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Healthy Pregnancy Series: Anemia in Pregnancy

admin February 2, 2011

If you’re new here, don’t forget to check out my other pregnancy posts!

When you’re pregnant, anemia is common.  It often develops in the second and early third trimesters.  For most women, mild anemia is not a concern; however, severe anemia can become a problem.  How do you know if you are anemic, and what should you do about it?

Many doctors will do a blood test at your initial appointment, usually around 8 weeks.  One of the things they’ll check is your hemoglobin (iron levels) to see if you are anemic.  Most doctors are looking for a level around 11 – 12 umol/L (some will say 10 is normal, though it’s on the low side).  Women do tend to be lower than men, on average (up to 30 is still normal). 

As you get further into your pregnancy, though, your blood volume expands rapidly, ending up 50% greater than normal.  This expansion can lead to anemia.  It is common for iron levels to be lower when they are re-tested, typically at the start of the third trimester.  Anemia levels can be checked by a blood draw, or a simple finger prick (and it’s one of the few tests that I recommend for all women).

Why Does Anemia Matter?

Mild anemia may not matter too much, although it’s better if you can get your levels up.  If you are above 10 umol/L, chances are you are in the “okay” category, though levels of 12 and up are even better.

If your levels are low, then your baby (who depends on you for iron) is at risk for anemia during infancy.  You’re also at risk for a low-birthweight baby and pre-term labor.  In addition, there is an increased risk of blood loss during labor, and you may be especially vulnerable to infection.  For these reasons, if you are very low, a homebirth might not be safe for you.  If you are low, your doctor or midwife will recommend some type of supplementation and/or diet changes in order to bring your levels up.

You are at extra risk for anemia if you’ve had heavy periods before pregnancy, are vomiting frequently, or have a history of anemia.  In this case, make sure your levels get checked early and often, and that you are taking the steps below to try to prevent anemia.

Raising Iron Levels

The first thing some of you are thinking is, “But I hate those iron pills!”  You’re right to hate them.  Ferrous sulfate, the type of iron pills that doctors usually prescribe, are very hard to on the stomach.  They often cause stomach cramps, vomiting, and diarrhea.  Some women may experience severe constipation while taking iron supplements.  Many women discontinue them because of the difficult side effects.  (I tried taking them when I wasn’t even pregnant yet and that’s what happened to me! This type of iron is not well-absorbed by the body, anyway.

There are other options, though.

  • Increase iron-rich foods in your diet

Ideally, you’re doing this during your entire pregnancy, whether you’re really anemic or not.  It may prevent the problem entirely.  Grass-fed beef, liver, egg yolks (pastured and raw if at all possible), leafy greens (not as well absorbed as animal sources), oysters, clams, and beans (again, not as well absorbed as animal sources) are all rich in iron.  Focus on eating plenty of beef, liver, egg yolk, and occasionally fish to keep your iron store up.  Don’t forget to read Healthy Pregnancy Super Foods for healthy recipes including these foods, plus sneaky ways to eat them!

Also, please know that calcium blocks iron absorption, so don’t consume these with dairy, bone broth, or other calcium-rich foods if possible (though ironically, calcium and iron are often found in high levels in the same foods, like blackstrap molasses).  Coffee and tea (black and green) also inhibit the absorption of iron, so be careful of your consumption of these, especially with iron-rich foods.

Vitamin C increases the absorption of iron, so eat fresh citrus fruits or other vitamin C-rich foods with your iron.  A smoothie with raw egg yolks and fresh orange juice is a great idea.

Spirulina is a type of blue-green algae and is a whole food supplement that can benefit anyone, but especially pregnant women.  It is high in iron, as well as other trace minerals.  Most women can tolerate large amounts of it to up their levels rapidly.  Taking too much will result in temporary minor stomach cramps and diarrhea; most midwives will tell you to deliberately find out how much it takes to get to this point, then back off just slightly (especially if you need to raise your levels a lot or quickly).

  • Cook in cast-iron pans

While this is a good idea anyway, as cast-iron pans are very safe (unlike modern non-stick pans), food cooked in cast-iron will absorb some iron.  This can help boost your iron levels, too.

  • Drink your pregnancy tea

Many of the herbs in pregnancy tea are very rich in iron.  Consuming a quart a day, especially in your third trimester, is a great idea.  Red raspberry leaf is especially helpful at this time anyway, as it tones and prepares your uterus for birth.

With these steps, hopefully you can prevent or remedy anemia before it becomes a serious problem for you.

Were you anemic in pregnancy?  How did you resolve it?

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6 Comments

  1. This is a great post! I am 16 weeks with my 4th little one. My other 3 pregnancies we pretty much on a normal American diet. We have changed a lot of what and how we eat, and I need all the help I can get with what to do this time around!
    I have a question. I have a cold. Any preggo friendly home remedies?
    Thanks!

    Reply

  2. Thanks for sharing. I enjoy collecting recipes for all around. I really enjoy your blog very much.

    If you are looking for more great recipes check out the link I provided.

    ~Enjoy Everyone

    Reply

  3. I had anemia in each of my pregnancies (6 in all). The biggest problem I had with anemia is that I had difficulty standing because I would get light headed and dizzy. Since I am naturally clumsy, these symptoms in pregnancy are really dangerous. I will say that for the first 3 pregnancies, I took those iron pills and I was sooo sick with them. When I was pregnant the 4th-6th time, I was very careful with my diet and I didn't take the pills. There \were times at the end of my 6th pregnancy that I would not even test as anemic, and I felt really good. I would highly recommend following a high iron diet for all pregnant women who are anemic. It is much better than those pills.

    Reply

  4. Very useful info i too had anaemia during pregnancy i used to eat more iron tablets this link helps to me to suggest good iron food instead of tablets anaemia-during-pregnancy

    Reply

  5. We liked reading this article post along with would definitely agree with anything you said.

    Reply

  6. I’ve done my best to eat a high-iron diet: grass-fed beef daily (no liver though), occasional clams, cooking in cast iron, eggs, pumpkin seeds, hemp, dried apricots, Rapadura in baking, etc, but my iron levels were dropping rapidly. I picked up an iron supplement at the health food store, a ferrous bis-glycinate chelate, that is much more tolerable for me than the RX stuff. And all the research I found on online when I googled “ferrous sulfate vs ferrous bis-glycinate chelate” seemed to indicate that the health food store supplement was absorbed well and more easily tolerated. Just thought I’d share in case anyone is i the same boat!

    Reply

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I’m Kate, mama to 5 and wife to Ben.  I love meeting new people and hearing their stories.  I’m also a big fan of “fancy” drinks (anything but plain water counts as ‘fancy’ in my world!) and I can’t stop myself from DIY-ing everything.  I sure hope you’ll stick around so I can get to know you better!

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