Anaemia, low ferritin, very worried. A bit of a vent.

[Yukana]

I am anaemic, although my iron has been low for the majority of my life, all my doctor has ever said is that I have low iron and I need more iron in my diet. They have never prescribed anything for me before pregnancy.

Now that I'm pregnant, the doctor somehow has let the cat out of the bag that I am anaemic (which my family have suspected for years) and that I need treatment. However, I am now 31 weeks pregnant and she had not bothered to treat me in any way until she prescribed me 200mg Ferrous Sulphate tablets to take twice a day, when I was about 29-30 weeks pregnant.

My midwife at my appointment today said that they are giving me 3-4 weeks to show improvement with my iron levels (all could decipher from the notes was that my ferritin level is 6) or they will admit me to hospital until my baby is born (as I won't be able to get there on a daily basis which is apparently what they require) and give me iron injections every day.

She also talked to me about losing blood during the birth and that I am at risk of haemorrhaging, she also talked to me about the possibility of dying whilst giving birth. The thought of dying and leaving my partner, let alone my new family alone terrifies me, and I can't get it out of my mind. Why did she talk to me about this? Although I am somewhat grateful to not be left in the dark regarding this, I am now scared of childbirth.

Is there a high chance these iron tablets will thoroughly avoid the need to go into hospital for injections? I am uncomfortable with needles, and the thought of being away from the emotional support of my partner (I have an anxiety disorder) worries me. I can only hope that I can get my iron levels up quickly enough so that I would have improved greatly when my midwife gives me a blood test again in two weeks.

I just want my baby and me to be okay.

I have no experience of this but I do know that to help up your iron level you eat lots of dark green leafy vegetables, wholemeal bread, iron-fortified cereals, potatoes, lean red meat, shellfish, raisins, prunes and pulses. You should also get as much vitamin C as possible because that helps your body to absorb iron better. (Drink lots of orange juice etc).
Another thing I have been told it to avoid anything with caffiene (sp?!) in it as this stops your body taking in iron. I have had to give up coffee, tea, and coke.
Drink lots of water and PLEASE take good care of yourself.
Also, please try not to worry too much. I am sure things will not get as bad as your midwife suggested and most times (apparently) Ferrous Sulphate tablets do help.
I'll be keeping my fingers and toes crossed for you.
Good luck with everything.

I had a similar but not quite dramatic situation in my first pregnancy.
my ferritin is always a bit low and therefore I am often at the brink of anaemia.
during my first pregnancy I took a pregnancy vitamin and thought it would be enough iron in there. at 28 weeks I had blood taken for tests, got the results at 34 weeks - anaemic. was prescribed iron 3x 200mg a day. went into labour still slightly anaemic, had a pph, was offered a blood transfusion (I refused).
during my second pregnancy I told the mw from the beginning of the anaemia and was prescribed 2x200mg iron from 8w.
for many women during pregnancy, iron intake via food is just not enough, especially when starting out slightly anaemic. but I agree, take care of yourself, try to limit coffee, tea, milk (can hinder iron absorbtion) and take the iron tablet together with organge juice which will also help with the iron-constipation. if you don't agree with the tablets your gp can prescribe different tablets that only dissolve in the intestines (duodenal tablets) which don't cause stomach upsets.

I am generally borderline anaemic, so during each pregnancy I have ended up with low levels. With DS1 I was at 7. I was prescribed ferrous sulphate too. I am currently on it to get my levels back up to 10 from 8.6 or I won't be able to have a home birth this time.

It has started working but not quite fast enough as I'm now 36 weeks, so I have upped my vit C intake. I got some not too strong vit c supplements from boots and hopefully they will work.

My mw did say some people find the ferrous stuff hard to absorb, and said if it hadn't started working for me to go and get some floradix. This is much easier for the body to absorb apparently.

I'm sure you will be fine and they will get your levels back up before you have the baby or even need to stay in hospital. I think that they have frightened you a bit unnecessarily tbh.

I'll buy some orange juice either at the local shop or even better if I can get into town and buy a larger lot. I used to be vegetarian and then went vegan for four years before I was pregnant, but due to having an eating disorder during that time I didn't take any medication or supplements because I scared myself into thinking that any form of tablet/etc would contain calories.

I snapped myself out of it a short while before becoming pregnant, but it means throughout my pregnancy my iron has been low. I just wish my doctor/midwife had done something sooner instead of scaring me and making a rush of things.

For now though I have Barretts Vitamin C with Zinc chewy sweets I can take for Vitamin C , and this morning I had two bowls of Honey Cheerios too (it does have iron in it, not as much as bran flakes or weetabix, but it is a cereal I enjoy) :) Is 50% wholemeal and 50% white bread enough do you think? I use this as an alternative as wholemeal heavy products (wholemeal rice being a prime example) tend not to agree with my stomach very well. I've never been a tea or coffee drinker, and usually stay away from carbonated products.

Eglu I think the midwife went a bit far as well, she knows I suffer from depression and an anxiety disorder, but I feel as if the threat of iron injections everyday is a bit much. I'm trying not to think about dying during birth, but it does scare me.

I know this page is considering anaemia in light of home birth, which you haven't said you're interested in, but it does have some data you might find interesting as it does address questions such as "am I more likely to have a pph if I'm anaemic."

