Anemia and Pregnancy

Your body goes through significant changes when you become pregnant. One change is the amount of blood in your body increases by about 20% to 30%. This increases the amount of iron and vitamins needed to make hemoglobin, the protein in red blood cells that carries oxygen to other cells in the body.

During pregnancy, the need for iron grows to ensure there is enough for you, your baby, and the placenta. This is an organ that forms during pregnancy to provide oxygen to the developing baby. When your body needs more iron than it has available, you can become anemic. Nearly 60% of women have low levels iron, regardless of whether they are pregnant or not. Women with pre-existing iron deficiency are more likely to become anemic earlier in pregnancy.

Mild dilutional anemia is normal during pregnancy due to an increase in blood volume. More severe anemia, however, can put your baby at a greater risk for anemia later in infancy. In addition, if you are significantly anemic during your first two trimesters, you are at greater risk for having a preterm delivery or a baby with low birth weight. Being anemic also increases the mother's risk of blood loss during labor and makes it harder to fight infections.

Symptoms of Anemia

Many of the symptoms of anemia during pregnancy are also symptoms you may experience even if you are not anemic. These include:

  • Feeling tired or weak
  • Skin getting paler
  • Rapid heartbeat
  • Shortness of breath
  • Trouble concentrating

Doctors typically screen for iron deficiency anemia with complete blood count in first trimester and often in later second trimester to optimize for delivery. Additional iron studies or other evaluations may be needed.

Am I at Risk for Anemia?

You are at greater risk for becoming anemic during your pregnancy if you:

  • Have two pregnancies close together
  • Are pregnant with more than one child
  • Are vomiting frequently due to morning sickness
  • Do not consume enough iron
  • Had a heavy pre-pregnancy menstrual flow
  • Have a history of known iron deficiency

Is Pregnancy-Related Anemia Preventable?

Good nutrition is the best way to prevent anemia if you are pregnant or trying to become pregnant. Eating foods high in iron content can help ensure that you maintain the supply of iron your body needs to function properly:

  • Dark green leafy vegetables
  • Red meat
  • Fortified cereals
  • Eggs
  • Peanuts

Your obstetrician will also prescribe vitamins to ensure that you have enough iron and folic acid. Make sure you get at least 27 mg of iron each day. If you do become anemic during your pregnancy, it can usually be treated by taking additional iron supplements or by getting intravenous iron.

Women with a history of bariatric surgery should talk to their obstetrician about taking vitamin B12 supplements because they are at a higher risk of becoming deficient — leading to pregnancy-related anemia as a result.

Ask your doctor about your risk for anemia and make sure you are tested at your first prenatal visit. You also may want to get tested in the third trimester and at four to six weeks after delivery. Depending on your condition, your doctor may refer you to a hematologist, a doctor who specializes in blood conditions.

Read More on Iron Deficiency Anemia in Pregnancy

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