Anemia, Iron Deficiency, in Pregnancy

So, you have Anemia? There are options. Odds are, if you ask a few friends, there’s a high chance you will find others who have navigated low iron levels before. Ask your healthcare provider. Ask your doula. Ask your childbirth educator. Ask your friends. Normalize talking about it.

Anemia, or low iron in the blood, is very common, with up to 40% of pregnant people experiencing it globally, from the World Health Organization. More than mild anemia untreated can be concerning as it can put your baby at higher risk for anemia, leading to early or low birth weight and developmental issues.

The good news is there are many ways to treat anemia! There are various medications, treatments, and diet changes that can range in protocol per person.

First, what does having anemia during pregnancy really mean?

Anemia in Pregnancy

When growing a baby, your body makes A LOT more blood to give to the baby.

Since you need more iron to transport sufficient oxygen to your baby, not having enough iron stored or not getting enough iron during pregnancy could lead to deficiency, or anemia.

Some symptoms of Anemia

Fatigue

Weakness

Dizziness or lightheadedness

Headache

Pale or yellowish skin

Shortness of breath

Craving or chewing ice

Low blood pressure

What is the difference between Hemoglobin and Ferritin?

You may hear your healthcare provider talk about your hemoglobin and ferritin levels and how important it is to know both.

Hemoglobin is a protein in your red blood cells that transports oxygen to tissues throughout your body. The iron in your body is used to make hemoglobin.

Low hemoglobin can be caused by low iron levels from not getting enough iron in your
diet; thus is known as iron deficiency anemia.

Symptoms of low hemoglobin include fatigue, weakness, shortness of breath, body
aches, brittle nails, some paleness, cold hands and feet, maybe feeling down, depressed,
or more anxious than usual.

Ferritin is a protein that stores iron inside the cell. So, this is how much iron you already have, or are storing up.

We want to keep that number up! (check out some of the recommendations below)

Symptoms of low ferritin can look very similar, but could also include hair loss,
hypothyroidism, depression, and inflamed bowels.

High ferritin and low hemoglobin levels can indicate iron overload while 

Low ferritin and low hemoglobin levels can indicate iron deficiency.

Many of these symptoms overlap with each other as well as general pregnancy symptoms, you can check with your doctor to have blood tests to check for anemia during your pregnancy.

Since you need blood stores to be high enough during birth to restore the blood that you lose, we want to work on this ahead of time ~ and there are many ways to!

History of Gastric Bypass Surgery//Iron Infusions

If you have a history of gastric bypass or small bowel surgery or are unable to take iron
supplements, you may be recommended to receive iron infusions through an IV.

Often, instead of, or in addition to, supplements or diet change, iron infusions are
recommended by healthcare providers to prevent complications from anemia during
pregnancy. As iron supplements could be difficult to digest, iron transfusions could be
preferred for the second or third trimester. Usually, iron infusions include one or more
sessions and could take up to 3 or 4 hours.

Iron infusions can be more expensive than other anemia treatments and take time. They
could include some side effects including headaches, nausea, itchiness, and change in
heart rate. There are rare, but serious issues that could arise from iron infusions such as
iron toxicity. Typically, your healthcare provider will do a test dose very slowly to prevent
this from happening.

Benefits of an iron infusion later in pregnancy is that it increases iron levels in the body quickly which can increase your energy and make it easier to breathe. You would start seeing these changes within a few weeks after your final infusion. Combining iron treatments can also increase iron absorption and have prolonged benefits.

Treatment and Prevention

Much of low iron treatments look similar, if not the same, to prevention methods.

• Make sure you're getting enough iron, B12 and folic acid

• Prenatal vitamins everyday (with a recommendation from healthcare provider)

• Some high iron foods: leafy greens, lean meats, legumes, dried fruit, and fortified cereals

• Iron absorbs best with vitamin C. Include vitamin C rich foods in your diet such as oranges, strawberries, and bell peppers

• Having an acidic gastrointestinal environment can help adequately dissolve and absorb iron supplements. Many clinicians and studies suggest that taking Vitamin C with iron supplements can help absorb iron as Vitamin C helps create that acidic gastrointestinal environment!

• Now, you get to explore with different meals and snacks! If you like to cook - find some yummy protein rich recipes you want to try out!

• Check out the protein bar section at the store and find some yummy flavors that you could put on your bedside for a protein rich 3am snack when you wake up a little hungry! - yum!

You’ve got this! Think like a bodybuilder - Pump those irons!

Written by Sarina Abraham, Doula at Sweet Willow Birth, www.sweetwillowbirth.com