Question for Mears or any other midwives out there!

[musica]

I've just had an antenatal check, and although my haemaglobin levels are ok at the moment, the mw said I had no iron at all stored, and should try and boost this with iron rich food. I was wondering if this was likely to be a problem later on in the pregnancy (I'm just into the 2nd trimester), and if so, what's the best thing to do - should I think about taking iron supplements?

Don't mean to jump in here and I am not as qualified as Mears and Leese but it is normal to have a lower haemoglobin level during pregnancy because your blood is more diluted than usual and the concentration of haemoglobin will be lower... this doesn't mean you are anaemic!

Thanks pupuce - it wasn't the haemaglobin level she was concerned about, but the iron reserve I think.

Musica, I wouldn't worry about it too much. Take a one-a-day vitamin with iron which you should do anyway during pregnancy. That will have enough iron in it to cover any extra you need during pregnancy. I had a major haemorrage (sp?) after my dd's birth and my father (a scientist) called the top two haemotologist researchers in the world to determine whether I was taking the right level of iron. They said that even with my large blood loss after a few weeks of high dose I really didn't need to be taking any more than what you get in a one-a-day multi vitamin. I guess the body processes the iron in your food much more efficiently if it's not swamped with iron supplements (which constipate you terribly - not something you want to add to the other miserable symptoms of pregnancy).

Hi Musica - I am unsure about what your midwife said. Did your blood result show low iron stores? It just seems a bit unlikely if your haemolglobin level is OK.
However, it is always a good thing to eat iron rich food so I would concentrate on that. Iron supplements used to be given routinely, but now they are only advised when women become significantly anaemic. Try not to worry yourself - I am sure that your midwife will monitor your iron levels to ensure they remain OK.

Thanks for the replies - Mears, she said my haemaglobin was about 13, but that I had no iron reserve - on my notes she put L2, as far as I could decipher....!

I can?t offer any practical advice here - just my own experiences for you to consider.
I was diagnosed as being significantly anaemic at around 20 weeks (can?t remember the score now) and was told that if it didn?t improve, they wouldn?t let me have my birth in the local low tech hospital as planned etc. etc. I was worried too. I asked her how I could avoid having a high tech birth and raise my levels enough to be considered low risk again. She gave me a two week eating plan with recipes to boost my levels naturally and when that failed to get it to rise substantially enough, sent me to my doctor. He prescribed mega high iron tablets (much stronger than the standard over the counter ones) and this did the trick. I was amazed at how much better I felt after just a couple of days - hadn?t even realised how fatigued I had become. Went on to have great 3rd trimester and a happy healthy baby...
I would dig out your recipe books and try solving it through diet first and if that fails I am sure your midwife will pick it up in her next test and advise you further. Even if you do have to be put on high strength supplements, I am sure it will work out fine (just be prepared for the side effects - extra iron intake may turn your poo black and leave you constipated!! Sorry to be so matter of fact, but it is worth knowing!!)
Good Luck

I have had a similar experience to Jaytree - first time round my haemoglobin count dropped to 8 and my consultant had kittens and told me I had to take the vile 'Pregaday' iron supplement, which does indeed turn your poo black and prevent you from going to the loo more than once a week! However, once I started taking it I felt 100 times better, much less tired and miserable, and was able to really enjoy my third trimester with lots more energy.

I think many women suffer from anaemia or a re prone to anaemia unawares - I developed it again after a miscarriage earlier this year and am now pregnant again, this time with a haem count hovering around 11, courtesy of one Pregaday every 2 days. So I would say if your haemoglobin is low don't put off taking the prescription iron pills as it makes a big difference to your tiredness levels and general health.

musica - I suspect your midwife checked your 'ferritin' levels, which are indeed your iron stores. This is becoming an increasingly popular test - one designed to root out those who will become anaemic if not treated - prevention being better than cure if you like.
Basically your iron stores have been boosting your circulating haemoglobin levels, so whilst your hb is good (and 13 is excellent), it may not stay good as the amt of iron you have in reserve is low.
Just do as others have suggested, and eat food rich in iron, drink less caffeine etc. This may just help to boost depleted stores, preventing the need for iron tablets. Wouldn't suggest you take iron tablets at the moment, as your actual hb is fine. The ferritin check is just a look into the future if you like. Hope this makes sense!

Hi Leese - nice to see you

We do not check ferritin levels routinely hence why I was a bit confused. Seems we have added another test to worry women - no doubt we will be doing it soon

Anyway, I have just returned from being rejected at the Blood Donor session. My Hb is 9.7. Knew I felt a bit tired.
However, you get a nice leaflet telling you what to do to boost your Hb levels.
"Eating foods rich in iron such as fresh vegetables, particularly dark, green leafy vegetables such as cabbage and spinach, fruit, red meat, pulses such as lentils and breakfast cereals with added iron.
Taking a citrus drink such as fresh orange or grapefruit juice along with your meal helps absorption of iron from your food."

I'm off for a glass of wine

Oh Mears, you always make me laugh! Feet firmly on your Scottish soil!
We don't routinely do ferritin levels either, but the big wigs at the hospital are seeing them as the next big thing, hence lots of community requests for them. My friend rang me in tears last night, as she'd been to the hospital 8 wks ago (@ 22 wks) and had Hb and ferritin levels done, and asked to call back next day for results. She did, and Hb was fine (she didn't know to ask for ferritin results, as she didn't know what specifically had been tested for). Besides, ferritin level results take a bit longer - about five days to come back with us.
Anyway, she went again to the consultant at the hospital yesterday, who alarmed her greatly by saying her ferritin levels were very low (and have been for last 8 wks, tho' noone thought to tell her), which would mean she would have a 'scrawny baby' (his words!) if she didn't 'do something about it' (take iron)! Can you believe it? Her HB had been 12.0 (I think thats great), and now she's convinced she is about to expire. these things can go a bit too far don't you think?.....

If only midwives ruled the world eh?

Thanks very much everyone! Dh is celebrating because he wants steak every night!!! I do feel reassured so thank you all!

I thought we did mears?...............

In place of the dreaded iron tablets (and charcoal briquette poos), my midwife recommended Floradix, which is a liquid supplement you can get from Holland and Barrett. It costs about £8 a bottle and looks like Baby Bio, but it is much gentler on the stomach. It was my pregnancy top tip!

You can also get a springwater -rich in iron- in sachets from Boots- big orange box. I assume it's safe in pregnancy- tastes a bit metallic but can be added to orange juice.

I took Pregnacare tablets when pg and had very good iron levels. Didn't make me constipated at all and are an excellent multivitamin for pg women.

Also from Boots. Has folic acid, C and B12 which also help prevent anaemia without stuffing you full of iron.

aloha- I took pregnacare as well with ds2- it was good. Boots used to do a pregnancy supplement that included oils as well but stopped it so I also took efanatal with ds2.

I took that Boots supplement first time round Jimjams and had good Hb levels throughout. It's such a shame they discontinued it. Floradix helped after my C-section because the standard iron tablets I was prescribed made me so ill I thought I was dying.

I used to take ordinary adult multi-vits-with-iron - not pregnancy ones - always took them with fresh orange juice and my Hb level would hover around 12. It kept me off the nasty solid-iron-bung-you-up-for-a-week stuff anyway.

Used to eat liver once a week too. Those were the days!

Never heard of ferritin mind you.