Anemia During Pregnancy

What is anemia during pregnancy?

Anemia is when you don’t have enough red blood cells to carry oxygen throughout your body. When your body doesn’t get enough oxygen from your blood, it can’t function properly. A person who has anemia during pregnancy is considered anemic.

The red blood cells (RBCs) contain an important protein called hemoglobin. This protein holds oxygen and helps your red blood cells carry oxygen from your lungs to your body. It also helps carry carbon dioxide from your body to your lungs so you can breathe it out.

To produce RBCs and hemoglobin, your body needs a consistent supply of iron and vitamins. Without that supply, your body won’t produce enough hemoglobin to properly carry oxygen to your organs. It’s common for women to become anemic during pregnancy because they don’t have enough iron and other vitamins.

What are the types of anemia affecting pregnant women?

There are more than 400 types of anemia. Some are more common during pregnancy, including:

• Iron-deficiency anemia, from a lack of iron.
• Folate-deficiency anemia, from a lack of folic acid.
• Vitamin B12 deficiency anemia, from a lack of vitamin B12.

Who is most likely to have anemia during pregnancy?

Throughout pregnancy, the amount of blood in your body increases by 20% to 30%. That means your body needs more iron for more red blood cells. You may be at higher risk for anemia during pregnancy if you are:

• Pregnant with multiples.
• Not consuming enough iron.
• Having back-to-back pregnancies with minimal time between.
• Experiencing a heavy menstrual flow before pregnancy.
• Vomiting often because of morning sickness.

Is it normal to be anemic during pregnancy?

Yes. Because blood volume increases during pregnancy, mild anemia is normal. Iron deficiency is common in pregnancy, with up to 52% of pregnant women in developing countries not getting enough iron. Severe anemia is not typical.

Both mild and severe anemia, however, require treatment to protect the health of you and the fetus.

How does anemia affect the baby during pregnancy?

The developing fetus relies on you to get enough iron, vitamin B12 and folic acid. Anemia can affect the growth of the fetus, especially during the first trimester.

If anemia goes untreated, your baby is at higher risk of having anemia after birth, which can lead to developmental problems. Also, anemia increases the risk of delivering your baby early and having a low-weight baby.

Can anemia during pregnancy cause miscarriage?

No. Anemia during pregnancy doesn’t directly cause miscarriage, but severe anemia can cause pregnancy complications.

What causes anemia during pregnancy?

Pregnancy itself is a cause of anemia because of the increase in blood volume. Other causes of anemia during pregnancy include not consuming enough iron, vitamin B12 or folic acid.

Other causes of anemia that occur in nonpregnant people can also cause anemia during pregnancy:

• Certain diseases, including sickle cell anemia and thalassemia.
• Donating blood.
• Heavy menstrual flow (before pregnancy).
• Ulcers and polyps.

What are the symptoms of anemia during pregnancy?

You may not notice any symptoms of mild anemia at first. Over time, you may feel:

• Fatigue.
• Cold.
• Shortness of breath.

Other symptoms include:

• Dizziness or weakness.
• Fast heartbeat.
• Headache.
• Pale, dry or easily bruised skin.
• Sore tongue.
• Unintended movement in the lower leg (restless legs syndrome).

How is anemia during pregnancy diagnosed?

A blood test called a complete blood count (CBC) can diagnose anemia. This blood test is often done at one of your first prenatal appointments.

Your healthcare provider uses the CBC to analyze:

• How many red blood cells you have, their size and shape (which can indicate certain conditions like sickle cell anemia).
• How much iron your body has stored.
• If you are low in vitamins B12 and B9.

What is considered severe anemia during pregnancy?

Severe anemia is when results of the CBC show hemoglobin that’s 6.5 to 7.9 grams per deciliter (g/dL). If your results show you have severe anemia, your provider may do a blood transfusion, most likely in an outpatient setting. A blood transfusion will give you a healthy amount of red blood cells.

How is anemia treated in pregnancy?

Treatment for anemia during pregnancy depends on the severity. If you have:

• Mild to moderate anemia: Your provider will usually treat it with a daily prenatal vitamin or iron supplement. This gives your body healthy amounts of iron, vitamin B12 and folic acid.
• Severe anemia: You may need a blood transfusion.

How can I treat anemia at home while pregnant?

The best way to treat the most common types of anemia is to make sure you’re getting enough iron, B12 and folic acid. Take a prenatal vitamin every day. Talk to your healthcare provider about which prenatal vitamin they recommend.

Diet changes can help, too. Eat more foods that are high in iron like spinach, lean beef and turkey. Foods that are high in vitamins that help your body absorb iron (like vitamin C) are important as well, including citrus fruits, tomatoes and peppers.

How soon after treatment for anemia during pregnancy will I notice a change?

If you have iron-deficiency, B12-deficiency or folate-deficiency anemia, you should begin to feel better within a few days of taking a supplement. If you don’t notice a change, talk to your provider.

What does untreated anemia do to the body?

Untreated anemia can get worse over time. Having too little oxygen in the blood can damage your organs. It also forces the heart to work harder, increasing the risk of:

• Arrhythmia (irregular heartbeat).
• Enlarged heart.
• Heart failure.

How can I prevent anemia during pregnancy?

The best thing you can do for anemia prevention is to eat at least 30 milligrams (three servings) of iron each day. If you can’t get that much iron in your diet, talk to your provider about taking an iron supplement.

You should also take a prenatal vitamin daily. If possible, you should start taking prenatal vitamins before you get pregnant. Some prenatal vitamins don’t have enough iron in them. So, talk to your healthcare provider to determine which type of prenatal vitamin is best for you.

Keep in mind that you can do all the right things and still get mild anemia during pregnancy. That’s because of the natural increase in blood volume. If you feel tired, dizzy or have any other symptoms, talk to your provider.

What is the outlook for someone with anemia during pregnancy?

If treated, the outlook for someone with anemia during pregnancy is very good. You can easily treat this condition with supplements and minor diet adjustments. After you give birth, your blood volume and plasma levels should go back to normal.

When should I worry about anemia during pregnancy?

Talk to your provider if you experience signs of anemia:

• Dizziness.
• Headaches.
• Fast heartbeat.
• Pale skin.
• Sore tongue.
• Unintended movement in your lower legs.

If you’re worried, ask your provider about testing for anemia and what you can do to maintain healthy red blood cell levels throughout your pregnancy.

How do I take care of myself when I have anemia during pregnancy?

The best way to care for yourself when you have anemia is to try and eat a healthy, iron-rich diet. Get plenty of rest and drink lots of fluids. Take a prenatal vitamin and/or iron supplement. Talk to your provider about the best supplement for you.

A note from Cleveland Clinic

You may be slightly anemic during pregnancy because blood volume increases by 20% to 30%. Keeping your diet rich in iron, vitamin C and B vitamins helps correct and prevent anemia. Taking a daily prenatal vitamin can help, too. Talk to your provider about your risk of anemia during pregnancy and any concerns you may have.