What to do if hemoglobin is low during pregnancy

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There’s a lot to think about when it comes to body changes during pregnancy. Although every pregnancy is different, there are a few things most people can expect, including an increased risk for anemia.

This condition occurs when you don’t have enough red blood cells to carry oxygen to the tissues in your body. Mild anemia may make you feel exhausted, but it can also become serious if it becomes too severe or is left untreated.

In fact, anemia during pregnancy can lead to a higher risk of premature birth, low birth weight, and even maternal mortality.

Understanding more about different types of anemia, common symptoms, and treatment options will help you recognize the warning signs of anemia so you can avoid complications.

Don’t fret, though. Just keep your healthcare team updated on all your symptoms, and they’ll help you along the way. Let’s learn more about anemia during pregnancy.

While mild anemia is common for many people during pregnancy, it can become a serious problem that requires more advanced medical treatment if left unmanaged.

When you lack sufficient red blood cells to move oxygen throughout your body, it has an impact on your organs and bodily functions.

There are more than 400 kinds of anemia. There are also many different causes, but it often comes down to red blood cell production and health.

By contrast, physiological anemia (or dilutional anemia) is a normal process associated with pregnancy.

While the overall blood volume increases during pregnancy, the liquid (or plasma) volume increases more than the increase in the red blood cell volume. The result is a lower percentage of red blood cells in the overall blood volume — a change that is reflected in a blood test.

Iron-deficiency anemia

In the United States, a lack of iron stores before and during pregnancy leading to iron deficiency is the most common culprit of anemia.

With this type of anemia, the lower iron stores lead to reduced production of hemoglobin (the oxygen-carrying component of the red blood cell).

During pregnancy, your body works harder to provide the right nourishment for your growing baby, causing blood volume to increase by about 45 percent. And that’s where that physiological anemia might come into play.

Your body also provides baby with the iron needed to make their own hemoglobin. Go, baby, go!

This increase in your blood volume and production of baby’s hemoglobin allows for more transportation of vital oxygen and nutrients, but it increases the daily requirement for essential minerals like iron.

Folate-deficiency anemia

Folate-deficiency anemia is another common kind of anemia that occurs during pregnancy.

Folic acid is a water-soluble vitamin that helps prevent neural tube defects, or cognitive brain problems, during pregnancy.

People with a vagina need higher levels of folate during their reproductive years and in pregnancy, which is why it’s often recommended to take a folic acid supplement even before trying to get pregnant.

Vitamin B12 deficiency

Vitamin B12 is also used by the body in the production of red blood cells.

Vitamin B12 is found primarily in fortified foods and animal products like meat, fish, poultry, and eggs.

For this reason, people with a vagina who don’t regularly consume these foods, including vegans and vegetarians, may be at a higher risk of deficiency.

Some people may have also difficulty processing B12, which can lead to a deficiency as well.

Folate deficiency and vitamin B12 deficiency often occur together. If you think you may have a deficiency, your healthcare provider will need to look at lab values to determine what type of anemia you have.

In most cases, anemia is preventable during pregnancy, especially with a diet rich in good nutrition.

Here are some ways to make sure you’re getting the necessary vitamins and minerals to keep your red blood cell levels within the right range.

1. Prenatal vitamins

Prenatal vitamins typically contain most of the micronutrients that you need during pregnancy, including iron and folic acid.

Taking a prenatal vitamin once a day is an easy way to help supplement a healthy diet with essential vitamins and minerals for sufficient red blood cell production. It’s ideal to start a prenatal vitamin at least 2 to 3 months prior to trying to conceive.

2. Iron supplements

If you have low iron levels, your doctor may recommend a separate iron supplement in addition to your daily prenatal vitamin.

Typically, pregnant people need around 27 milligrams of iron daily.

However, the dose can vary depending on the type of iron or iron supplement consumed, so it’s best to talk to your doctor about how much you need.

You should also avoid taking calcium supplements around the same time as iron supplements, as calcium may prevent your body from properly absorbing iron.

Antacids can also interfere with proper iron absorption. Be sure to take iron 2 hours before or 4 hours after you take antacids. Taking your iron supplement with vitamin C will help your body absorb more of the iron. Some supplements even include both to make it easier.

3. Proper nutrition

Most people can get sufficient amounts of iron and folic acid during pregnancy by eating the right foods. Good sources of these essentials minerals include:

• poultry
• fish
• lean red meats
• beans
• nuts and seeds
• dark leafy greens
• fortified cereals
• eggs
• fruits like bananas and melons

Animal sources of iron are the most easily absorbed. If your iron is coming from a plant-based source, pair it with foods high in vitamin C, like tomato juice or oranges, to help increase absorption.

Sometimes, supplementing with oral iron is not enough to raise iron levels. In that case, your doctor might talk with you about other therapies.

In some cases, intravenous supplementation of iron or a blood transfusion may become necessary.

While mild cases of anemia may have no symptoms at all, moderate to severe conditions may present with the following symptoms:

• excessive fatigue or weakness
• pale skin
• shortness of breath, heart palpitations, or chest pain
• lightheadedness
• cold hands or feet
• cravings for nonfood items like dirt, clay, or cornstarch

You may experience all or none of these symptoms if you have anemia during your pregnancy.

Fortunately, blood tests to screen for anemia are usually routine during prenatal care. You can expect to be tested early in your pregnancy, and usually once more as you move closer to your due date.

A complete blood count (CBC) test is the most common tool used to diagnose anemia, which is a group of tests that measure the size and number of blood cells in a sample.

If you are diagnosed with anemia, your doctor may also use other blood tests to evaluate the specific cause or identify any nutrient deficiencies.

Be sure to speak with your doctor right away if you’re concerned about any of the symptoms listed here or if something feels wrong.

If you’re pregnant or trying to become pregnant, be aware of the importance of sufficient amounts of iron, folic acid, and vitamin B12.

Follow a well-rounded diet, take prenatal vitamins, and speak with your healthcare provider if you’re experiencing symptoms of anemia.

If you do have an iron deficiency, your doctor can recommend the right course of treatment for you and help decide whether supplementation is necessary.