Q&A: What are the complications associated with low iron during delivery?
Dr Moore gives advice to a mom-to-be who is worried about how her haemoglobin will affect her and her baby during labour.

A reader asks:

I’m 34 weeks and three days pregnant. I have an hb of 11.1g/dl. The nurse told me I still don’t have enough blood for me and the baby. She said my hb must be above 12g/dl. So I want to know what must I eat or take in order to increase my iron levels. I want something that will give me better results in a short space of time because I really don’t want a blood transfusion during delivery. Is oxtail liver recommended for pregnant women? Also, what are the complications associated with low iron during delivery?

Dr Bronwyn Moore (gynaecologist) answers:

Anaemia in pregnancy is defined as a haemoglobin (Hb) of < 11g/dL by the World Health Organisastion (WHO). The values given on lab reports are usually for non-pregnant patients. In pregnancy there is a physiological anaemia due to a greater increase in plasma volume than red cell mass, meaning your Hb is a bit lower. Your Hb levels aren’t something for you to worry too much about.

Iron demands are increased in pregnancy so moms are advised to take a vitamin supplement containing iron during pregnancy. This contains enough iron to maintain iron levels, but if you areanaemic then a higher dose is necessary. In patients with signi cant anaemia close to delivery an iron drip can help get a rapid response, but due to side effects should only be used if necessary.

A balanced diet will help to provide your body with the vitamins and minerals needed. Foods rich in iron include red meat, liver, eggs, dark green leafy veg, raisins and prunes and legumes. Any mom can have excessive blood loss after delivery (post-partum haemmorrhage) and there are specific practices in place to try and prevent this. However it can still occur and may necessitate transfusion.

We try to limit transfusions and generally will only transfuse if your Hb drops to below 7-8g/dL. The higher your Hb is going into labour, the more unlikely it is you will need to be transfused. I suggest you take your pregnancy supplements, and eat a balanced diet.

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