Pregnancy anaemia

Overview

Pregnancy anaemia is when you have fewer red blood cells or less haemoglobin (the part of blood that carries oxygen) than normal during pregnancy. This can make you feel very tired and weak because your body and your baby are not getting enough oxygen.

Yes, pregnancy anaemia is very common. Many pregnant women develop some degree of anaemia, especially if they are carrying twins or have had close pregnancies.

It can affect any pregnant woman, but you are more at risk if you had heavy periods before pregnancy, you are carrying more than one baby, you have a poor diet, or you have had several pregnancies close together.

Symptoms

Common symptoms

• Feeling very tired or weak
• Pale skin, lips, or nail beds
• Shortness of breath even with mild activity
• Dizziness or light-headedness
• Fast or pounding heartbeat
• Headaches

Causes

Main causes

• Iron deficiency – your body needs more iron to make extra blood for your baby, and you may not get enough from your diet.
• Folate deficiency – folate (a type of B vitamin) is also needed to make red blood cells.
• Vitamin B12 deficiency – less common, but can happen, especially in women who do not eat animal products.

Risk factors

• Carrying twins or more
• Having pregnancies close together
• Poor diet low in iron, folate, or vitamin B12
• Heavy periods before pregnancy
• Certain conditions like stomach or bowel problems that affect nutrient absorption

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above, call your local emergency number immediately.
• If you feel extremely weak or dizzy and it does not go away after resting

Book a routine appointment if:

• Attend all your antenatal (pregnancy) appointments – you will have routine blood tests to check for anaemia.
• If you notice mild symptoms like tiredness or pale skin, mention it at your next check-up.

Diagnosis

Pregnancy anaemia is usually found during a routine blood test that is part of your antenatal care.

Tests that may be done

• Full blood count (FBC) – measures your haemoglobin level and the number of red blood cells.
• Ferritin test – checks your iron stores.
• Folate and vitamin B12 levels – if needed to find the cause.

What to expect at your appointment

A simple blood sample is taken from your arm. Results are usually ready within a few days. Your midwife or doctor will explain the results and recommend treatment if needed.

Treatment

Treatment depends on the type and severity of anaemia. Most cases are treated with supplements and changes to your diet.

Self-care at home

• Eat iron-rich foods such as lean red meat, poultry, fish, beans, lentils, spinach, and fortified cereals.
• Include foods high in vitamin C (like oranges, strawberries, or bell peppers) with meals to help your body absorb iron.
• Avoid drinking tea or coffee with meals, as they can block iron absorption.

Medical treatments

Your doctor may prescribe iron, folate, or vitamin B12 supplements. It is important to take them exactly as directed. If your anaemia is severe or you cannot take pills, you may need an iron infusion (iron given through a drip) or a blood transfusion. These treatments are safe during pregnancy and are only used when necessary.

Living with this condition

Take your supplements as prescribed, eat a balanced diet, and rest when you feel tired. Most women start to feel better within a few weeks of starting treatment.

Lifestyle tips

• Plan your day so you have time to rest.
• Ask for help with household tasks or caring for other children.
• Stay active with gentle activities like walking, but do not overdo it.

Diet and exercise

Focus on foods rich in iron (e.g., red meat, beans, dark leafy greens) and folate (e.g., leafy greens, citrus fruits, fortified grains). Gentle aerobic exercise, such as walking or swimming, can boost your energy levels when you feel up to it.

Mental health and emotional wellbeing

Feeling very tired all the time can affect your mood and make you feel low. It is important to talk to your midwife or doctor if you are feeling anxious or depressed. Treating the anaemia often helps improve your emotional wellbeing.

Prevention

You can reduce your risk by eating a healthy diet rich in iron and taking prenatal supplements that contain iron, folate, and vitamin B12 as recommended by your healthcare provider.

Screening programmes

During pregnancy, you will have routine blood tests in early pregnancy and again around 28 weeks to check for anaemia. This allows early detection and treatment.

Complications

If left untreated

• Increased tiredness that makes daily life difficult
• Higher risk of infections
• Premature (early) birth
• Low birth weight baby
• Need for a blood transfusion during or after delivery

Long-term outlook

With early detection and treatment, most women with pregnancy anaemia recover fully and go on to have a healthy pregnancy and baby. Treatment is safe and effective.

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