Low iron in pregnancy: Causes, signs, and more

Pregnancy is a risk factor for iron deficiency, which can complicate pregnancy and delivery. People deficient in iron before they conceive may experience a more severe deficiency while they are pregnant.

Iron deficiency is a common pregnancy health issue that can affect both the pregnant person and the developing fetus.

The body uses iron to produce hemoglobin, a protein that carries oxygen throughout the body. If a person does not have enough iron, it cannot make adequate hemoglobin, which can deprive the body’s cells of oxygen.

This can cause shortness of breath, weakness, and an increased heart rate.

Taking an iron supplement can usually resolve iron deficiency. A doctor may also recommend folate and B12 supplements.

Read more about what causes low iron during pregnancy, signs of the condition, who is at risk, and more.

During pregnancy, an individual’s blood volume grows steadily. Most people have a 45% increase by the third trimester.

The increased blood volume means a person needs more iron. If they do not consume enough, they may become deficient.

However, low iron does not always cause anemia — it is a separate diagnosis.

Severely low iron or chronically low iron can lead to iron deficiency anemia. This happens when a person’s body does not get enough iron, which can reduce their red blood cell count or hemoglobin levels.

Mild anemia is relatively normal during pregnancy. It may either cause minor symptoms or none at all. However, more severe anemia can complicate pregnancy and endanger a pregnant person’s health.

It is possible to be iron deficient and have no symptoms.

Many pregnancy symptoms are similar to those of iron deficiency, so some people may not know they have the condition. If a person suspects they are deficient in iron, they will need a blood test to confirm a diagnosis.

Some signs of anemia, iron deficiency, or both during pregnancy include:

  • low energy
  • weakness
  • fatigue
  • shortness of breath
  • feeling out of breath or winded after everyday activities
  • skin paleness, especially in the nail beds and inner eyelids

All pregnant people have a higher risk of iron deficiency. A 2020 study of pregnant individuals found that the rate of iron deficiency anemia increased as their pregnancy progressed.

This is because pregnancy increases blood volume, which increases the body’s demand for iron.

Some people are at a higher risk of iron deficiency. They include those who:

  • have a history of heavy bleeding, including heavy menstrual periods
  • have two pregnancies close together, usually within 18 months
  • do not eat enough iron
  • are vegetarian or vegan — heme iron, found in animal products, is easier to absorb than plant-based iron
  • are pregnant with more than one baby
  • experience severe vomiting

With or without anemia, having low iron can make a pregnant person feel run down and exhausted. It may make it harder to exercise, prepare healthy food, and make other healthy decisions that improve pregnancy outcomes.

Many people who have iron deficiency during pregnancy also experience it after giving birth. Iron deficiency in the postpartum period may intensify the fatigue that often accompanies caring for a newborn.

In addition to making pregnancy and postpartum more difficult, iron deficiency can cause serious health complications, including:

  • intrauterine growth restriction, which means that the baby’s growth is too slow
  • low birth weight
  • premature labor
  • anemia in the newborn
  • breathing issues in the baby at birth

A simple blood test can diagnose iron deficiency.

If a person has symptoms of low iron, a doctor may decide to order several tests. They can use a complete blood count to check hemoglobin levels and a ferritin test to check iron levels.

Testing a person’s ferritin, a protein that contains iron, is the most accurate way to detect iron deficiency.

Iron deficiency is common, and it is relatively easy to treat.

In most cases, a person will need to take an iron supplement. They can choose tablet, capsule, or liquid supplements.

People with severe iron deficiency anemia may need intravenous (IV) iron.

It can take several weeks for a person’s iron to reach normal levels. Until then, they may need help managing their symptoms.

This may include taking more frequent naps, avoiding tiring activities, and asking friends and family for help with household tasks.

People with an iron deficiency may need regular blood testing to ensure their treatment is working.

In addition to iron supplements, a doctor may recommend a person take vitamin D, folate, or B12. These can all promote healthy red blood cells.

A doctor or midwife may recommend taking iron supplements alongside other supplements, such as vitamin D, folate, or B12, to promote healthy red blood cells.

If iron levels do not rise enough after a few weeks of taking a supplement, a doctor may recommend other interventions.

Iron deficiency during pregnancy is common. For many people, it is difficult or impossible to prevent.

However, people concerned about their iron levels can take steps to reduce their chances of developing anemia. They can try:

  • asking their doctor or midwife if they are at risk of iron deficiency
  • taking an iron supplement or prenatal vitamins that contain iron
  • taking iron supplements with vitamin C on an empty stomach, which may increase iron absorption
  • eating an iron-rich diet, including foods such as dark leafy greens, eggs, red meat, and legumes

Iron deficiency during pregnancy is common. It can make a person feel tired, weak, and fatigued.

If a person has low iron symptoms, they can contact a doctor, who may confirm a diagnosis with a blood test. They can treat a person’s iron deficiency with iron supplements.

People can reduce their chances of iron deficiency during pregnancy by eating iron-rich foods and taking a prenatal vitamin that contains iron.


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