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.
Causes of 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 premature birth and low birthweight. Premature birth is birth before 37 weeks of pregnancy. Low birthweight is when a baby weighs less than 5 pounds, 8 ounces at birth.
Illness or disease
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.
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)
- 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.
Getting enough 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.
You can help lower your risk of anemia by eating foods that contain iron during your entire pregnancy. Foods high in iron include:
- Dried fruits and beans
- 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.
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
Most common questions
What is mononucleosis?
Mononucleosis (also called mono) is an infection usually caused by the Epstein-Barr virus (EBV). It’s sometimes caused by another virus called cytomegalovirus (CMV). EBV and CMV are part of the herpes virus family. Mono is most common in teenagers and young adults, but anyone can get it. Mono is called the “kissing disease” because it’s usually passed from one person to another through saliva. In addition to kissing, it can also be passed through sneezing, coughing or sharing pillows, drinks, straws, and toothbrushes.
You can have mono without having any symptoms. But even if you don’t get sick, you can still pass it to others. Symptoms can include:
- Achy muscles
- Belly pain
- Fatigue (feeling tired all the time)
- Sore throat
- Swollen glands in your neck
If your symptoms don’t go away or get worse, tell your health care provider. He’ll most likely do a physical exam and test your blood to find out for sure if you have mono.
There’s no vaccine to prevent mono. There’s also no specific treatment. The best care is to take it easy and get as much rest as you can. It may take a few weeks before you fully recover.
Can Rh factor affect my baby?
The Rh factor may be a problem if mom is Rh-negative but dad is Rh-positive. If dad is Rh-negative, there is no risk.
If your baby gets her Rh-positive factor from dad, your body may believe that your baby's red blood cells are foreign elements attacking you. Your body may make antibodies to fight them. This is called sensitization.
If you're Rh-negative, you can get shots of Rh immune globulin (RhIg) to stop your body from attacking your baby. It's best to get these shots at 28 weeks of pregnancy and again within 72 hours of giving birth if a blood test shows that your baby is Rh-positive. You won't need anymore shots after giving birth if your baby is Rh-negative. You should also get a shot after certain pregnancy exams like an amniocentesis, a chorionic villus sampling or an external cephalic version (when your provider tries to turn a breech-position baby head down before labor). You'll also want to get the shot if you have a miscarriage, an ectopic pregnancy or suffer abdominal trauma.
I had a miscarriage. How long should I wait to try again?
Before getting pregnant again, it's important that you are ready both physically and emotionally. If you don't need tests or treatments to discover the cause of the miscarriage, it's usually OK for you to become pregnant after one normal menstrual cycle. However, it may take longer for you to feel emotionally ready to be pregnant again. Everyone responds differently to a miscarriage. Only you will know when you are ready to try to get pregnant again.
Are gallstones common during pregnancy?
Not common, but they do happen. Elevated hormones during pregnancy can cause the gallbladder to function more slowly, less efficiently. The gallbladder stores and releases bile, a substance produced in the liver. Bile helps digest fat. When bile sits in the gallbladder for too long, hard, solid nuggets called gallstones can form. The stones can block the flow of bile, causing indigestion and sometimes serious pain. Staying at a healthy weight during pregnancy can help lower your risk of gallstones. Exercise and eating foods that are low in fat and high in fiber, like veggies, fruits and whole grains, can help, too. Symptoms of gallstones include nausea, vomiting and intense, continuous abdominal pain. Treatment during pregnancy may include surgery to remove the gallbladder. Gallstones in the third trimester can be managed with a strict meal plan and pain medication, followed by surgery several weeks after delivery.