Pregnant Just 11 Weeks After Bariatric Surgery: How Touro Helped One Mom Navigate a High-Risk Pregnancy
- Category: Women's Health, Weight Loss, Pregnancy
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Ashley Walker, 34, knew she was in for a difficult pregnancy as soon as she saw the positive result on her pregnancy test on September 6, 2025.
For the past several years, she had battled numerous health challenges, including sleep apnea, hypertension, prediabetes, asthma, seizures, pneumonia and a blood clot in her lung. A mother of three children, ages 14, 11 and 6, Ashley had just started a new job after spending nine years as a medical assistant.
“The day after my last day of work, my daughter mentioned her period had come, and I thought, wait - mine never came,” Ashley said. “I took a test, and it came back positive."
But what concerned Ashley most was the timing of her pregnancy. Just 11 weeks earlier, on June 19, she had undergone gastric sleeve surgery, a weight-loss procedure that reduces the size of the stomach.
A health crisis that led to a life-changing decision
Ashley’s health concerns date back to 2023. One night, her sleep apnea caused her to stop breathing, and her body responded with a seizure. During it, she vomited and aspirated into her lungs.
"I was in respiratory failure because of the aspiration," she said. "I was only breathing at about 80%."
Chest X-rays revealed pneumonia and a blood clot in her lung. During the same hospitalization, she also tested positive for COVID-19. Ashley was placed in a medically induced coma and intubated in the intensive care unit (ICU) and remained hospitalized for about seven days.
Although she survived the medical emergency, the experience left her with a lingering fear.
"I was afraid to go back to sleep," she said. "Because if I go to sleep and have another seizure, I might not wake up."
Over the next two years, Ashley sought help from several specialists to address her physical and mental health. She worked with a psychiatrist and therapist for depression and anxiety, a hematologist for her blood clot history, and a pulmonologist for her asthma. A sleep study confirmed severe sleep apnea.
"I was overweight at the time. I was on the obese side," Ashley said. "But I didn't realize being obese would cause this many health issues for me."
She tried a GLP-1 medication first. However, she experienced difficult side effects, achieved only modest weight loss, and eventually lost insurance coverage for the medication. So, she looked into weight loss surgery instead, and she had the gastric sleeve procedure in June 2025.
"The surgery went well. It went wonderful," she said. "I kind of didn't realize that once my weight came down, my fertility would increase."
Her medical history also complicated her birth control options. Because of her blood clot history, Ashley couldn't use the common types, which left her very few options.
"Worrying about pregnancy wasn't a thing for me and my husband at the time," she said. "Then September came."
Navigating pregnancy after bariatric surgery
Ashley didn't wait for an appointment. She sent a message through the LCMC Health patient portal to Stacey L. Holman, MD, her OB/GYN, laying out everything at once: the seizures, the clot, the medications, the bariatric surgery she'd had eleven weeks earlier, and the unexpected pregnancy test.
"I told her, I just had surgery, and now I'm pregnant, and I don't know what I'm going to do," Ashley said. "But all I know is, I want a healthy baby. How can I make that happen? And I trusted her to guide me in the right direction."
Her original appointment was weeks out. Recognizing the complexity of Ashley's pregnancy, Dr. Holman arranged to see her sooner.
Dr. Holman is a Professor of Obstetrics and Gynecology with LSU Health. She currently serves as the Division Director for Women’s Services at Touro. Her interest in comprehensive patient-centered obstetric care also guides her work with the Louisiana Perinatal Collaborative, a statewide quality initiative to reduce maternal morbidity and mortality. Her experience in maternal health and high-risk pregnancies would play an important role in guiding Ashley's care.
Ashley expected to be told she was an unusual case. Instead, she learned that pregnancy after bariatric surgery is far more common than she realized.
“When I looked it up, I thought, I didn’t know this was something that happens this often,” she said.
She and her husband, Alfred Stewart, decided to move forward. Ashley’s focus narrowed to one thing.
“My main concern was the baby’s health. I didn’t want to bring a sick baby into the world. I didn’t want to cause my baby to suffer,” she said. “But how can I make that happen when my stomach is so small now, and I can barely consume any food? How can I nourish my baby?”
Managing severe nausea, dehydration and blood clot risks
Ashley's pregnancy presented challenges from beginning to end.
The nausea and vomiting didn't stop after the first trimester. They continued throughout her pregnancy, making it difficult to eat enough food and stay hydrated.
"I would eat a small portion, not even a whole meal, and I would still throw it back up," Ashley said. “I often wondered if the baby was getting what he needs to grow."
Her care team, consisting of Dr. Holman as well as the LSU Maternal Fetal Medicine specialists, developed a treatment plan to manage her symptoms and address her underlying health conditions. Ashley was on multiple anti-nausea medications, along with medication for acid reflux, prenatal vitamins, and antidepressants. Because of her history of pulmonary embolism, she also started Lovenox, a blood thinner, to reduce the risk of another clot.
"I thought I was going to be doing an injection once a week," she said. "No. I had to stick myself daily. Every afternoon."
Hydration became its own problem. Because her stomach could accommodate only small amounts at a time, Ashley struggled to balance eating and drinking enough fluids.
"It was a choice," she said. "Either you're going to eat some food right now, or drink liquid. But you can't do both."
