Pregnancy Prevention
Your body may not absorb oral forms of contraception (e.g., “the pill”) after total gastrectomy, which means oral contraceptives may not prevent pregnancy. If you do not want to become pregnant, discuss other forms of contraception, such as intrauterine devices or implanted devices, with your health care team and OB/GYN.
Pregnancy After Total Gastrectomy
Preimplantation genetic testing (PGT)
PGT is a medical procedure that allows people who carry the version of a gene that causes an illness to screen embryos and ensure that a child will be born without that gene variant. The PGT process can be a part of in vitro fertilization (IVF). For more on PGT, see “Genetic Testing and HDGC.“
Nutrition before pregnancy
Good nutrition is important for fertility and for a healthy pregnancy. Good nutrition is also needed to prevent micronutrient deficiencies, to reach a healthy weight before pregnancy, to support healthy pregnancy weight gain, and to support fetal growth and development. See “Diet and Nutrition After Gastrectomy: What You Should Know” for more details on nutrition after total gastrectomy.
Weight
Because your weight will drop and may not stabilize until 6-12 months after total gastrectomy, current guidelines recommend waiting at least that long, or until weight is stable, before trying to become pregnant.
Recommendations for weight gain during pregnancy are available here: Weight Gain During Pregnancy from the CDC.
Talk to your health care team about your specific weight goal prior to and during pregnancy.
Calorie and macronutrient intake
Calories are a common unit of measurement for the amount of energy a food provides you. Macronutrients are the types of nutrients your body needs in large amounts. The three main types of macronutrient are carbohydrates, proteins and fats. You can find the calorie, carbohydrate, protein and fat content of a food on its Nutrition Facts label.
In the first trimester, people with a healthy body mass index (BMI) may not need to increase their calorie intake. In the second and third trimester, those with a pre-pregnancy BMI in the normal range need an additional 350-450 calories per day from nutritious foods and drinks. If your BMI is in the overweight or obese range, you need fewer additional calories per day. Talk to your dietitian and health care team about your calorie goals during pregnancy.
Post-gastrectomy symptoms, such as early satiety (feeling full quickly), lack of hunger cues and changes in nutrient absorption can make it difficult to eat enough to gain the necessary weight for a healthy pregnancy after total gastrectomy. Additional pregnancy symptoms, such as nausea, may make it even harder to gain weight.
See “Diet and Nutrition After Gastrectomy: Your Plan” for tips on getting more calories and protein. Talk to your dietitian if you have trouble getting enough nutrition to meet your weight goals.
Micronutrients
Micronutrients are the vitamins and minerals needed by your body in small amounts. Even if you only need a little bit of each, these nutrients are critical for your health.
Total gastrectomy increases the risk of multiple vitamin and mineral deficiencies, including, but not limited to, deficiencies of:
- Iron
- Vitamin B12
- Calcium
- Fat soluble vitamins A, D, E and K
- Thiamine (vitamin B1)
- Folate
- Zinc
These vitamins and minerals are not only important for your overall health, they are also very important for fetal growth and development.
Specially formulated vitamins, referred to as bariatric vitamins, result in fewer deficiencies than standard multivitamins after a total gastrectomy. These vitamin supplements are formulated to meet unique micronutrient needs after total gastrectomy. See “Diet and Nutrition After Gastrectomy: What You Should Know” for more information on vitamin supplementation after total gastrectomy. Talk to your dietitian and health care team about your specific supplement needs before trying to get pregnant.
Prenatal formulations of bariatric multivitamins are also available to help meet the unique nutrition needs during pregnancy after total gastrectomy. Note: Standard prenatal multivitamins do not meet the micronutrient needs of an individual during pregnancy after total gastrectomy.
Prenatal vitamins provide more folate, iron and B12, among other nutrients than standard vitamins. Most prenatal vitamins provide vitamin A as beta-carotene instead of preformed vitamin A, because too much preformed vitamin A is dangerous during pregnancy.
Available guidelines recommend a specialist obstetric service to monitor micronutrient levels and supplementation during pregnancy. Talk to your dietitian, obstetrician and/or health care team about which specific prenatal multivitamin meets your needs and how to monitor your vitamin and mineral levels during pregnancy.