Please help me help moms avoid the complications that can accompany the blood loss that accompanies childbirth!
The average adult has 20 cups of blood in his/her body. During a vaginal delivery, at least 2 cups are lost. During a c-section delivery, at least 4 cups are lost. This is important to know because heavy bleeding after delivery is the leading cause of pregnancy-related death on the day of delivery and a leading cause of death within the first 12 weeks afterward (ACOG).
A protein called hemoglobin is a component of blood that is responsible for delivering oxygen to your body. A mineral called iron is needed to make hemoglobin. Normal values for hemoglobin in a woman are between 12 and 15 g/dl. During pregnancy, the amount of blood in the body increases, and that increase results in an increased need for hemoglobin. When hemoglobin levels are low, it is referred to as anemia, and the person who has anemia is considered to be anemic.
Anemia during pregnancy can result in many complications, including the baby not getting what he/she needs to survive and both the baby and mom having complications. Anemia during the first trimester of pregnancy has been linked to a complication called pre-eclampsia in the third. I did not know this until I had a bout with it during my most recent delivery.
In talking with women, there are 2 reasons that moms are at risk for these complications:
1. They are taking prenatal vitamins that do not contain iron.
Unfortunately, most gummy prenatal vitamins do not contain iron. This is the category that I fell into. It is preposterous to me as a healthcare provider that there is no label on the prenatal vitamins indicating that they that do not contain iron considering the statistics that were mentioned above and considering the fact that they do indicate when they contain dha and folic acid. The only reason I even thought to look at the ingredients on the bottle is because a healthcare provider said to me, “Keep taking your prenatals with iron.” That was only after my midwife informed me that my iron may be too low to have a home birth. At that time, I was 6 months pregnant.
2. They believe that their prenatal vitamins containing iron are causing them to have nausea so they stop taking them in favor of taking prenatals without iron.
What moms may not know is that there is a very important hormone by the name of progesterone that is needed for the baby to properly grow. That hormone increases throughout pregnancy and it also slows digestion. Because of this, nausea and vomiting can be experienced and it have nothing to do with the prenatal vitamin. I believe that if moms knew this, they could make more informed decisions about their prenatal vitamins.
Moms that choose not to take prenatals with iron even If their birth team says that it’s okay should:
- Have their hemoglobin levels checked more regularly so that a dip in hemoglobin levels can be detected sooner than later.
- Eat a diet that is rich in iron. Please see a list of foods at the link below: https://www.redcrossblood.org/…/iron-rich-foods.html
- When eating iron-rich foods, pair them with vitamin C which improves the body’s ability to use it. When possible, do not pair them with milk or other dairy products as they can block the body’s ability to use iron.
- Be aware of the signs of low hemoglobin like feeling tired, weak, sleepy, cold, dizzy and having lower than normal blood pressure and contact your doctor immediately if you experience any of these signs.
For moms who find themselves in this situation later on in their pregnancy, there are options. The options normally include either being put on iron supplements or receiving an iron infusion. I encourage moms to discuss the option that is right for them. For me, getting on the right prenatal and eating iron- rich foods. Unfortunately, I am one of the women who still had complications, but fortunately, the blood loss during delivery did not result in my demise.
Now, whenever I encounter a woman who is trying to conceive or is pregnant, I ask if she is on a prenatal with iron. If she is not, a conversation ensues so that she does not find herself in the same situation that was in.
My ask to you is that if you are pregnant or know someone who is pregnant, please encourage her to check the label on her prenatal vitamins and if they do not have iron in them, encourage her to purchase ones that do or at least to talk with her doctor to see what her most recent hemoglobin levels were.
Thank you in advance for helping me with this effort. When people talk about preventable complications and deaths, I believe that prevention starts with education and I will not stop educating until everyone within my sphere of influence has the knowledge that they need.
