Anaemia during pregnancy: what you should know

Iron deficiency is a frequent cause because pregnancy increases the body's need for iron, but low vitamin B12 or folate, inherited blood conditions, bleeding, and other health problems can also contribute. A blood test confirms anaemia; symptoms alone cannot establish the diagnosis.

Haemoglobin in red blood cells carries oxygen. During pregnancy, blood plasma expands and the body must also support the placenta and developing baby, so haemoglobin can fall. Anaemia may cause unusual tiredness, weakness, dizziness, headaches, breathlessness, palpitations, pale skin, cold hands and feet, or difficulty concentrating. These symptoms overlap with normal pregnancy changes and other conditions, which is why testing matters.

A clinician may check a full blood count and, depending on the pattern, iron stores, vitamin levels, or tests for inherited blood disorders such as thalassaemia. The result is interpreted alongside the stage of pregnancy, symptoms, medical history, diet, medicines, and any bleeding.

Arrange follow-up with your maternity team or clinician to confirm the likely cause. Do not start or increase iron solely because you feel tired: excess iron will not correct every type of anaemia and may cause constipation, nausea, or stomach discomfort.

If iron deficiency is confirmed, treatment commonly includes an oral iron supplement and iron-rich foods such as meat, lentils, beans, leafy greens, and fortified cereals. Taking iron with a vitamin C-containing food or drink can help absorption, while tea, coffee, calcium supplements, and antacids taken close to the dose may reduce it. Your clinician can advise how to separate medicines and may repeat blood tests to check the response.

Tell the maternity team if tablets are difficult to tolerate or blood levels do not improve. They can review how the medicine is taken, reconsider the cause, or discuss another form of treatment appropriate to the pregnancy.

Seek urgent medical help for chest pain, fainting, severe breathlessness at rest, a very fast or irregular heartbeat with weakness, confusion, or heavy vaginal bleeding. Do not wait for a routine appointment when these symptoms occur.

Contact your maternity team promptly if breathlessness is worsening, palpitations keep returning, dizziness affects walking or daily tasks, tiredness becomes extreme, or prescribed treatment causes troublesome side effects. New bleeding, black tar-like stools unrelated to expected darkening from iron, or reduced fetal movement also needs prompt assessment through the maternity service.

Useful questions include: What type of anaemia does my blood test suggest? Should my iron stores, folate, vitamin B12, or inherited blood conditions be checked? How should I take the prescribed supplement around meals and other medicines? When will my blood be rechecked? Which side effects or symptoms should make me contact the maternity team sooner?