HIgh Risk?
It really depends on what practice you go to. The hospital/OB I use has years of experience with post-WLS pregnancies and considers all malabsorption procedures (RNY, DS) automatically "high-risk" since many of you will need repeated blood work through out pregnancy to check your levels and the malabsorption of fats/nutrients may negatively effect the fetus' development requiring more frequent u/s to check growth.
It's probably best to call around and see if WLS= High Risk to your local MWs.
Grats on your pregnancy and Good luck.
It's probably best to call around and see if WLS= High Risk to your local MWs.
Grats on your pregnancy and Good luck.
With Tristan I was 7 months post op and i had a consult with a highrisk OB but they were more concerned with making sure the diabetes I had pre op was really gone than my WLS. Frankly put your stomach is not connected to your uterus. The biggest thing I had to watch was my labs. My OB ran my labs monthly to make sure that all of my vitamin levels were ok since I was so early out. ( I ended up with a c-section)
This time, my OB is the same one, but he is going to let me try for a VBAC.
Perhaps if a midwife won't take you (and some won't because they don't know a lot about wls) maybe you can find an OB who will let you attempt a VBAC.
Good luck and congrats!
This time, my OB is the same one, but he is going to let me try for a VBAC.
Perhaps if a midwife won't take you (and some won't because they don't know a lot about wls) maybe you can find an OB who will let you attempt a VBAC.
Good luck and congrats!
~Victoria
How are your labs and are you able to eat adequate amounts of quality food, especially protein? If your labs are good, you take your vites and eat well, and you're not losing weight really rapidly, I think you might be able to convince a MW practice to take you. Be ready with labs, concerns, and reasons you want midwifery care.
I also was concerned about being risked out of MW care. I want to VBAC too but my major concern wasn't even the WLS, it was the fact I had a chronic hypertension dx in my first pregnancy and it has really stuck to me like glue despite the fact that my BP behaves now. At one point a couple months ago, the MWs were going to transfer me to OB care because I had one high diastolic. I'll be honest, I lost my composure right there in the exam room and cried like a baby. I thought I would be stuck with the OBs, but the MW actually went to the other MWs the next day at their meeting and stuck up for me, saying I was very committed to VBAC and being cared for by midwives. The group consulted with a peri and OBs who said they felt it would be OK for me to be under the care of midwives in this pregnancy! So I guess my advice is to fight for what you want, and if you are going with hospital midwives, try to find a practice that works alongside OBs who are pro-VBAC in case you have to transfer care for some reason. I am delivering at a Level 1 trauma center and the OBs have a fairly low c-sec rate (20%) and are known to support VBAC because the hospital is well-staffed with OBs and anesthesiologists in case of an emergency, so the idea of transferring care doesn't feel as awful as it initially did. Of course, I'd rather stick with the midwives, but I will do whatever needs to be done.
It's important to be flexible, of course, but I hope you can find a good provider or group of providers and have a good pregnancy and birth. There are some studies out there about post-op pregnancy and one abstract I read the other day said that even early post-op pregnancy tends to have good outcomes - that might be something to bring to your appointments!
I also was concerned about being risked out of MW care. I want to VBAC too but my major concern wasn't even the WLS, it was the fact I had a chronic hypertension dx in my first pregnancy and it has really stuck to me like glue despite the fact that my BP behaves now. At one point a couple months ago, the MWs were going to transfer me to OB care because I had one high diastolic. I'll be honest, I lost my composure right there in the exam room and cried like a baby. I thought I would be stuck with the OBs, but the MW actually went to the other MWs the next day at their meeting and stuck up for me, saying I was very committed to VBAC and being cared for by midwives. The group consulted with a peri and OBs who said they felt it would be OK for me to be under the care of midwives in this pregnancy! So I guess my advice is to fight for what you want, and if you are going with hospital midwives, try to find a practice that works alongside OBs who are pro-VBAC in case you have to transfer care for some reason. I am delivering at a Level 1 trauma center and the OBs have a fairly low c-sec rate (20%) and are known to support VBAC because the hospital is well-staffed with OBs and anesthesiologists in case of an emergency, so the idea of transferring care doesn't feel as awful as it initially did. Of course, I'd rather stick with the midwives, but I will do whatever needs to be done.
It's important to be flexible, of course, but I hope you can find a good provider or group of providers and have a good pregnancy and birth. There are some studies out there about post-op pregnancy and one abstract I read the other day said that even early post-op pregnancy tends to have good outcomes - that might be something to bring to your appointments!
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