C section with low iron

[lowironandsurgery]

Does this cause issues for the surgery ?
I am 36 weeks and booked in for a c section but my iron was low at 28 week bloods, 11? Not sure what the numbers mean to be honest but Ive read iron stores can take months to build up, so I guess it's not like much can be done now with 3 weeks to go.
Was told I didn't need iron supplements but I still feel like absolute crap most days. I have no energy. Am always woozy, which is worse in the mornings. Very breathless, headaches but that's probably just hormones. Could my iron levels have got even worse the last 8 weeks ?

Just worrying now about my iron reserves being low and having surgery, what would the hospital do about this if anything ?
Would be great to hear from others who have been through similar

Thanks

I’m also booked for a C section and a few weeks back my ferritin came back as low (18 I think). The midwife was a bit ambivalent about starting iron supplements as the level was ‘borderline’ for treatment, but I decided to get the prescription and take them. I’ve read that levels continue to fall for a period after birth, and I could see that my levels had been decreasing across pregnancy, which is normal but did make me a bit concerned for the postnatal period. Since I’ve been taking the supplements I don’t feel quite as tired and it’s like my concentration improved as well.

It’s never been discussed in the context of the C section though. When I have my pre-op I will ask about continuing to take them, and even whether I need a new prescription as my current one runs out in mid-February and I’m due in the next 2 weeks!

It does take a while to build up but there's no harm in taking what you can pre-emptively. I was really keen to avoid having low iron at my last C-section so religiously took spatone and floradix. If you can, try to take that daily. It might help a bit.

Depends a bit on whether that’s your serum iron or ferritin and what your Hb is. There’s still time for an iron infusion to make a difference if you are low and it might be worth asking your obstetrician about that. Low iron won’t make a difference to the operation but if you’re starting off low it’ll be lower post op and that can make you feel pretty rough. HTH.

My iron was low at my 28 week bloods and had to have an iron infusion in the hospital at 34 weeks to bring it up before my c sec at 38 wks. Really felt a difference. Maybe ask your midwife or consultant.

Thank you everyone. Yeah I will mention it.
How long do iron transfusions take ? Is it something you have to stay in for ?

I do feel it's got lower as I'm really feeling dreadful most the time now, just so woozy and lethargic feel like I need to sit down all the time and rest/catch my breath

Take the iron. You lose a lot of blood in childbirth so very likely this will worsen. Make sure you take it with vitamin c to reduce constipation and aid absorption.

If your ferritin level (Iron stores) is under 50 it can cause anaemia like symptoms in women so you are well under the level needed to feel well. As you say can take months to build this up so the earlier you get started the better.

Apart from making you feel unwell when you will be sleep deprived and trying to look after an infant, low iron can also affect your milk supply if you are thinking of breast feeding.

Thank you I didn't realise that !!

My last section I saw on my notes I lost 800ml of blood, would it likely be more with low iron is that what happens ? Or does having low iron just mean I can't make more blood ? Sorry I don't know much about biology and how all this works !

Don’t worry

Mine was low / borderline at birth about 16/17?
I lost around litre I think they said it was an average amoun during elcs and they didn’t offer a transfusion.

I started taking the feroglobin iron supplements onto of multivitamins the ones that have the little yellow and brown balls after birth.
I also committed to eating steak once a week.

When DD was 14m old i got pregnant again and they tested my iron and it was pretty good…

your current iron stores will make no difference to how much blood you lose and contrary to PP not everyone ‘loses a lot of blood’ in childbirth. If it’s your ferritin (rather than serum iron) you’re referring to (and it’s not clear from your post which it is) then it’s a bit low and may well benefit from a top-up and as per above there’s still plenty of time for an iron infusion to work if they think that’s necessary. It’s not your iron stores that would determine whether you needed a blood transfusion - that decision is based on blood loss and haemoglobin levels. This is all fairly common and routine stuff in pregnancy and really nothing to get too stressed about - just needs a conversation with your obstetrician to decide what they think is best in the context of the rest of your results and your medical history. (DOI: iron deficient obstetric anaesthetist)

@Greybeardy Sorry to resurrect a really old thread but I'm wondering if you see this do you have any general advice please?

