Low iron levels and homebirth?

[clickingtock]

Hello all

Just wondered if anyone has any thoughts/experiences on this? My iron level has dropped to 10.0 and should be 10.5 (I'm now 31wks). When I last saw the midwives they said they would be unlikely to support a homebirth with low iron levels. Do you know why it's a big deal?

I'm now taking floradix and an iron supplement (20mg) - plus trying to boost through diet - so I'm hoping the count will go up.

I had a great HB with my first and would be upset not to give it a go a second time.

Thanks for looking/discussing!

Hi Clickingtock - we are sat next to each other dates-wise on the 40+ thread (I think!) and am interested in any advice you get as in vaguely similar position - hoping for possibility of HB but just tested low for iron too (but haven't had proper HB discussion with anyone yet)

I know this has been discussed on threads before but currently on phone so cannot search. Am wondering if posting in childbirth section will help?

Just found this - www.homebirth.org.uk/ - then click on the 'can I have a homebirth if...' link which has info on low iron.

Also found some older threads which are useful - quite easy to find if you enter homebirth and low iron - good luck!

My midwife told me it's to do with your risk of hemorrhage - if your iron levels are low you are more at risk. It was one of the risks we discussed when I booked in for a home birth, as they don't carry blood or fluid.

isambardo there's a different interpretation of this on the site I linked to. - wonder which is right? (Cannot link as it only takes you to main website):

The main concern for labour is that, if you are genuinely iron-deficient, your blood will not be able to carry as much oxygen as it should. You are no more likely to haemorrhage, but IF you were to suffer a severe haemorrhage, you might be in more danger than a woman whose blood was able to carry more oxygen.

I'm 38+2 with DC2 and although had a slightly different issue, I have a low platelet count, I am still being 'allowed' to have a home birth. I was asked to see the consultant to discuss my platelets and the HB and the only concession I had to make was o have an active/managed 3rd stage rather than a physiological one (& another blood test at 39wks).

I would recommend reading homebirth.org.uk and getting clued up on this issue; nobody can FORCE you into hospital but most people, for obvious reasons, would listen to medical advice from the HCP. However, it may be a discussion you can have with your MW/consultant after the next set of blood tests, depending on how low your count is then. If you don't get given a blood tests at 34wks in your trust, could you perhaps request one? If you aren't able to have a proper discussion about your birth options, you should speak to the Supervisor of Midwives and discuss your options.

eagleray is correct, the reason HB is not advised is that a PPH is more dangerous if you are already iron deficient. Your iron really isn't that low though - with a good diet and supplementation you should definitely be able to get it up to the normal range in a few weeks' time.

As its not that low, if it were me I'd just insist on the hb. No one can make you go in and they have a duty of care to provide a mw if you choose to stay at home. The protocols are partly to protect you and partly to protect themselves, so that if you did have a pph, they'd be able to say they had recommended a hospital birth. Are you near enough a hospital to transfer quickly if need be?

It is safer to be in hospital if you have a PPH.

You are less likely to have a PPH in the first place if you are at home.

why not just take iron supplements - spatone are good, and don't cause constipation so much as the pills

knock it back with orange juice as vit c helps aosrption - don't drink caffeine with it or at the same time.

of course you can still insist on a HB, but it is nicer when they support you.

my levels were low, but not below treatment level - i took the iron things anyway as was feeling tired & drained.

I had this. But 10 is really not low. I'm sure I read somewhere that levels dip slightly at this stage of pregnancy anyway. Do you feel anaemic? If not then argue for your homebirth. I had two home births after similar levels and had no issue..

Some really interesting info being posted here! My levels are 10.7 I think, and I'm around 30 weeks. I feel fine, but have started a Spatone regime as don't want the levels to get any worse, nor do I want it to be the reason it is inadvisable for a HB.

I am under consultant care for a medical condition which was at low risk of affecting my pregnancy, and it has been determined now that it has had no effect at all. However, when I saw the MW recently she said I would be giving birth in hospital as I had consultant care! So now I need to get some sort of statement from him that I still have all my birth choices open to me as I am being perceived as having risky medical issues.

eaglersy your MW can't tell you where to give birth ! No-one can.

I know Edgar - I think she possibly assumed I wasn't considering anything but hospital.

Generally though, I live in an area with a high incidence of HB (compared to the rest of the country) and so there is a lot of information available, and the emphasis seems to be on the individual, rather than about general policies.

good to hear it :)

10 is fine. crack on.

Thanks all - that's really helpful. Yes, I didn't think 10 is that low. I'm due to be tested again and hopefully the floradix and solgar iron tabs will have kicked in. Just interested as to why there was some resistance. I lost v little blood with my first HB - so much so that the MW commented on it. I really feel like a second HB would not be a prob. My nearest hospital is about 5 mins drive away so I really don't think low-ish iron levels would be life-threatening.

Love homebirth.org - was being a bit lazy by not looking there.

Hi Eagleray - hope you're doing ok and good luck to you. I really hope you get that HB; it was one of the best experiences of my life and I'm sure I have a v happy balanced DS because of it (not that hospital babies aren't happy and balanced - just that I was so relaxed and I think hospital might have unsettled me lots). I will be v resistant to a hospital regime, unless there is real evidence that the baby is at risk. I expect to go v overdue as well - 15 days with DS! - but will be avoiding induction as long as possible.

Good luck to everyone here and thanks for advice!

10 is really not that low and you have plenty of time to get your hb up before the birth. Mine were 9.9 at 28 week check and mw was still happy for me to go ahead with homebirth. If you can't tolerate ferrous sulphate try spatone, they really worked for me and lots of others I know.

Hi Clickingtock - lovely to hear you had such a good experience first time around, and really hope you get to do it again. I have to admit to feeling very uncomfortable in hospital due to an awful tragedy some years ago when my then partner was in hospital for several months and didn't know if he would survive or not.

I have been pondering the going overdue thing - have no previous births to go by as this is my first, and live in an area where the policy is to recommend induction at 40 weeks if you are over 40 (although this is often misinterpreted as compulsory induction at 40 weeks!). I think all I can do is prepare for the worst and hope for the best.

Good luck with the iron - I will keep my fingers crossed that the tablets are doing their stuff!