Re. Cereal - although the packet says it contains iron, it's iron in a metallic form (which is pretty hard for your body to extract and use) rather then a salt (much more easily useable). If you're bored you can see it by whizzing some cereal and water in a food processor until it's mush, and then holding a magnet on the side as it all comes to a halt - the black powder that collects is the iron.

In addition to the suggestions already made, you could get hold of some Spatone or Floradix - both natural sources of iron in an easily absorbed form. They're usually available in shops like Holland and Barrett.

Offal is also a very good source of iron - not liver! - but kidney and heart are very good if you don't mind eating it (or could persuade yourself to eat maybe steak and kidney pie)

Dried fruit is meant to be good (particularly appricots, iirc) and good dark chocolate if you want some variety.

It does sound like your mw has maybe presented things in the most negative light - but it is a fine line to tread to warn women of the risks without scaring them unnecessarily. Fingers crossed you don't get pressured to go into hospital (could be worth asking whether it would be possible to get it done at your GP's or by the community nurse rather then tying up a hospital bed - if it comes to that) and that you have a straightforward birth with no pph, regardless of your iron levels at the time.

I also had a blood test at 29 weeks which showed I was a bit anaemic, so I've been taking 2 x 200mg ferrous sulphate tablets a day since then. I'm booked in for a ELCS in two weeks so I had another blood test yesterday (now 37 weeks) to see how it's doing. The doctor mentioned I might need an iron transfusion if levels are still low (I got the impression this would be a one-off thing) but didn't say anything about daily injections of iron, so perhaps your MW didn't give you all the alternatives.

One other thing - check the small print on the label of the ferrous sulphate as there is a list of things you shouldn't eat/ drink within 1-2 hours of taking it. I just mention this because one of the things listed is 'whole grains'. I've interpreted this to include whole grain breakfast cereals and bread products, thoygh not sure if I'm right. So I have my morning tablet and a vitamin C tablet when I first wake up (the label says that iron preparations are best absorbed on an empty stomach), and then try to avoid having my (healthy-ish) breakfast cereal for another hour.

HTH and that all goes smoothly for you from now on.

Just checked my maternity notes, haemoglobin level is 8.8 and ferritin is 6. I don't know how low that is exactly, but I am told it's very low.

I called the midwife ward at the hospital and the duty doctor, and they told me although I've been prescribed 2x ferrous sulphate tablets a day, I can take 3x ferrous sulphate + spatone with orange juice a day. I'm going to give this a shot, if it means I can avoid staying in hospital (and using up a bed for someone who really needs it) I'll deal with stomach cramps.

I assume that the combination of iron products + cereal and whatever I feel like eating (I try to keep a balanced diet) that day will keep my iron levels up enough to satisfy them.

I do hope things go smoothly from now on, I know on my mother's side of the family girls tend to be born early (35-37 weeks most commonly) but perfectly healthy and with rather straightforward labours.

I would also second the suggestion of Floradix. My MW says its easier for the body to absorb and she has seen it bring iron levels up very quickly. I am taking it because my iron count went from 14 to 10 in 2 weeks and I started passing out. Feel fine now however my community midwife doesn't want to retest me until I am 28 weeks (currently 20 weeks) so perhaps 10 isn't that low.

I've just had a course of iron infusions - you can normally have them in one go which takes a few hours I think or like I had 5 short sessions. It takes 15 mins per treatment (although it takes longer to get everything set up and blood pressure checked etc) and I am normally in and out in an hour. My Hb was 9 point something before I had them and I felt so tired. After two of them I felt a lot better and had loads more energy.

I started them once I reached the second trimester and they usually do them a week apart at the hospital near me. Not sure why they are saying you'd have to have them daily - maybe because your levels are so low and you are in 3rd trimester? Cannula didnt hurt much going in at all as the nurses doing it were very experienced. Good luck!

Tangle Yukana may not need that link about home births but it has proved very informative for me. As I said further up my mw is saying my hb levels need to be 10 for a hb. It is an interesting read, and I may need it after this weeks blood test.

Hello, jsut to give you some context on numbers.. my iron level has always been low, but I got it to 15 (whatevers) for my booking in appointment so my MW and GP were happy for me to stop taking extra supplements.

So yes, 6 is quite low. However you can TOTALLY get it up but taking supplements. Floradix was a godsend for me because the ferrus sulphate made me feel really sick. It also contains the vit C you need to absorb iron. However it's not the cheapest and if you can stomach the tablets it's probably best to take them.

I suspect your MW was trying to instill in your how important it is to get a good iron level as you will lose blood in labour. But follow their advice and I'm sure you'll be rosey.

good luck, katy

Hi hon my ferritin levels have dropped as my pg has progressed despite taking ferrous fumerte every day. My ferritin got to 4 and they agreed then to give me iron infusions. I didnt go in daily but had 2 infusions one week apart. They were given on the delivery ward and they monitor you quit closely (for side effects) but still in and out within a couple of hours.
Im 38 + 2 and have been told it might take a couple of weeks for the levels to come up. I would ask midwife to clarify if this is an option or even ask to speak to another midwife. Goodluck.