Anaemia in pregnancy

What is anaemia?

Anaemia is a common condition of the blood which occurs when there are not enough red blood cells. Iron is used to make haemoglobin (red blood cells), which carries oxygen around the body. During pregnancy your blood volume increases by a third, so more iron is needed to make enough red blood cells.

Will I be tested for anaemia during pregnancy?

Your blood will first be tested during your booking appointment and then again at 28 weeks pregnant. In the third trimester anaemia is more common because of the growing demands your baby is making on your body’s iron stores.

In the first trimester, the normal range for haemoglobin is more than 110g/L, and in the second and third trimesters it should be greater than 105g/L.

If your levels fall outside of the normal ranges, your midwife will discuss alterations to your diet and may suggest iron supplements.

Depending on your level of anaemia, you may also have further blood tests to investigate different types of iron stores in your body.

If you are pregnant with twins or more, you will have an extra blood test for anaemia at around 20-24 weeks of pregnancy.

Types of anaemia

The most common type of anaemia is iron deficient anaemia, which a lack of haemoglobin. There are other types of anaemia which are not routinely checked for in pregnancy – Vitamin B12 and folate deficiency. These may be checked if your haemoglobin levels are very low.

Symptoms of anaemia 

The main symptom of anaemia is tiredness – this is also a common pregnancy symptom, which makes it difficult to diagnose from symptoms alone.  This is why you are offered the blood tests to check your iron levels.In severe types of anaemia, you may feel faint, dizzy, see spots before your eyes, experience breathlessness and palpitations.If you experience any of these symptoms you should always contact your GP or midwife immediately.

Treatment for anaemia in pregnancy

Anaemia is easily treatable with iron supplements available on prescription from your GP, but it should be noted that constipation is a common side-effect. Taking Vitamin C alongside these supplements can increase the absorption of iron, for example having a glass of fruit juice, or eating an orange.

The best foods for anaemia

You can try to avoid anaemia by eating an iron rich diet. These foods include: red meat and green leafy vegetables, such as watercress and curly kale. Some breads and cereals are fortified with iron and pulses (beans, peas and lentils) are a good source of iron.

As mentioned already, Vitamin C boosts the amount of iron absorbed from food so try to pair these foods together.

Drinking tea and coffee can decrease the effectiveness of the body in absorbing iron from your diet, so keep your intake of these drinks to a minimum.

Will anaemia affect my baby?

As anaemia is easily treated, it is unlikely that either you or your baby will go on to have any serious side effects.

However, if severe of left untreated it has been linked to the following conditions:

• Low birth weight
• Premature birth
• Stillbirth
• Placental abruption
• Iron deficiency in the first months of your baby’s life
• Your body being less able to cope with blood loss at birth
• Some impairment to your baby’s mental development

Although these may seem significant, the chance of these occurring is very low, and even more so if the anaemia is treated.

Anaemia and breastfeeding

It is possible to breastfeed with anaemia, and it is also safe to breastfeed whilst taking iron supplements.

If you have significant anaemia, this may affect your milk supply, so speak to your midwife or health visitor for extra support.