, iron, and vitamin D that are particularly important in early pregnancy. Managing Crohn’s into a stable remission before conception is part of our preparation.
We went through a nutritional deficiency crisis ourselves at around month eleven – fatigue, brain fog, cold intolerance – which showed us how easy it is for levels to slip and how long it takes to correct them. That experience reinforced our determination to be genuinely nutritionally stable before adding the demands of pregnancy on top.
What Preparation Actually Looks Like
Two years post-surgery, our preparation for eventually trying to conceive has involved consistent six-monthly blood panels, supplementation adjusted based on results, working with our GP on a joined-up plan that involves our bariatric team and gynaecologist, and Kirsten’s ongoing Crohn’s management.
The specific nutritional focus areas are folate (critical for neural tube development), iron and ferritin, vitamin D, B12, calcium, and omega-3. All of these are commonly depleted after bariatric surgery and all of them matter in pregnancy. We want levels to be solidly within healthy range, not just technically not deficient, before we consider trying.
The other preparation is mental. Four late miscarriages leave marks. We are approaching the next attempt with as much clinical preparation as we can, and also with realistic expectations about what we can and cannot control.
What We Know Now That We Did Not Know Then
When we first wrote about this topic, we were a year and a half out from surgery and thought the timeline might be coming soon. Two years on, we are glad we continued to wait. The nutritional foundation is stronger. Kirsten’s Crohn’s is better managed. We feel more settled in the habits that will need to continue through a pregnancy: consistent supplementation, regular monitoring, good protein intake, and the discipline to maintain those things when the demands of early pregnancy make eating harder.
For anyone researching this topic before or after their own surgery – every situation is different, and our experience includes factors that most people will not share. But the core clinical message applies broadly: give your body the time it needs to stabilise before adding pregnancy to the equation. That advice exists for good reason, and our experience has only reinforced it.
Sources
RCOG (Royal College of Obstetricians and Gynaecologists) – Information for women considering weight-loss surgery before or during pregnancy
BOMSS (British Obesity and Metabolic Surgery Society) – Patient pathway and commissioning guidance for bariatric surgery
Johansson K et al. – Outcomes of pregnancy after bariatric surgery (New England Journal of Medicine, 2015)
Mechanick JI et al. – Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures – 2019 Update (Surgery for Obesity and Related Diseases, 2020)
NHS – Obesity and pregnancy (nhs.uk)
About this content
This blog is written by James and Kirsten, a couple from the UK who had gastric sleeve surgery together in March 2024.
We started this blog because we couldn't find any sources of content that details before surgery, the surgery and then life post surgery - so we decided to write one ourselves.
Everything on this site is based on our own experience and the research we have done along the way. It is not medical advice. Gastric sleeve surgery is a serious procedure and every patient's journey is different. Please always consult your own bariatric team or GP before making any decisions about your health or treatment.
Some posts on this site may contain featured or sponsored content, or affiliate links. Where this is the case, it will always be clearly stated at the top of the article. Our opinions are always our own.
Publish Date: 25 August 2024 | Last Reviewed: 7 June 2026 | Next Planned Review: 7 December 2027