Think I may be anaemic but MW refused to test...

[DangerMousey]

Had my 16 week appointment this morning with MW. Told her that I'd been feeling utterly exhausted, needing 3 hour naps every afternoon, real effort to drags self up the stairs to my flat etc....and said I was worried I was anaemic.

My mum was anaemic in all her PGs.

The MW was quite dismissive and said "your bloods were fine at your 8 week appt, they were 12.2, so I an guarantee you're not anaemic. Pregnancy just makes you tired."

But surely things could have changed in the 8 weeks that have passed since my early blood tests?

Would it be weird to go see my GP separately and ask for a blood test to check for anaemia??

Also after the leaving the MW I noticed she'd stuck my blood results from 8 weeks in the back of my notes and it quite clearly says:

"possible iron deficiency and/or alpha thalassaemia carrier. Iron status must be checked."

Has she just ignored the recommendations in the hospital blood results?!

Ps - also what the hell is alpha thalassaemia and should I be worried that I might be carrying it?! She didn't mention this at all!

How odd. Yes, you could certainly go to your GP and get checked out. When I suspected anaemia I started taking Spatone (from health food shop) and by the time I did get a blood test the levels were just about okay, so I think I had been anaemic before taking the iron.

The gp will check it for you, what a divvy midwife!

I don't think you are being unreasonable. The midwife didn't sound very sympathetic at all. If you're worried then make an appointment with the GP. Sounds as if she has ignored the hospital blood results. I'd ask to see a different midwife from now on if possible.

If you think you're anemic why not just take steps to redress it yourself, like Spatone or Floradix or supplements?

Honest question, I'm just not sure what they would do for you that you can't try for yourself. I know a blood transfusion would be offered in severe cases, but best avoided if possible.

That's really odd! In your shoes I would probably start taking iron to see if it helps and also get your iron levels tested. Can you make another MW appt and see a different one?

alpha thalassaemia is a fairly severe condition but quite unusual (says Google).

Also, if you are anemic, getting a blood test will make you feel much worse (well, it did, in my case, I didn't have iron to spare!). Much better to proceed thinking I was prone to anemia & drink lots of Floradix as preventative (other supplements didn't work well for me).

I think in this situation you need to see your GP. Unless your midwife has a crystal ball she has no way of knowing at all whether you're anaemic or not. 12.2 is on the low side for a non-pregnant woman (although OK during pregnancy), so possibly the blood test results saying iron deficiency may be due to that. Either way it's worth getting further advice IMO.

Thanks guys. There's only 1 MW at our surgery who I have to see for all my antenatal appointments so dont think I can really see another one.

I started taking Spatone from Boots (over the counter) a few days ago and it seems to have made a slight improvement. However, I know from my mum's years of anaemia that if a blood test shows an anaemic result, they give you iron supplements much stronger than anything you can buy over the counter. I think they might be what I need!

My GP is usually very good so I might just go see her and ask for a blood test to be sure. Grrrrr so annoying! That's more time out of the office :-/

DangerMousey - the same is true about MW at my practise. However, I had such a bad time with her in my pregnancy that I lost faith in her and saw a Dr who confirmed that I could ask to see another if I got pregnant again.

12 is fairly low but not anaemic so every chance this would have dropped again by now. Like the others said I would just take Supplements and see if you feel better. I felt better almost instantly when i started tablets. They should check levels again around 20 weeks I think anyway.

The alpha thalassaemia note should be taken seriously. (I have the same thing). It means that your red blood cells are smaller than normal. on a day to day basis it is of little consequence, although ordinary blood tests for anaemia (which I understand look at the size of red blood cells as smaller cells can indicate anaemia) are not adequate, and you need a Ferritin blood test. It is not a good idea to take iron supplements if you aren't actually anaemic.

However, the problem is that if your partner has the same thing, it can be problematic for the baby. That is why I'm surprised the alpha thalassaemia hasn't been picked up before. In my case, we were called for genetic counselling and DH had to have a blood test to see if he had the same trait - he didn't so no issues for us.

Alpha thalassaemia trait is rare in northern Europeans but more common in other racial groups (sorry, I forget which) so if your partner is white British then there's probably no concern, but I do think you should be going back to the midwife and making a bit of a fuss about this one.

Can I just add it is ten years since I went through all this when pregnant with DS1 so my knowledge is rusty, but I do remember that it was important it was checked.

Perfectly acceptable to go and see the GP.

They don't routinely test til you're 28 weeks in my area. I'm 24 weeks and requested a blood test which showed I was quite anaemic, despite already taking supplements so in your shoes I'd definitely make a GP appointment.

You can buy the ones they prescribed me over the counter. Spatone and floradfix were no good as you have to drink the whole bottle but I always just buy mine as easier than repeat prescription. Will message their proper name later.

The reason prescription iron tablets have higher levels of iron is because it's so hard to absorb iron from tablets.

The liquid form (Spatone, floradix, ferroglobin) is much more easily absorbed and so can contain much lower levels yet your get roughly the same amount in your body overall.

Take yourself off to your Gp. I was anaemic when pg and my mw kept insisting my level of 9 was borderline despite the fact my bp was through the floor. GP told me to take the iron tablets and the stupid MW told me not to. I took them with no ill effects and felt fab within a few weeks.
Then same stupid mw told me if I didn't come off them I would damage my baby through too much iron and so I stopped. Cue me being totally anaemic after birth despite losing minimal blood and therefore felt crap for the first three weeks of ds's life due to anaemia and resulting low bp.
If you have no trouble taking iron tablets- take them they are so cheap and as it takes a few weeks to kick in at least you'll have started them before you get your blood test back.

gp-prescribed iron tablets are massively high in iron - i can see alberts 's point there.

there are loads of iron supplements though - mentioned already are floradix and spatone.

definitely recommend those ( i was anaemic afterwards and had borderline iron all the way through pg)

but also get that alpha thalessaemia checked with gp.

Maybe hang off the OTC supplements until you've got an answer? You don't want to mask/correct the result before you've seen the GP.

I think the liquid forms of Iron supplement are also less likely to cause digestive upset. True for me & anecdotally for others.

Remember that you can't mix floradix with pregnacare or other pregnancy vitamins though - floradix is not just Iron, it has too many other vits in it.

ah, that's useful to know.

you can use spatone with the vit supplements as it's just iron sulphate

Alpha thalessaemia is against my details in the hospital system and on my notes but that's only because when we were grilled at my early booking appointment with the midwife, my husband said his great grandmother was Italian and Mediterranean heritage carries a risk of alpha thalessaemia. Might you have mentioned a similar thing to do with yours or your babys father's heritage at your very first appointment with the midwife? Also if you mentioned at the same time that your mum was anaemic in pregnancy then that's where those notes may come from...

If you get on with the spatone, carry on with that. Take 2 sachets every day in orange juice.
I had to have high iron dose in my first pregnancy and I hated the constipation that goes with it. I switched to spatone myself after I heard about it on mumsnet and got on fine.

Obviously see how you go.