Low iron and been told MUST have hospital birth

[StillPukin]

Apparently my iron levels are 10.5 (I dont know what exactly the measurement is) and I've been told that unless they rise significantly then I wont be allowed to have a home or birthing suite birth, I MUST go to the hospital.
I desperately do not want to go into the hospital unless I have to (I had my DS in hosp and it was awful, I dont want a repeat of this experience).
Has anybody had any experience of this or know why this would affect where I have my baby??

No experience, but they can't refuse you a home birth so you can fight for this if that's what you want - although I'd suggest asking them to explain the risks so you can make an informed decision. They can refuse to let you use the birth centre though.

Thanks, yeh I need to find out more.

How far along are you? When are they planning on next testing you? I was warned with DD2 that my iron levels looked a bit low at 28 weeks (or whenever it was that they did routine bloods) and that they would advise against home birth if they fell further, but no one tested me or mentioned it again .

I don't know much about iron levels, but from a legal perspective:

• A birth suite/MLU is the hospital's facility, they can control who uses it.

• A homebirth is your legal right to choose and they can advise against it.

I think you need to understand a lot more about what a normal level is, what their concerns are about the birth and what you can do to raise your levels. Then you can make an educated choice about whether to go against advise or whether it is something you should listen to and follow.

how long have you got (roughly ) If I remember 10.5 isn't massively low - mine was 9ish at one stage and a regime of spatone in orange juice, red meat and dark green veg got mine up again...in quite a short period of time (couple of weeks if i remember ....)

Hi - I was in exactly the same position this time last year - wanted a home birth but iron levels dropped in last few weeks, which raised concerns.

What happened in my case though, was that all the HCPs I spoke to seemed to have a slightly different opinion on how serious it was though

Community MW wasn't too worried and just told me to take iron tablets and didn't mention me not having a HB. But later that same day I got a call from a hosp MW who was v stern and said it was a Big Problem and I was unlikely to be able to have a HB. I never did get to the bottom of what the 'official' threshold was, nor who had the final say.

Anyway, I knocked back the iron tablets like they were going out of fashion and my iron levels climbed quite impressively just in time!

I ended up being induced in hospital but that was nothing to do with iron levels

I did post about it at the time - let me see if I can find out what I said at the time as I think my levels were very similar to yours. BTW, I never really went along with the 'allowed/not allowed' thing but did take note that v low iron levels were generally not a good thing.

How far along are you?

low iron levels mean that your blood is not carrying a good amount of oxygen in your body - it could become problematic if you haemorrhage or there are any other complications and you might need a blood transfusion.

you'd get very tired very quickly which means that if you have a long labour you might not have energy to push at the end - which will put both you and baby at risk.

I don't know if they could legally refuse anything - but hospital care is probably safest for both of you, especially if you end up needing an emergency section.

your wish for a home birth is nice, but safety comes first.

I suggest you start taking iron supplements, I highly recommend either Floradix with Iron (liquid) or Solgar Gentle Iron (tablet).

I would not take the GP prescribed ones, they made me very ill.

hth

How far along in the pregnancy are you? I was low at about 33 weeks and was told I would need to get my levels up. I took the supplements and then double sachets of spatone when I got an upset stomach. By 36 weeks my levels had increased enough.

I only really bothered as I was desperate for my home birth, but actually it was worth it as it made me feel much less tired. I had been getting breathless on stairs and blaming the baby weight when in this went away when I was no longer anaemic. I also had lighter and shorter bleeding postnatally.

So I would suggest buying some spatone and taking two a day religiously.

Just checked what happened to me last year (DD was due mid-Jan) and in mid Nov Hb levels were 10.7 (was classified as 'slightly anaemic' by GP but no major concerns). Started taking Spatone, then by the end of December (by which point I was 37ish weeks) and they were 9.8. Took iron tablets and by my due date they were up to 11.something and everyone was happy again.

