A pregnant person driving a car
By Katrina Nardini, CNM, WHNP-BC, MPH

Avoid Anemia: Tips to Get More Iron in Pregnancy

Fatigue and other common pregnancy symptoms may indicate you are anemic. Spot the signs of an iron deficiency and know what to expect if your provider diagnoses you with anemia

Iron-deficiency anemia is common during pregnancy, affecting around 15-25% of all pregnancies. It happens when the blood does not have enough iron to make red blood cells that carry oxygen to the body and fetus. Getting enough oxygen is crucial for a healthy pregnancy.

Nearly half of pregnant people are anemic at some point in pregnancy. During pregnancy, the body makes 20-30% more blood to support the growing fetus. This increase lowers the amount of red cells in the blood. You need extra iron to build more red blood cells while pregnant.

Most people who aren’t pregnant need 18 mg of iron per day. During pregnancy, you need 27 mg of iron or more. Without treatment, iron-deficiency anemia can reduce how much breast milk your body makes. It can cause brain problems in the baby. Anemia can also increase your risk of:

If you are worried about anemia, speak to your healthcare provider. Iron medicine can help build your iron levels. You can buy it over the counter. In severe cases, you may need to fill a prescription or get medicine at the hospital.

Symptoms of Iron-Deficiency Anemia

Many pregnant patients do not have symptoms. If they do, the most common are feeling weak and tired. Other symptoms of include:

  • Brittle nails
  • Bruising easily
  • Cold or numb hands and feet
  • Craving or chewing ice
  • Dizziness or lightheadedness
  • Fast or irregular heartbeat
  • Headaches
  • Restless legs syndrome: A disruptive, overwhelming urge to move the legs.
  • Shortness of breath
  • Sore tongue
  • Trouble concentrating
  • Yellowish or pale skin


Many of these overlap with normal symptoms of pregnancy. Contact your healthcare provider if you have anemia symptoms.

How Anemia Is Diagnosed

A healthcare provider will give you a blood test at your first prenatal appointment to check your hemoglobin (which helps make red blood cells) and see how many red blood cells you have. A low level may indicate iron-deficiency. Your healthcare provider may order more tests or refer you to a specialist.

Iron levels can change during pregnancy. Your healthcare provider may test your blood again in the second and third trimesters. If you are anemic, your healthcare provider can suggest iron supplements and diet changes to help increase iron levels.

Iron Supplements

For many people, prenatal vitamins have enough iron to support extra blood volume. If you need more, your healthcare provider may prescribe a separate iron supplement. Do not take it at the same time as your prenatal vitamin—taking it alone helps it work better and gives you a second dose of iron.

Taking iron supplements can cause side effects such as:

  • Black, green or dark stool
  • Constipation
  • Diarrhea
  • Heartburn
  • Nausea
  • Stomach cramps
  • Worsened morning sickness

If you have side effects, your healthcare provider can suggest a different dose or kind of iron supplement. Your healthcare provider also may recommend diet changes to help you get more iron from food.

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It's never too soon to start taking care of your body and your baby — and there's no better time to start than before your baby's conceived.

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Tips to Eat More Iron

Eat More of This

Vitamin C strengthens your immune system and helps you absorb iron better. Take your prenatal vitamins and eat an orange every day for an extra boost of vitamin C.

Eating iron-rich food can help increase your iron levels. Try to eat a balanced diet of healthy foods such as:

  • Beans, peas and lentils
  • Dark, leafy greens (spinach, kale, swiss chard, collards)
  • Fruits (apples, berries, raisins, dates, prunes, figs, watermelon)
  • Green vegetables (Brussels sprouts, green beans, broccoli, asparagus)
  • Lean meat (beef, chicken, turkey)
  • Low-mercury fish (salmon, shrimp, cod, tilapia)
  • Root vegetables (beets, carrots, potatoes, squash)

Eat Less of That

Limit foods that interfere with iron absorption, such as:

  • Added sugars and natural or artificial sweeteners
  • Coffee and black tea
  • Milk and dairy products: Eat calcium-rich foods at different times than you eat iron-rich foods or supplements.
  • Processed meats (lunch meats, sausages, hot dogs, ham)
  • Soy protein (soy protein powder, tofu, soy milk): Eat soy protein-rich foods at different times than you eat iron-rich foods or supplements.

With proper treatment, most people with anemia can restore their iron levels and have healthy pregnancies. Iron levels usually return to normal 4-6 weeks after delivery. But not getting enough iron in pregnancy or losing a lot of blood in delivery can make it take longer. Your healthcare provider may continue to check your iron at postpartum visits until it returns to normal.

Talk with a healthcare provider if you think you have low iron. To schedule an appointment, call us at 505-272-2245

Categories: Women's Health