Women's Healthcare Topics

Do I Need to Take an Iron Supplement While Pregnant?

Reviewed by James Brann, M.D.

Anemia is Expected, Remember your Iron

Anemia is a common pregnancy complication. Pregnant women are usually tested twice for anemia - once during the first prenatal visit and then again at 28 weeks pregnant when they are screened for gestational diabetes.

During pregnancy, your blood vessels expand as your blood volume increases. Because the volume of your blood is increasing so rapidly, the concentration of your red blood cells can become diluted and cause you to become anemic. This can decrease the amount of oxygen available to the baby, and this can lead to poor fetal growth, miscarriage, premature births, and low birth weights. That’s why it is important to prevent anemia during your pregnancy.

Anemia occurs when you don’t have enough healthy red blood cells in your body. You may experience fatigue, lack of energy, irregular heartbeat, dizziness, pale skin, and shortness of breath.

Anemia has been defined as hemoglobin levels less than 11 g/dL (hematocrit less than 33 percent) in the first and third trimesters and less than 10.5 g/dL (hematocrit less than 32 percent) in the second trimester. Women with hemoglobin values below these levels can be considered to have anemia and should undergo testing to figure out why.

Learn about anemia in pregnancy.

Most of the time, anemia in pregnancy is do to the inadequate iron stores that are need to handle the extra demand for iron in pregnancy. This type of anemia is called iron deficiency anemia and is treated by prescribing prenatal multivitamin with iron or a separate iron supplement.

If your doctor prescribes iron, remember to take it with food to avoid nausea. Avoid taking it with milk; the calcium will prevent the iron from being absorbed into your body. Instead, take your iron pill with orange juice or another form of vitamin C. Vitamin C helps absorption.

In the cases of severe iron deficiencies, after other treatments have failed, a red blood cell transfusion might be needed.

When you are pregnant, remember to eat iron-rich foods and sources of vitamin C to avoid anemia. Iron-rich foods include red meats, eggs, leafy green vegetables (such as spinach and broccoli), dried beans and tofu, and dried fruits (such as raisins, prunes, and apricots).

An iron deficiency can also go hand-in-hand with a folic acid deficiency. Folic acid is a B-vitamin that works with iron to make new cells, including red blood cells. It’s very important to get enough folic acid in your diet during pregnancy.

You can find folic acid in whole-wheat products, fortified breakfast cereals, meats, beans, asparagus, leafy green vegetables, and fruits (such as oranges, strawberries, and melons).

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