Anemia in Pregnancy: What It Is and How to Prevent It

Anemia is common in pregnancy. It often develops when your blood volume increases, resulting in a lower percentage of red blood cells and reduced oxygen flow. But there can also be other causes, and it could require medical attention.

Pregnancy anemia occurs when you don’t have enough red blood cells to carry oxygen to the tissues in your body. Mild anemia may make you feel exhausted, but it can also become serious if it becomes too severe or is left untreated.

In fact, anemia during pregnancy can lead to a higher risk of premature birth, low birth weight, and even maternal mortality.

Understanding more about different types of anemia, common symptoms, and treatment options will help you recognize the warning signs of anemia so you can avoid complications.

While mild anemia is common for many people during pregnancy, it can become a serious problem that requires more advanced medical treatment if left unmanaged.

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Physiological anemia (or dilutional anemia) is a typical process associated with pregnancy. As the overall blood volume increases during pregnancy, the liquid (plasma) volume increases more. The result is a lower percentage of red blood cells in the blood.

But there are other types of anemia that have different causes during pregnancy. This includes:

Iron-deficiency anemia

During pregnancy, your body works harder to provide the right nourishment for your growing baby, causing blood volume to increase by about 45% . Your body also provides babies with the iron needed to make their own hemoglobin.

This increase in your blood volume and production of baby’s hemoglobin allows for more transportation of vital oxygen and nutrients, but it increases the daily requirement for essential minerals like iron. This can lead to reduced production of hemoglobin (the oxygen-carrying component of the red blood cell) or iron deficiency.

Folate-deficiency anemia

Folate-deficiency anemia is another common kind of anemia that occurs during pregnancy because pregnant people need higher levels of folate.

Folic acid is a water-soluble vitamin that helps prevent neural tube defects, or cognitive brain problems, during pregnancy.

Vitamin B12 deficiency

Vitamin B12 is also used by the body in the production of red blood cells.

It’s found primarily in fortified foods and animal products like meat, fish, poultry, and eggs.

For this reason, females assigned at birth (FAAB) who don’t regularly consume these foods, including vegans and vegetarians, may be at a higher risk of deficiency.

Some people may also have difficulty processing B12, which can lead to a deficiency as well. Folate and vitamin B12 deficiencies often occur together.

While mild cases of anemia may have no symptoms at all, anemia symptoms may include things like fatigue, pale skin, or shortness of breath. You may experience all or none of the symptoms if you have anemia during your pregnancy.

Be sure to speak with your doctor right away if you’re concerned about any of the symptoms listed here or if something feels wrong.

You might be at a higher risk of developing anemia during your pregnancy if you:

• are pregnant with multiples
• have two or more pregnancies in quick succession
• aren’t eating enough foods rich in iron
• experienced heavy periods before becoming pregnant
• are routinely vomiting as a result of morning sickness

During pregnancy, you’ll usually have a complete blood count (CBC) test done to check if you have anemia at your first prenatal appointment. They may also test you toward the end of your pregnancy.

The doctor may look at the amount and size of your red blood cells, as well as your levels of hemoglobin, ferritin, folate, or vitamin B12.

The doctor may then order other tests to determine if you have another type or another underlying medical problem.

Severe anemia during pregnancy is usually treated with blood transfusions. However, anemia is preventable, especially with a diet rich in good nutrition.

Here are some ways to make sure you’re getting the necessary vitamins and minerals to keep your red blood cell levels within the right range.

1. Prenatal vitamins

Prenatal vitamins typically contain most of the micronutrients that you need during pregnancy, including iron and folic acid.

Taking prenatal vitamins once a day is an easy way to help supplement a healthy diet. It’s ideal to start a prenatal vitamin at least 2 to 3 months prior to trying to conceive.

2. Iron supplements

If you have low iron levels, your doctor may recommend a separate iron supplement in addition to your daily prenatal vitamin.

Typically, pregnant people need around 27 milligrams of iron daily.

However, the dose can vary depending on the type of iron or iron supplement consumed, so it’s best to talk with your doctor about how much you need.

You should avoid taking antacids or calcium supplements around the same time as iron supplements, as these may prevent your body from properly absorbing iron. Taking it with vitamin C will help your body absorb more.

3. Proper nutrition

Most people can get sufficient amounts of iron and folic acid during pregnancy by eating the right foods. Good sources of these essentials minerals include:

• poultry
• fish
• lean red meats
• beans
• nuts and seeds
• dark leafy greens
• fortified cereals
• eggs
• fruits like bananas and melons

Animal sources of iron are the most easily absorbed. If your iron is coming from a plant-based source, pair it with foods high in vitamin C, like tomato juice or oranges, to help increase absorption.

Sometimes, supplementing with oral iron is not enough to raise iron levels. In that case, your doctor might talk with you about other therapies.

In some cases, intravenous supplementation of iron or a blood transfusion may become necessary.

What is the main cause of anemia in pregnancy?

The most common causes of anemia in pregnancy are iron and folate deficiencies.

How do you treat anemia in pregnancy?

Depending on the type, it usually involves taking vitamin supplements. In some cases, you could need a blood transfusion. However, most cases can be prevented before they develop or become severe.

In what pregnancy trimester does anemia develop?

Research shows more than 90% of pregnancy anemia cases develop in the third trimester.

If you’re pregnant or trying to become pregnant, be aware of the importance of sufficient amounts of iron, folic acid, and vitamin B12.

Follow a well-rounded diet, take prenatal vitamins, and speak with your healthcare professional if you’re experiencing symptoms of anemia.

If you do have an iron deficiency, your doctor can recommend the right course of treatment for you and help decide whether supplementation is necessary.

Last medically reviewed on April 13, 2023