Anemia During Pregnancy

    Anemia is defined as not having enough red blood cells. During pregnancy, blood is usually tested at the first prenatal visit and then again at the beginning of the third trimester. The tests for anemia are hemoglobin and hematocrit. Pregnant women with hemoglobin levels below 11.0 g/dl and/or a hematocrit level below 33% are generally considered anemic, though complications and symptoms from anemia during pregnancy do not usually occur until hemoglobin levels are well below 11.0 g/dl.


    If you are unable to get adequate amounts of iron from your diet alone, consult with your doctor about taking an iron supplement. If you are already experiencing gastrointestinal discomfort due to your pregnancy, ask about carbonyl iron which is naturally regulated by the body and may help minimize side effects associated with increased iron intake.

    Symptoms of moderate to severe anemia (usually beklow 8.0 g/dl) include:

    • Fatigue
    • Weakness
    • Breathlessness
    • Fainting
    • Dizziness
    • Nausea
    • Headaches
    • Paleness
    • Low blood pressure
    • Increased heart rate

    Anemia is a common problem during pregnancy because of dilution of the blood which expands to almost twice the normal volume by the 28th week of pregnancy to ensure enough oxygen is getting to you and your baby. 

    Making sure that an adequate amount of hemoglobin has developed can improve pregnancy outcome and a quicker recovery postpartum. Being anemic puts you at risk when you bleed more than usual after delivery (postpartum hemorrhage) and increases the need for a blood transfusion.

    When anemia is diagnosed, several additional tests are usually done to find the possible causes of the anemia.These tests include serum ferritin and transferrin levels or total iron binding capacity, hemoglobin electrophoresis, and checking stool for blood.

    Causes for anemia include:

    • Iron-deficiency anemia
    • Anemia from blood loss
    • Vitamin B12 deficiency
    • Folic acid deficiency
    • Back-to-back pregnancies
    • Inherited anemia (sickle cell anemia, thalessemia, fanconi anemia)

    Here is a list of foods that are high in iron:

    • Legumes
    • Organ meats, especially chicken liver
    • Whole grains
    • Black rice
    • Beans
    • Dark leafy greens
    • Figs
    • Seeds
    • Nuts (especially almonds)
    • Eggs

    Foods that contain high amounts of folate are also important to have in your diet. The following foods are rich in folate:

    • Asparagus, barley, beef, brewer’s yeast, brown rice, cheese, chicken, dates, green leafy vegetables, lamb, lentils, legumes, liver, milk, oranges, split peas, root vegetables, salmon, tuna, wheat germ, and whole grains.