I'm 38+1 and due a C Section (3rd) on Friday. My haemoglobin has been static at 8.7 since 28 weeks due to struggling to tolerate oral iron, but I have been taking them just every couple of days cause every day causes horrendous untreatable constipation for me and with vitamin C etc.
I've been offered one iron transfusion on Wed, 2 days before the C Section. I'm reluctant to take it though because I had a bad reaction to the iron transfusion when I had my daughter, also been told it won't help now for during the op just postnatally cause it's too late. I'd rather not risk having it and just try to get my levels up after the op.
Do you think this is ok or am I being reckless not attempting the transfusion? Also if I decline it, can they postpone my booked section because of it?

Thanks if you see this

sounds like something might have got lost in translation somewhere? Do you mean iron infusion or blood transfusion. It'd be unusual to start an elective c-section with a starting haemoglobin of 87 (particularly not a 3rd section), but you need all the info to know what their thought processes are. Probably best to chat to your MW/consultant asap to clarify.

I had low iron and had my infusion the week after my c section. It was lovely! Felt almost instantly better

@Greybeardy Thanks for responding. Apologies - I mean I've been trying to get my haemoglobin up since 28 weeks but struggle to tolerate the tablets/liquid, so it's remained static at 8.7. This was picked up last week at an antenatal appointment that it is still this low. So they phoned around and have offered me an iron infusion (sorry I got confused) on Wednesday 22nd and I am due to get my 3rd C Section on Fri 24th. Can I ask what you mean that it would be unusual to start a 3rd C Section with Haemoglobin of 87? Do you mean they'll prospone the date (it has to be done in the 39th week and Friday is 39+0), or that they'll give me a blood transfusion before it?
Thanks xxx I will phone them tomorrow.

@TulipsTwoLips Glad you felt better, maybe I could also get it after.

it would be unusual for them to be relaxed about starting an elective section with a haemoglobin that low, and may well need a pre-op blood transfusion a day or two before - depends a bit on why it's so low/how urgent the section is etc. You really need to get advice from your obstetrician re. how they're going to manage things safely. An iron infusion probably is a good idea at some point, but that isn't going to make surgery this week safer.

I had to have a blood test before my c section to check iron levels

I didn't have low iron pre birth, but lost 1300ml in labour, so my levels were very low afterwards. As it was explained to me by the haematologist, it's very hard to be a new mum if every time you stand up, you feel faint and dizzy, so they recommended a blood transfusion (I didn't get an emergency O neg transfusion straight after labour as I hadn't lost quite enough blood to meet that protocol). Had the transfusion and felt a million times better. But blood transfusions use a vital resource and I think if you can get levels up by taking iron supplements or an infusion before birth then is a better way to go. And you won't feel shit for three days like I did!

@Greybeardy Thank you again. I think it's so low just due to being pregnant and because of me being unable to tolerate the iron tablets every day, I can only take them every second or third day. It dropped from 11.8 at booking to 8.6 at 28 weeks and has just remained the same. Ferritin dropped from 78 to 11 and is now 14.
I'm not sure of how urgent the section is, but the reason for the section is because I've had 2 previous C Sections and have never laboured first so they strongly advised against attempting any VBA2C and put me down for a section in week 39 - which starts this Friday! I'm wondering if it would also be a concern if I was to go into labour myself which I guess the chances get higher the further it gets postponed - then it'd be an EMCS rather than elective and I understand that's riskier in general.
I phoned today and my consultant has apparently retired so the new consultant who has taken over is going to phone me, hopefully tomorrow.
Do you think they might do the infusion on Weds and then postpone the section to say next week? Would that give it more time to work? They didn't mention transfusion at all.

I had low iron at time of my c section, I was fine, it was never mentioned but then mine was a cat a emergency