Low ferretin levels at 36 weeks - scared!

[Almie]

I am 36+1 today.

At my 28 week appointment, my midwife told me I looked pale and asked if I'd been feeling tired as she was worried I was anaemic. I had indeed been feeling very tired and breathless, but I'd assumed this was just because I was pregnant whilst looking after my 1yo!! I am a lifelong vegetarian, but I've also never had any problems with anaemia in the past or in my first pregnancy. I usually get my bloods done and tested for all sorts once or twice a year with my consultant for an unrelated health problem, and I know my iron levels have always been fine historically. I didn't hear anything back after this 28 week blood test, so I assume all was fine.

I wasn't scheduled another midwife appointment until I was 35 weeks. I had my bloods done then, and a week later I was asked back as my ferritin levels were low, and they wanted to repeat the test. This was on Thursday, it's Monday today and they've just rang me to say that my ferritin and iron levels were low (can't figure out which result is the iron, but it says my ferritin is 8) and I need iron tablets. So I've been to collect them this afternoon and taken the first one just now.

I'm now panicking - I'm 36 weeks, my first baby was a few days overdue but I'm worried this next one will come early and my iron won't have increased enough in time. I'm not scheduled to see the midwife again until next week when I will be 37+4.

I'm now reading things online about how anaemia can impact the baby's development and can be bad in the event of blood loss during birth. I'm terrified! Has anyone got any experience with giving birth with low ferritin levels? Did it go ok? Are there things I should be doing or asking (other than eating as much spinach as humanly possible)?

In my first birth, the midwife told me I was haemorrhaging so had to have the oxytocin injection to get the placenta out and stop the bleeding. However my community midwife said the notes from my birth say I had a perfectly normal level of blood loss, so this confusion is adding to my worries as well as I just have no idea what's going on anymore 😭

[breakfastbagel]

Lots of Vitamin C to increase iron absorption and look in to the most bioavailable form of iron supplement (iron bisglycinate) as it may not be what the NHS has prescribed you (they tend to offer the cheapest on prescription option first).

Lentils and eggs if you eat them.

Don't worry too much it is natural to have a dip in iron late in pregnancy as your blood volume has increased enormously. It doesn't necessarily mean anything bad will happen but obviously it's good to address it.

[Betsyboo87]

Can you ask about the possibility of an iron infusion? My levels were low at 35 weeks so I had one as it is the quickest way to bring your iron levels back up. I had a retained placenta (manual removal) and haemorrhaged during my first birth so I am at higher risk and they want to ensure my levels are back up before giving birth.

[cara089]

I'v always had iron infusions towards the end of my pregnancies, perhaps you can ask for one. Try not to worry though, I think it's quite common.

[SouthwestSis]

Try and time eating or drinking something heavy in vitamin C for within half an hour of taking your iron supplement.
Beware constipation can be a side effect of taking iron so you may need some movicol or lactulose after a week or 2 on the iron tablets

[Almie]

Thank you all for your advice. I will definitely make sure to take with orange juice. @breakfastbagel I will have a look out for that, it was something-sulphate they gave me so I will see if I can get the bisglycinate one anywhere. I do actually eat tons of lentils, but I'm definitely slacking on eggs - I had a few vegan years a while ago and I have never had a taste for eggs since. I could probably manage some eggybread at least 😋

@Betsyboo87 Ohhh you've reminded me, I also had a retained placenta that they had to manually remove. It didn't occur to me that would be relevant. I will ask about an infusion.

Hmm, I'm definitely going to have to give my midwife a call as we've not discussed anything regarding the birth and I'm really feeling uneasy now. I don't think I can wait until I'm nearly 38 weeks to see anyone again, especially given the confusion over the notes from my first birth, I may well have had the bloomin baby by then!!

[BackOfTheMum5net]

Tofu is a good source of iron too if you can't face eggs. Though you may have had too much of that during the vegan years?!

[pbdr]

I'm a GP. This is totally routine and extremely common in pregnancy, that's why they monitor iron levels regularly; because so many pregnant women need iron tablets to top them up. It really is nothing to worry about at all. Iron infusions are typically reserved for patients who have a fairly significant iron deficiency anaemia. Are you anaemic, or just iron deficient?

[Almie]

@BackOfTheMum5net haha no danger of that, I actually love tofu! I've not had too much lately though as I've been doing my shopping in Aldi, and they don't tend to stock it in my local one. I have experimented recently with blending silken tofu into pasta sauces for extra protein, maybe I should make it a regular thing

@pbdr thank you so much for the reassuring words. In answer to your question... I have no idea, I don't even know what the difference between the two is! I've not seen a doctor or midwife in person since the most recent blood test result, but the midwife told me over the phone that both my iron levels and ferritin levels were both very low. I can see on my pregnancy notes app that my ferritin was 8, but I can't make sense of the rest of it to figure out which is the iron level. Maybe I will try and see what I can figure out with the help of google.

[Greybeardy]

this is really common. The baby will be fine - they're parasites and just take whatever they need from you (that's why your levels have dropped). There's still time for your levels to come up and oral iron in the first instance isn't unreasonable usually.
Re. the confusion over the synto injection in your last pregnancy - they may have advised it because you were bleeding briskly and were heading for a PPH rather than because you'd actually had one - better to prevent bleeding by getting the placenta out than waiting for an actual PPH and then chasing things. HTH.