Btw, Spatone did diddly squat for me - you may need something stronger, especially if you need to get your iron levels up quickly.

Re Spatone - I was given the telling off of my life by the MW for taking Spatone as apparently it contained nowhere near enough the iron I needed. And indeed while I'd been on two sachets a day, my levels had dropped!

It possibly works well for some people, and not so well for others. Best to get a couple of professional opinions on what's best

Zing - I agree with everything you say about choosing hospital if it is safest, but I suppose that depends very much on how low the OPs levels are and what 10.5 means. If, for example, it's one of those random things where some areas are happy as low as 10 and others like 11 (like the widely different views on how overdue it starts to be a good idea to induce) then it's a bit of a different assessment to if everyone is consistent that it should be at least 15 or something (no idea about the numbers myself!).

I'm 34+3 so I hope there is time for the levels to rise.
I have been prescribed iron tablets and I've been trying to eat more green veggies. There has been no mention of a retest but hopefully they will do it before baby is due.
Littleducks, yep I'm the same, getting out of breath easily and sometimes I feel my heart racing, Dr Google mentions it could be an iron/anemia issue so hopefully the tabs will help that too.
I've not heard of spatone but will definitely look out for it, thanks

There is a page on low iron levels on homebirth.org.uk .

Do find out when they plan to retest you OP. If your levels are worryingly low, you have quite a long time to push them up a bit. And you shouldn't be ruled out based on a test at this point if they do change.

What else have you been trying to eat? Red meat, obviously. I was told apricots by my midwife this time - easy to eat a few each day as your snacks (I found I was snacking a lot by 34 weeks as I wouldn't eat much in one go) .Fortified breakfast cereals. Also, do you drink tea? I've read that that can limit iron absorbtion (including caffeine free versions) so might be worth ditching too?

I had low iron in my second pregnancy. 10.5 isn't great, I think about 14 is better. I believe the risks are (but I am not a medical person) a higher risk of bleeding after the birth and because of the low iron, it's harder for your blood to clot. It's a shame they haven't given you the information that you need to make an informed decision.
I guess you need to weigh up, as anyone does when planning their birth, whether the benefits of a homebirth outweigh the risks for you? And secondly, how you would feel if you needed to be transferred to hospital after the birth. I am, for the record, very pro-home birth. But also remember that you can have completely different birth experiences in hospital too. How much time have you got? You might be able to get things back up to make it a non-issue, best of luck and congratulations!

Interesting that that sample letter talks about below 10 being an issue RedKites whereas the OP's is already above that. Does suggest it might be a borderline case/different in different areas thing. Definitely worth investigating more fully OP I'd say.

They can't make you go to hospital. If I were you, I would take the prescribed pills and then insist on a retest close to your due date. Then you can make an informed decision.

I had low iron towards the end with dd and it was around 10.3 iirc at 34 weeks. They said below 10 was of concern but hovering close to it made them twitchy. I mainlined iron tablets, made my diet 75% iron, took spatone as an extra precaution and managed to get up to a whopping 10.4 by 38 weeks. I tried for a homebirth and it didn't go to plan. I was transferred in during the second stage and undoubtedly lost more blood than expected and was exhausted more than I would have been due to the anaemia. Post emcs, my iron levels were 6 and I was quite unwell. I didn't have the reserves to lose in the first place. In hindsight, I'd probably still have tried for the homebirth, indeed I tried for a second 4 years later but I should have transferred to hospital earlier and been less adamant that the anaemia wouldn't cause an issue.

You can have a homebirth of course. Make sure it's an informed choice, work on getting your iron levels up and hope that you can stay at home. It might be worth looking at what elements were bad from first time round in case you do end up with a hospital birth for whatever reason. Perhaps see if there are ways of preventing them? Because I was so adamant I wanted to give birth at home, that the hospital experience with dd felt like a failure from the beginning. And it wasn't. It saved my life and the life of my unborn dd. I started her life with ptsd and pnd and a lot of it stemmed from worry over the birth.

