Your body goes through significant changes when you become pregnant. The amount of blood in your body increases by about 20-30 percent, which increases the supply of iron and vitamins that the body needs to make hemoglobin. Hemoglobin is the protein in red blood cells that carries oxygen to other cells in your body. Iron is required to make hemoglobin. Many women lack the sufficient amount of iron needed for the second and third trimesters. When your body needs more iron than it has available, you can become anemic. You may feel more tired than usual (which usually isn’t the case in the second trimester). Many of the symptoms of anemia during pregnancy are also symptoms you may experience even if you are not anemic; these include:

• Progressive paleness of the skin
• Rapid heartbeat
• Shortness of breath
• Trouble concentrating

Mild anemia is normal during pregnancy due to an increase in blood volume. More severe anemia, however, can put your baby at higher 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 pre-term delivery or low-birth-weight baby. Being anemic also burdens the mother by increasing the risk of blood loss during labour and making it more difficult to fight infections. There is no evidence that maternal anemia increases the risk of congenital anomalies in offspring.

Am I at Risk?

You are at higher 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 (ie have a restricted diet)
• Have a heavy pre-pregnancy menstrual flow

Your doctor will perform a couple of tests throughout pregnancy to check the amount of hemoglobin in your blood. These are indicators of whether you are at risk for becoming anemic.

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 (such as dark green leafy vegetables, red meat, fortified cereals, eggs, and peanuts) can help ensure that you maintain the supply of iron your body needs to function properly. 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 iron supplements.

Since most women do not have adequate iron stores to handle the demands of pregnancy, iron is commonly prescribed as part of a prenatal multivitamin or as a separate supplement.

New recommendations suggest all women should take iron in the third trimester to prevent the inevitable deficient iron stores at delivery: ferrous fumarate 300 mg taken as a single pill at bedtime, on an empty stomach, with a glass of orange juice or 500 mg of vitamin C, is the most efficient way to replace iron stores.

Physiologic anemia of pregnancy should resolve by six weeks postpartum since plasma volume has returned to normal by that time.