Anemia During Pregnancy: Causes and Treatments

Health Professional

During pregnancy, one of the first bodily changes a woman experiences is the expansion of their blood volume by 20 to 30 percent, according to the American Society of Hematology. Anemia can occur as a result of this change. In fact, about 52 percent of women will become anemic during pregnancy.

What is anemia?

Anemia is a fancy way to say that the amount red blood cells in your body has dropped below a normal number. Anemia can lead to symptoms that are hard to distinguish from pregnancy symptoms and may be easily overlooked. According to the American Society of Hematology, examples of symptoms include:

  • Fatigue
  • Shortness of breath
  • Pale skin
  • Difficulty concentrating
  • Pica (craving non-food items)

Why does anemia happen in pregnancy?

Anemia can strike even when you are doing everything right. Most of the time, anemia is related to normal changes during pregnancy and not complications of pregnancy or other diseases, according to the American Society of Hematology. Sometimes, not consuming enough iron-rich foods can lead to anemia.

You may also have an issue with anemia if you are pregnant with twins, triplets, or more. Sometimes you are already anemic when pregnancy begins; this could be because of poor nutrition, or even having your pregnancies too closely spaced. If your pregnancies are complicated with severe morning sickness, that can also disrupt the absorption of iron.

Testing for anemia in pregnancy

Your midwife or doctor may test for anemia multiple times in pregnancy. You may be tested once in the beginning of pregnancy, typically along with your initial prenatal blood work, and as you enter the third trimester. You may also be tested at other times during pregnancy if you have been previously diagnosed with the disorder earlier in pregnancy or prior to pregnancy.

Treatment for anemia

Treatment for anemia takes a couple of forms. The first is preventive, as more than half of pregnant women are diagnosed with anemia. One of the ways that anemia might best be prevented is with a regular prenatal vitamin.

A prenatal vitamin can be prescribed when you begin to plan for pregnancy. It can also be given at the first prenatal visit. There are both over the counter and prescription prenatal vitamins available. Most women do not require specialty prenatal vitamins, but some do exist for various ailments, including anemia. In addition, supplemental iron may be given, though there is a debate as to how much of this the body actually absorbs. If you are taking prenatal vitamins or iron supplements, avoid antacids, antibiotics, calcium, coffee, and tea for two hours before and four hours after taking them, as these things can block absorption. On the other hand, you can take them with orange juice for better absorption.

Treating anemia through nutrition is another option. For example, you can simply increase your intake of foods that are high in iron. More nutritious options may be better absorbed, such as dried fruits, whole grains, salmon, lean red meat, and legumes, including tofu. You can also buy foods that are fortified with iron, like cereals and grains.

Risks of anemia

The effects of anemia on the body are certainly not fun. It’s difficult to cope with tiredness during pregnancy already, and additional fatigue from anemia can make it nearly unmanageable for many people. Being anemic also puts you and your baby at a greater risk of preterm birth and low birth weight. During and after labor, if you have a hemorrhage and lose a greater amount of blood than normal, you may also need additional interventions like a blood transfusion more quickly.

Postpartum anemia

After you have given birth, your body will take time to heal. Be sure to ask for your doctor or midwife to check your anemia status at your postpartum visit, even if you did not have complications at birth. The bleeding that normally occurs after delivering a baby can leave you further depleted of iron. Continuing anemia treatment for a few months may be recommended until your iron stores are back to normal. If you choose to have another baby, be sure to get your iron levels to a normal level and seek preconceptional health care to ensure that you have the healthiest pregnancy possible.

See more helpful articles:

Seeing Your Doctor for Preconception Care: What to Expect

What Is Prenatal Care?

Top Pregnancy and Fertility Books You Should Read