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Anemia is when you don't have enough healthy red blood cells to carry oxygen to the rest of your body. Without enough oxygen, your body cannot work as well as it should, and you feel tired and run down.

Anemia can affect anyone, but women are at greater risk for this condition. In women, iron and red blood cells are lost when bleeding occurs from very heavy or long periods (menstruation).

Anemia is common in pregnancy because a woman needs to have enough red blood cells to carry oxygen around her body and to her baby. So it's important to prevent anemia before, during and after pregnancy. Your provider tests you for anemia at a prenatal care visit

What causes anemia?

Usually, a woman becomes anemic (has anemia) because her body isn't getting enough iron. Iron is a mineral that helps to create red blood cells. In pregnancy, iron deficiency has been linked to an increased risk of preterm birth and low birthweight. Preterm birth is birth before 37 weeks of pregnancy. Low birthweight is when a baby weighs less than 5 pounds, 8 ounces at birth.

Some women may have an illness that causes anemia. Diseases such as sickle cell anemia or thalassemia affect the quality and number of red blood cells the body produces. If you have a disease that causes anemia, talk with your health provider about how to treat anemia.

What are signs and symptoms of anemia?

Anemia takes some time to develop. In the beginning, you may not have any signs or they may be mild. But as it gets worse, you may have these signs and symptoms:

  • Fatigue (very common)
  • Dizziness
  • Headache
  • Cold hands and feet
  • Pale skin
  • Irregular heartbeat
  • Chest pain

Because your heart has to work harder to pump more oxygen-rich blood through the body, all of these signs and symptoms can occur.

How do can you get the right amount of iron? 

Before getting pregnant, women should get about 18 milligrams (mg) of iron per day. During pregnancy, the amount of iron you need jumps to 27 mg per day. Most pregnant women get this amount from eating foods that contain iron and taking prenatal vitamins that contain iron. Some women need to take iron supplements to prevent iron deficiency.

Which foods are high in iron?

You can help lower your risk of anemia by eating foods that contain iron during your entire pregnancy. Foods high in iron include:

  • Poultry
  • Dried fruits and beans
  • Eggs
  • Iron-fortified cereals, breads and pastas
  • Organ meats (liver, giblets)
  • Red meat
  • Seafood (clams, oysters, sardines)
  • Spinach and other dark leafy greens

Foods containing vitamin C can increase the amount of iron your body absorbs. So it's a good idea to eat foods like orange juice, tomatoes, strawberries and grapefruit every day.

Calcium (in dairy products like milk) and coffee, tea, egg yolks, fiber and soybeans can block your body from absorbing iron. Try to avoid these when eating iron-rich foods.

Do you need to take iron supplements during pregnancy?

If you are anemic, your health care provider may prescribe an iron supplement. Some iron supplements may cause heartburn, constipation or nausea. Here are some tips to avoid or reduce these problems:

  • Take the supplement on an empty stomach. If it upsets your stomach, take the supplement with a small amount of food. 
  • Take the supplement with orange juice or a vitamin C supplement.
  • Don't take a supplement with dairy products (milk, cheese, yogurt), eggs, high-fiber foods (whole grain breads and cereals, raw vegetables), spinach, tea or coffee. Don't take an iron supplement if you're taking an antacid.

Last reviewed: December, 2013