When dehydration triggered contractions, Dr. Holman and Ashley discussed getting to the hospital on several occasions for intravenous (IV) fluids.
Despite these challenges, regular monitoring throughout her high-risk pregnancy continued to provide reassuring news: Her baby was growing and developing normally.
"They kept telling me he's growing, he's fine," Ashley said. "But it was always in the back of my head. Is he getting enough?"
The part no one prepares you for
About halfway through her pregnancy, Ashley hit a wall that had nothing to do with her stomach or her blood. She faced another serious challenge: her mental health.
"I felt really, really depressed, and I felt like my antidepressants weren't helping me," she said. "My emotions weren't where they needed to be. And I felt scared for myself and for the baby."
She had suicidal thoughts. What she remembers most clearly is the distinction her mind kept making.
"I knew I didn't want to hurt my baby," she said. "But I didn't want to live. I was asking, can y'all just take the baby out now? Because mentally, I can't."
Ashley sought care at Touro, where the obstetric care team recognized the seriousness of her symptoms and arranged for her transfer to an inpatient mental health facility for focused treatment and medication adjustments.
"They took good care of me there," she said.
Following treatment, Ashley's mental health improved significantly. She began seeing Dr. Holman and her psychiatrist more frequently, allowing her care team to closely monitor both her emotional and physical well-being. They came up with a plan that worked for her.
"That's one thing I really, really loved, being able to have all of my doctors on the same page," Ashley said. "Working together with the same goal: my health and baby's health."
Welcoming baby Avery at 36 weeks
Ashley's due date was May 23. A Cesarean section was already scheduled for 37 weeks because she had undergone three previous C-sections. Her medical team hoped to give Avery additional time to develop before delivery.
However, at 36 weeks, Ashley began experiencing contractions that prompted her to seek care at Touro's Family Birthing Center.
Dr. Holman wasn't on call that day but delivery was imminent. Andrew C. Jones, MD, also an LSU faculty obstetrician, performed the C-section. Although Dr. Holman was unavailable to perform the delivery, Ashley, awake for the whole thing, said the handoff didn’t shake her confidence for a second.
"Even though Dr. Holman wasn't the one doing the procedure, I was comfortable with the staff she had there, because they all work together," she said. "The nurses, the anesthesiologists, everybody works together."
Dr. Holman also visited Ashley and Avery following the delivery to check on their well-being.
Avery was born on April 29 at 7 pounds, 5 ounces. Even though he was four weeks early, he was her biggest baby by nearly a full pound.
"Just imagine if I would have kept him in all the way until May," Ashley laughed. "He would have been nine pounds."
Because Avery was born before 37 weeks, he was considered a late-preterm infant and underwent additional screenings and evaluations before discharge. These included heel-stick screenings and a car seat tolerance test in the neonatal intensive care unit (NICU) to ensure he could safely travel home.
"Other than that, he was completely fine," Ashley said. "He was eating okay. He was completely healthy."
Two details from that hospital stay stuck with her. The first was Touro's breastfeeding and lactation support team.
"The lactation specialist was really, really helpful with assisting with breastfeeding," Ashley said. "I'm still breastfeeding now, and this is the longest I've ever breastfed."
She tried with her three older children, and it lasted a week, maybe a month. “Avery is four months old and still nursing. I feel like the assistance they give there stands out."
Another memorable part of her hospital experience was a special celebration dinner provided to new parents before discharge.
"They provide a celebration dinner for mom and dad the day before you leave, where you get to pick the meal," she said. "They deliver it when they deliver the food trays. It's nice. It's really nice."
An unexpected complication after delivery
Just when Ashley thought the most difficult part of her journey was behind her, she experienced another serious medical complication.
Four days after delivery, Ashley's blood pressure started climbing and wouldn't come down. At her scheduled visit with Dr. Holman, she was sent straight to the emergency room, where she was diagnosed with postpartum preeclampsia, a potentially dangerous condition involving high blood pressure that can develop after childbirth.
"I didn't know that women deal with preeclampsia after delivery as well," she said. "I thought it only happened while you're pregnant. But no, it happens after as well, and it can be dangerous."
Thankfully, after two days in the hospital, Ashley's blood pressure improved for her to go home.
Grateful for coordinated care
Looking back on her pregnancy, delivery and postpartum recovery, Ashley credits the collaboration among her medical specialists for helping her navigate one of the most challenging periods of her life.
Her care involved a multidisciplinary team, including Dr. Holman, the LSU OB/GYN resident team, Touro lactation consultants, MFM nurse practitioner Angela M. Bradley-Byers, DNP, and specialists in MFM, psychiatry, hematology, cardiology, and bariatric surgery. A remote blood pressure monitoring program also helped support her care after she returned home.
For Ashley, knowing that her providers were communicating and working together gave her confidence during a pregnancy filled with uncertainty.
"For the labor and delivery staff and the doctors there: thank you for all that you are doing, providing excellent, amazing care to expecting mothers," she said. "What they're doing is a wonderful thing. When you're pregnant, you're so vulnerable, and they make sure that you're not just physically okay, but mentally okay, too."
To learn more about the coordinated, multidisciplinary care available at Touro, designated as a Level 4 Maternal Levels of Care birthing facility, and across the LCMC Health network, visit:
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