Anemia in Pregnancy

Anemia is when your blood has too
few red blood cells. Having too few red blood cells makes it harder for your blood to
carry oxygen or iron. This can affect how cells work in nerves and muscles. During
pregnancy, your baby also needs your blood.

Women are more likely to get anemia
during pregnancy if they:

  • Are strict vegetarians or vegans. They
    are at greater risk of having a vitamin B12 deficiency. 
  • Have celiac disease or Crohn’s
    disease, or have had weight loss surgery where the stomach or part of the stomach has
    been removed

Women are more likely to get
iron-deficiency anemia in pregnancy if they:

  • Have 2 pregnancies close together
  • Are pregnant with twins or more
  • Have vomiting often because of morning
  • Are not getting enough iron from their
    diet and prenatal vitamins
  • Had heavy periods before

You can get several kinds of anemia
during pregnancy. The cause varies based on the type.

  • Anemia of pregnancy. During
    pregnancy, the volume of blood increases. This means more iron and vitamins are
    needed to make more red blood cells. If you don’t have enough iron, it can cause
    anemia. It’s not considered abnormal unless your red blood cell count falls too
  • Iron-deficiency anemia. During
    pregnancy, your baby uses your red blood cells for growth and development, especially
    in the last 3 months of pregnancy. If you have extra red blood cells stored in your
    bone marrow before you get pregnant, your body can use those stores during pregnancy.
    Women who don’t have enough iron stores can get iron-deficiency anemia. This is the
    most common type of anemia in pregnancy. Good nutrition before getting pregnant is
    important to help build up these stores.
  • Vitamin B12 deficiency. Vitamin B12
    is important in making red blood cells and protein. Eating food that comes from
    animals, such as milk, eggs, meats, and poultry, can prevent vitamin B12 deficiency.
    Women who don’t eat any foods that come from animals (vegans) are most likely to get
    vitamin B12 deficiency. Strict vegans often need to get vitamin B12 shots during
  • Folate deficiency. Folate (folic
    acid) is a B vitamin that works with iron to help with cell growth. If you don’t get
    enough folate during pregnancy, you could get iron deficiency. Folic acid helps cut
    the risk of having a baby with certain birth defects of the brain and spinal cord if
    it’s taken before getting pregnant and in early pregnancy.

You may not have clear symptoms of
anemia during pregnancy unless your cell counts are very low. Symptoms may include:

  • Pale skin, lips, nails, palms of
    hands, or underside of the eyelids
  • Feeling tired
  • Sensation of spinning (vertigo) or
  • Labored breathing
  • Rapid heartbeat (tachycardia)
  • Trouble concentrating

The symptoms of anemia can be like
other health conditions. Always see your healthcare provider for a diagnosis.

Your healthcare provider will check
for anemia during your prenatal exams. It’s usually found during a routine blood
test. Other ways to check for anemia may include other blood tests such as: 

  • Hemoglobin. This is the part of blood
    that carries oxygen from the lungs to tissues in the body.
  • Hematocrit. This measures the portion
    of red blood cells found in a certain amount of blood.

Treatment will depend on your symptoms, age, and general health. It
will also depend on how severe the condition is.

Treatment for iron deficiency
anemia includes taking iron supplements. Some forms are time-released. Others must be
taken several times each day. Taking iron with a citrus juice, such as orange, can
help your body absorb it better. . Taking antacids may make it harder for your body
absorb  iron. Iron supplements may cause nausea and cause stools to become dark greenish
or black in color. They may also cause constipation.

If you have anemia during pregnancy, your baby may not grow to a
healthy weight, may arrive early (preterm birth), or have a low birth weight. Also being
very tired may keep you from recovering as quickly after birth.

Good pre-pregnancy nutrition not
only helps prevent anemia, but also helps build other nutritional stores in your body.
Eating a healthy, balanced diet before and during pregnancy helps keep up your levels of
iron and other important nutrients needed for your growing baby.

Good food sources of iron

  • Meats. Beef, pork, lamb, liver, and
    other organ meats.
  • Poultry. Chicken, duck, turkey, and
    liver, especially dark meat.
  • Fish. Shellfish, including
    (fully-cooked) clams, mussels, and oysters are good. So are sardines and anchovies.
    The FDA recommends that pregnant women eat 8 to 12 ounces per week of fish that are
    lower in mercury. These include salmon, shrimp, pollock, cod, tilapia, tuna (light
    canned), and catfish. Don’t eat fish with high levels of mercury, such as tilefish
    from the Gulf of Mexico, shark, swordfish, and king mackerel. Limit white (albacore)
    tuna to only 6 ounces per week.
  • Leafy greens of the cabbage
    These include broccoli, kale, turnip greens, and collards.
  • Legumes. Lima beans and green peas;
    dry beans and peas, such as pinto beans, black-eyed peas, and canned baked
  • Yeast-leavened whole-wheat bread and
  • Iron-enriched white bread, pasta, rice,
    and cereals

Experts recommend all women of
childbearing age and all women who are pregnant take vitamin supplements with at least
400 micrograms of folic acid. Folate is the form of folic acid found in food. Good
sources are:

  • Leafy, dark green vegetables
  • Dried beans and peas
  • Citrus fruits and juices and most
  • Fortified breakfast cereals
  • Enriched grain products
  • Anemia is a condition of too few red
    blood cells.
  • Four kinds of anemia can happen during
    pregnancy: anemia of pregnancy, iron deficiency anemia, vitamin B12 deficiency, and
    folate deficiency.
  • Anemia may cause your baby to not grow
    to a healthy weight. Your baby may also arrive early (preterm birth) or have a low
    birth weight.
  • Anemia is usually found during a
    routine blood test for hemoglobin or hematocrit levels.
  • Treatment depends on the type of
    anemia and how bad it is.
  • Good nutrition is the best way to
    prevent anemia during pregnancy.

Tips to help you get the most from a visit to your healthcare

  • Know the reason for your visit and
    what you want to happen.
  • Before your visit, write down
    questions you want answered.
  • Bring someone with you to help you ask
    questions and remember what your provider tells you.
  • At the visit, write down the name of a
    new diagnosis, and any new medicines, treatments, or tests. Also write down any new
    instructions your provider gives you.
  • Know why a new medicine or treatment
    is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated
    in other ways.
  • Know why a test or procedure is
    recommended and what the results could mean.
  • Know what to expect if you do not take
    the medicine or have the test or procedure.
  • If you have a follow-up appointment,
    write down the date, time, and purpose for that visit.
  • Know how you can contact your provider
    if you have questions.