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Iron Deficiency In Pregnancy – What You Need To Know

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Pregnancy is truly a journey. Whether it’s your first, your third or your sixth, carrying a child is a blessing that comes with a range of health challenges. Fatigue, nausea, sleeplessness and depression can all be the pregnant woman’s bedfellow — but one of the most common issues that expecting mothers face is iron deficiency.

The World Health Organisation estimates that between 30 and 40 per cent of all pregnant women suffer from iron deficiency — yet some midwives believe the figure to be much higher than that. This is largely due to the fact that many of the symptoms of iron deficiency are similar to the side effects of pregnancy, including extreme fatigue, weakness, pale skin, dyspnoea (shortness of breath), tachycardia (rapid heartbeat), dizzy light-headedness, and cold extremities (hands and feet). And, no doubt thanks to the Australian culture that encourages people to toughen up, instead of bringing these issues to the attention of a medical professional, pregnant women can often stay quiet. As a result, the condition remains ignored — and the mother can become more and more exhausted.

“I would honestly estimate 90 per cent of women experience some level of iron deficiency during their pregnancy — it’s practically at epidemic proportions,” Kathy Fray, a New Zealand midwife and the managing director of the MotherWise resources, says. “Plus many begin their pregnancy completely unaware they are either already depleted or already anaemic, or at such low ‘normal’ levels that without drastic changes, they will become anaemic as their pregnancy progresses.”

This is largely due to the fact that the body requires additional iron during pregnancy. “You need four iron molecules to make each haemoglobin red blood cell, and by the third trimester, a pregnant woman’s body has one and a half times the blood volume of her non-pregnant body,” Kathy says. With all this overtime work, it’s no wonder that so many pregnant women suffer from iron deficiency.

Adding extra fatigue to the already exhausting task of growing a child is nothing to joke about. Yet aside from the obvious physical symptoms of iron deficiency mentioned above, if left unaddressed, this condition can prove to be severe. “There are other potential consequential outcomes of iron deficiency anaemia in pregnancy, including increased haemorrhaging during childbirth due to low platelets — and obviously heavy bloodloss is not helpful to someone already low in red blood cells,” Kathy says, adding that there’s also the potential for the newborn to be born with iron-depletion anaemia too.

With all that in mind, it’s imperative that pregnant women take the symptoms seriously and bring up any concerns that they may have with their doctor as soon as they arise.

Preventing Iron Deficiency

Thankfully, there are many ways to manage iron deficiency and therefore have a more enjoyable and safer pregnancy. This can start as soon as you fall pregnant.

“I strongly recommend a multi-pronged approach,” Kathy says. “Include an iron stores blood test at your first antenatal appointment to pick up if you are already low, or low-ish, in iron instead of waiting until the latter second trimester to do the first check of Ferritin levels.”

By knowing your body’s iron stores prior to the second trimester, you can begin to take steps to add to your iron intake early in pregnancy. One easy way to do this is to take iron supplements outside of your usual multivitamins.

“There are almost no prenatal daily multi capsules that include adequate iron for the second and third trimester,” Kathy says. She also recommends bypassing the lower quality free or cheap iron tablets and going instead for high-quality iron supplements and sachets.

“Eat red meat every day during the pregnancy washed down by a glass of orange juice (vitamin C assists iron absorption) — or if you are not a red meat eater then get very proactive to access the best sources of quality iron supplementation you can afford,” Kathy says.

Finally, she recommends investing in regular pregnancy wellness visits with a naturopathic maternity clinician rather than only seeing your midwife/OB and assuming they know everything about maternity nutrition. “Take charge of your healthcare,” Kathy says.

The good news is that after pregnancy, most women will see their iron levels return to normal with the help of an iron-rich diet. But this can take weeks or months, and when you add sleep deprivation and lactation needs to the mix, those anaemic symptoms can pose even greater challenges to the mother. “It is far better for women to ensure that by the time they go into labour, their stored iron levels are fantastic,” Kathy says. “That is better for her birth, better for her recovery, better for her postpartum, and of course far better for her baby.”

About Kathy Fray

Kathy Fray is a NZ midwife who has been her country’s number-one best-selling birth/babies/motherhood author since 2005.

Kathy is managing director of the MotherWise resources, including her wonderful online advanced prenatal education programme MotherWise.app

Kathy is also the founding director of IIMHCO.com (Intl Integrative Maternity HealthCare Org), global thought-leaders in perinatal integrative medicine.

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Lauren Clarke

Lauren Clarke

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