At your 28-week appointment, you can typically expect your doctor to draw blood for two reasons: the gestational diabetes test (which we already talked about), and to check for anemia.
Although I opt out of the GD test, I do get checked for anemia. Being anemic can rule you out for home birth, because anemia increases the risk of hemorrhage (among other things).
In both of my other pregnancies, I was anemic at 28 weeks (not uncommon). This time I wasn’t. Read on to find out more about anemia: why it’s so common, and how you can help.
During pregnancy, a woman’s blood volume increases up to 50%. A lot of women can experience headaches, dizziness, extra thirst, increased hunger, etc. as their bodies are trying to make so much extra blood (plus a baby!). Consuming a lot of protein, up to 150g per day, can help ward off these symptoms (I craved protein during my second trimester…and did not experience the headaches and dizziness this time, which I had in both my previous pregnancies). Hemoglobin counts usually go down too, and are typically at their lowest level around 28 weeks (which is when the blood volume increase is complete and the body is starting to “recover,” according to my midwives).
Hemoglobin is typically measured in grams per deciliter of blood (gm/dl). Normal adult women are typically 12 – 16 gm/dl. Pregnant women are usually 10 – 12 gm/dl late in pregnancy. Most doctors will be “paying attention” if your number is below 12, and will prescribe iron supplements if you fall below 10. (My midwives will treat below 12, because even at 10 there is some increased risk.)
For example, I was typically at a level of 13 at the beginning of pregnancy, and around 10 at 28 weeks, with my first two. This was “normal,” though my midwives recommended supplementation. This time I don’t know what I was in early pregnancy (I’m assuming 13 or higher), and I was 12 at 28 weeks (yesterday). This places me in the “excellent” category and we have no need to worry about this.
What happens if you are anemic though, like I was the first two times?
The most likely option is that your doctor will prescribe ferrous sulfate supplements, or iron pills. Many women hate them, because they are really hard on the stomach — they can cause cramping, constipation or diarrhea, nausea, and sometimes even vomiting. Not fun! They’re also often not very well absorbed. (I know many women stop taking these supplements because of the side effects…which I did during my first pregnancy.)
There are other options, however!
- Eat lots of red meat, preferably grass-fed (I’ve done this during this pregnancy and believe it is the biggest factor in preventing anemia)
- Eat lots of leafy greens, like spinach (these contain both folic acid and iron, both of which can factor into anemia, especially in women who took the pill prior to pregnancy)
- Take a spirulina supplement (whole food supplement where iron is much easier to absorb)
- Eat lots of vitamin C along with your iron-rich foods or supplements (helps absorption)
- Skip the calcium-rich foods when you’re eating iron-rich foods or supplements (blocks absorption; have them at a different time of day)
It is absolutely possible to get your levels up, or keep them up, without supplements. I was easily able to do so this time. Red meat (please choose grass-fed; it’s much healthier!) also contains B12, which has been shown to reduce colic in infants. Just in case you needed another reason to have that steak!
If you are anemic at 28 weeks, your doctor may re-check your levels a couple of times to make sure you are not dangerously low. (My midwives did this.) If you are, it may change the way your birth is handled, and if you’re planning a home birth you may be referred to a hospital.
Were you anemic during pregnancy? How did you combat it?
Top image by WordRidden