Its funny how the perceived "safe" levels vary so much (I wonder if I could use that to my advantage lol). Of course I wouldnt put my baby or myself at risk but I really dont want to go to hospital for the birth which is why I'm trying to find out more about the true risks.

Its so frustrating,,, I had low-lying placenta and was told if it didnt move I'd have to have an elcs, it moved and so I was relieved and now this - blooming typical!!

please don't say things like they can't make you go into hospital. unfortunately if there is a risk, which it sounds like there might be then it might be safest to go into hospital.

basically, its the same with any pregnancy and any birth plan. things can and do change (for the 'better' and 'worse')because ultimately its for the best interest of the mother and baby.

Why shouldn't you say things like that Peapod In any medical situation, it is important for a patient to understand what their options are. You cannot be made to go to hospital, but there are circumstances where it is certainly the most sensible idea. However, understanding that you have a choice is certainly empowering in itself. Also, it can be important for future mental health to have researched your options, understand how serious your situation is and make an informed decision. That decision may well be to go to hospital, but blindly following medical advice isn't necessarily a better plan than questioning it and making your own decision.

Perhaps if you changed your mindset that having a hospital birth wouldn't be a failure on your part and having a home birth is a bonus, it would help.

Regarding your diet - eat iron rich foods: dark green leafy vegetables, iron fortified cereals, beans, meat, apricots, eggs, prunes and raisins. Eating foods or drinking drinks rich in vitamin C aids iron absorption.

The following inhibit iron absorption tea and coffee (don't drink these within half an hour of eating), calcium, antacids and acid reducing medicines and wholegrain cereals.

At the end of the day the decision is yours, but you obviously need to take into account the risks to yourself and the baby. Also many health professionals get twitchy about high risk homebirths because they don't want to lose their jobs.

penguin

I think if OP's iron levels go up - which can be easily achieved in a few weeks - there's no reason for hospital care at all as the problem will be solved.

I am trying to find out the facts in order to make an informed decision, like I said,, I would not risk putting my baby or my safety at risk and I am aware that there are many variables involved in pregnancy and child birth and things can change at any time.

I do not see going into hospital as a failure, if anything I feel it could be more of a risk. When I had my DS it was filthy. Seriously filthy. Blood on the curtains around the bed, blood and sanitary products all over the floors of the toilets and showers.
No staff - I was alone from going in until I was 8 cm dilated when I managed (eventually) to get somebody's attention. I was left alone in the delivery room until very near the end when a Dr was brought in.
The ward I was in afterwards was also filthy, full of other peoples visitors with loads of children running into my bed area (with the curtain around) all the time. Everything about it was horrible and from the people I have spoken to since, nothing has changed. Which is why I do not want a hospital birth if I can avoid it.

fruit

have you taken GP prescribed iron tablets?

I know a fair few people who had adverse reactions to them, some quite serious.
the dose is too high and they made me very ill - I honestly think they do more harm then good to some and it's best to avoid them.

StillPukin

the iron supplements I suggested are really good, but if you choose to take the GP ones watch out for signs of dizziness, heart palpitation, feeling faint, stomach cramps, short of breath etc. - if you experience any of these stop them immediately.

In my area the borderline was 10. I was 9.7 which is only 3% below the limit. I was having a hospital birth and was under consultant care, the doctors all told me my levels were nothing to worry about. As an analytical scientist I'd agree, there isn't an analytical method that could tell the difference between 10 (normal level) and 9.7 (low level). Ds came early and so I had a few tests close together and they did bounce about (as I expected).

How positive are they in your area towards homebirths? Could this be a convenient excuse to not support you in having a HB? If 10 is 'normal' in my area then 10.5 can't be that far off in your area even if they have a higher limit. Ask what level they'd be happy with and what you have to do to raise your levels. And if you are feeling particularly awful ask how precise and accurate the assay is in the lab the hospital uses.