How to Get the Iron You Need to Prevent Anemia During Pregnancy

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Anemia in pregnancy is common and it is most often caused by an iron deficiency. Iron is a mineral that everyone needs. Pregnant women need more iron for a variety of reasons. The biggest reason is that iron helps your body make new blood to carry the oxygen and nutrients to the baby during pregnancy. By the end of pregnancy, you will have a 30% to 50% increase in the amount of blood in your body compared to when pregnancy began.

Your need for iron will just about double over your pre-pregnancy requirements. It is also important that you get adequate iron in pregnancy because towards the end of pregnancy, your baby will also be storing iron for their first six months of life.

Anemia Risk Factors

Some women are at higher risk for anemia. You may be more likely to be anemic if:

  • You have been dieting to lose weight
  • Your pregnancies are closer than two years apart
  • You bled heavily with your periods
  • You don't usually eat foods high in iron
  • You have tested low or been told you have anemia
  • You are under 20 years old

Signs of Anemia

Being low in iron can also cause you to feel more fatigued than normal in pregnancy, make you more susceptible to illness and infection, and other possible complications. The common signs of anemia in pregnancy include:

  • Fatigue
  • Weakness
  • Dizziness
  • Shortness of breath
  • Feeling cold, especially in the hands and feet
  • Paleness
  • Headaches
  • Trouble concentrating

Testing for Anemia During Pregnancy

Whether you have any of these risk factors or signs of anemia, you will usually be tested at least twice during pregnancy for anemia. The timing is usually at the beginning of pregnancy and again around 28 weeks.

Between 24 and 32 weeks, your body has had a large surge in blood volume to almost twice your pre-pregnancy amount. This can cause the amount of iron in your blood to become diluted, leading to a lower hemoglobin and hematocrit on your 28-week blood test. If you were found to be anemic at your 28-week test, you will likely be retested later in the third trimester, typically around 36 weeks.

Preventing Anemia in Pregnancy

Ideally, the best way to get the iron you need is from your diet. Iron supplements are not the answer for everyone. Iron pills can cause diarrhea, constipation, and upset stomach; prevent your body from taking in other nutrients; and are not as readily absorbed as iron from food. Typically, it will take a few weeks for any supplementation to change your iron levels.

If you do need supplemental iron and you don't tolerate standard preparations, discuss this with your healthcare provider. You may be able to consider liquid sources, such as Chlorophyll, Flora-Dix (vitamin), or herbal alternatives. Increase vitamin C when taking supplements.

There are plenty of ways to get more iron in your diet. In addition to adding iron-rich foods (see below), try cooking with a cast iron pan. Avoid caffeine, and also avoid consuming excessive bran.

Iron-Rich Foods

Make a point to incorporate foods that are particularly high in iron, such as:

  • Green leafy vegetables, like broccoli, spinach, greens, kale, and bok choy
  • Tofu
  • Kidney beans
  • Black-eyed peas
  • Whole-grain bread and cereal
  • Eggs
  • Brown rice
  • Enriched pasta
  • Lean red meats

A Word From Verywell

Iron is not important in pregnancy. Everyone needs iron throughout their lives. Preventing or treating anemia will make you feel better and healthier during pregnancy and beyond. Find ways to get your iron through nutrition whenever possible.

Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

By Robin Elise Weiss, PhD, MPH
Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.