Anemia is a condition where there are not enough oxygen-carrying components (called hemoglobin) in a person’s red blood cells, or there are not enough total red blood cells in the body. This condition is concerning for all individuals, but in pregnancy it can cause particular problems such as: low birth weight, preterm birth, low iron stores in babies, and increased susceptibility to infection. It can also cause complications from bleeding following birth, and can increase rates of maternal mortality.
It is important to understand that your blood stream is what is responsible for carrying oxygen to your baby, and that if you do not have enough red blood cells, or they cannot carry very much oxygen, then the circulation to your baby becomes increasingly compromised (not good!).
Some symptoms of anemia include: weakness, fatigue, dizziness, shortness of breath, rapid or irregular heartbeat, chest pain, pale skin, lips, and nails, cold hands and feet, and trouble concentrating.
How can we tell if you are anemic?
We can tell if you have anemia by doing lab tests during your pregnancy to check your hemoglobin and red blood cell levels. These tests are done at your first midwifery visit, and again at 28 weeks gestation (since your blood volume expands and changes throughout your pregnancy). We may also test you at 6 weeks postpartum.
One of the criteria for birthing safely outside of the hospital in Oregon is whether or not you are anemic. If your first blood tests show that your hematocrit is less than 33, or your hemoglobin is less than 11, we will recommend additional supplements to help bring up your iron levels in time for birth. This, alone, does not require you to see a physician but we will still recommend treating your anemia.
A hematocrit of less than 30 at your 36th week gestation or hemoglobin less than 10 gms/100 ml means we must have a more thorough conversation about the risks out-of-hospital birth may pose you and your infant, and transfer may be necessary. In addition, we will likely need to consult with a physician about your case. If we cannot get you in for a consult prior to labor, or if the physician feels you are no longer a candidate for a safe out- of-hospital birth we will recommend delivery in the hospital. You may return to our clinic postpartum care!
Anemia can be caused by a variety of factors, but the most common reasons in pregnancy are vitamin B12 deficiency and iron deficiency. This can be easy treated with diet changes and supplements and we will work with you to improve your blood-work throughout the course of your pregnancy!
Food as Medicine
One of the simplest and most effective ways to treat anemia in pregnancy is to regularly eat foods which are rich in Iron and vitamin B12. Pairing these foods high in vitamin C also aids in the absorption of iron. You can also intentionally cook your foods in cast- iron cookware to increase their iron content (the iron from the pan leaches into foods, particularly acidic ones like tomato sauces).
Some great foods to make sure you are eating regularly are: