Q. I am having trouble deciding whether to have a baby first or gastric bypass surgery. I have no children yet. What is the waiting period? Or the risk of pregnancy after the surgery? I was approved for the surgery today and cannot make up my mind.

A. This is a difficult question, one that you would certainly want to discuss with your obstetrician first. In general, you will have difficulties no matter which you choose. Certainly, massive obesity (one that would justify gastric bypass surgery) is a high-risk state for pregnancy. Both the mother and the child are put at risk for a variety of complications. Likewise, the nutritional impacts of gastric bypass surgery may have an impact on the baby and on the pregnancy.

In general I think it would be better to be pregnant after the bypass surgery than before, though as I stated the final decision should be made with your obstetrician looking at your own particular case.

You can learn more about obesity in general at the following Web site: http://www.naaso.org/

In particular, they have a link there to a large NIH document on obesity. Two Web sites that give a little bit more information on gastric bypass are:

http://www.drrossfox.com/gastrby.html
http://onhealth.webmd.com/conditions/in-depth/item/item%2C2053_1_1.asp

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