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Anemia and Iron During Pregnancy

During pregnancy, a person's blood volume increases by an average of 1.5 liters.  Plasma, which functions to transport and nourish blood cells, begins to increase at the beginning of pregnancy, and peaks at about 24 weeks gestation.  At that point, the average plasma volume is about 50% greater than before pregnancy.  The total increase in red blood cells (which function to carry oxygen to and from tissues) is only about 20%, and occurs gradually throughout pregnancy.  Therefore, hematocrit and hemoglobin levels tend to drop until near the end of the second trimester, then stabilize, and then rise. 

Due to the unbalanced increase in plasma to red blood cell ratio, a “physiologic anemia” occurs. In addition to this, about one third of the mother’s iron supply is used by the fetus to form its blood. For these reasons, it is important that pregnant people consume adequate, easily absorbed iron. Thorough prenatal care includes testing hematocrit and/or hemoglobin levels several times during pregnancy to evaluate the blood volume expansion, and ensure that a woman has a sufficient amount of iron.  The hematocrit measures the percentage of red blood cells to total blood volume. The hemoglobin test measures the amount of hemoglobin (oxygen carrying capacity) in the blood.​​​​​

Normal Ranges of Hematocrit and Hemoglobin

Adult Female

Pregnant Female

Hemoglobin (mg/dL)

Hematocrit

(%)

12 - 16

11 - 13

37 - 47

33 - 39

Signs and Symptoms of Anemia

Potential Problems due to Anemia during Pregnancy

  • Low energy, fatigue

  • Muscular weakness

  • Lower threshold for physical activity

  • Loss of sex drive

  • Weakened immune system

  • Headaches

  • Dizziness 

  • Shortness of breath

  • Mother and baby receive less oxygen because there are fewer red blood cells to carry oxygen to tissues.

  • Mother may have lower energy level during labor.

  • Uterus may fatigue more easily during labor which can lead to less effective contractions and postpartum hemorrhage.

  • Postpartum iron deficiency for mother can lead to greater fatigue, greater risk of infection and greater risk of postpartum depression.

  • Risks to baby include higher incidence of fetal distress, lower birth weight, weakened immune system, greater risk of infection.

Iron Sources

Foods

Herbs

Supplements

Soybeans

Blackstrap molasses

Lentils

Tofu

Quinoa

Beans

Lima beans

Black eyed peas

Swiss chard

Chickpeas

Millet

Bulgar

Beet and dandelion greens

Seaweed

Tempeh

Kale

Spinach

Tahini

Raisins

Cashews

Bok choi

Dried apricots

Prunes

Almonds

Sunflower seeds (soaked is best)

Broccoli

Alfalfa sprouts

Eggs (especially the yolks)

Liver (organic)

Meats (especially beef, pork and venison)

Miso

Nettles tea

Yellow dock root 

Burdock root

Dandelion root

Parsley

Chickweed

Chicory

Red raspberry tea

Watercress

Sorrell

Comfrey

Alfalfa

Floradix with Iron:

2 tsp. 2 x/day

​

Liquid chlorophyll:

2 Tbs./day
(Liquid chlorophyll is almost identical in composition to the hemoglobin molecule.)

 

Spirulina or chorella:

6 tablets or

2-4 tbs. powder/ day

 

Kelp tablets:

6x/day

 

Wheatgrass juice 
builds blood:

1oz. 3-4x/wk.
 

More Iron Tips

  • Cook in a cast iron skillet.

  • Eat iron with Vitamin C foods ~ this can increase iron absorption up to six-fold!

  • Exercising regularly increases oxygen demand and stimulates absorption of nutrients.

  • Calcium and tannins reduce iron absorption. Black tea, coffee and high calcium foods or supplements should be ingested several hours before a meal which is rich in iron.

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