The typical suggestion in prenatal exam rooms when a hematocrit or hemoglobin test reveals that an expecting mother is suffering from low iron levels or anemia is to prescribe iron pills. Unfortunately, not only do these pills not work very well, but the inorganic iron in these supplements is not bio-available and can contribute to health problems (think gnawing on a chunk of iron from the local hardware store).
Fortunately, there are effective ways to increase a mother-to-be’s intake of organic iron, which is easily absorbed and metabolized by the body to achieve the desired increase in hemoglobin in the blood.
Who are Most at Risk for Anemia in Pregnancy?
Let’s look at what might cause issues with low iron or anemia in pregnancy to begin with.
First, women who are pregnant with more than one baby are obviously most at risk for developing this condition during gestation. Women who have had two pregnancies very close together experience a lower, but similar risk.
Morning sickness can play a role in pregnancy anemia as this can cause the mother-to-be to not eat enough iron rich foods or to vomit what she does manage to get down the hatch.
Finally, women who were anemic before becoming pregnant have a high risk of the condition continuing throughout gestation.
Signs of pregnancy related anemia include the following according to The Mayo Clinic Guide to a Healthy Pregnancy:
- Pale skin, lips, and nails
- Feeling tired or weak
- Air hunger or shortness of breath
- Rapid heartbeat
- Trouble focusing
Dangers of Anemia in Pregnancy
While anemia in pregnancy is very common, its effects are very serious indeed. This is why women with blood levels of iron that are too low are prevented from having their babies at a birth center or at home and are required to deliver in a hospital environment. Some of the short and long-term risks of anemia in pregnancy include:
- Baby that is preterm
- Baby that is low birthweight
- Emergency blood transfusion after delivery from loss of blood
- Postpartum depression
- Anemic baby that suffers from developmental delays
While women are typically tested for anemia early in pregnancy, a negative result does not mean she is in the clear. Most prenatal providers will test again in the second or third trimester to be sure anemia did not slowly creep up. In fact, a common scenario is for a low hematocrit to suddenly appear in the later stage of pregnancy when everything was fine earlier in gestation.
Why You Should Avoid Inorganic Iron (Yes, Those Pills Your Doctor Prescribed)
When anemia in pregnancy is diagnosed, iron pills are the go-to solution for most prenatal care providers. The trouble is, these things don’t work very well and should be avoided due to a potential aggravation of inflammatory conditions.
According to Dr. Nicole Dinezza, organic iron (from food) and inorganic iron (from supplements like iron pills or cast iron pans) are processed differently in the intestinal tract. Organic sources of iron require an additional (beneficial) processing by the liver before being fully metabolized. An increasing amount of research suggests that an excess of inorganic iron in the diet is responsible for encouraging a cascade of inflammatory conditions (1). Dr. Lawrence Wilson MD discusses more about the dangers of inorganic iron and the toxicity of iron added to processed foods and supplements in this article. Watch out for non-enameled cast iron pans too!
The rub with all of this is that you can be faithfully taking iron pills or other supplements containing iron and still remain anemic due to the lack of bio-availability of inorganic iron. Not only are they ineffective, iron pills frequently cause uncomfortable side effects such as constipation, diarrhea, leg cramps, and/or nausea. In addition, black stools are a frequent occurrence for those who take iron pills, one indication of how indigestible these things are! Such side effects do not occur when consuming food sources naturally high in organic iron (discussed below).
This is why when your prenatal care provider suggests iron pills for a low hematocrit, you might want to consider doing what I did. Smile, politely decline, and embrace the natural alternatives that will provide bio-available, organic iron to your diet instead.
Natural Ways to Relieve Anemia in Pregnancy
I suffered from low iron with all three of my pregnancies. Fortunately, it only cropped up late in the third trimester each time and was easily resolved with a tablespoon of blackstrap molasses every day stirred into a glass of grassfed milk. Blackstrap molasses is naturally very high in organic iron and a great food to naturally boost blood levels of this mineral. Don’t worry about those who say that consuming molasses with milk will interfere with iron absorption. The research is far from conclusive on this topic with some sources suggesting that milk does not interfere with iron absorption at all (2). I can personally attest to the milk/molasses approach working very effectively for me.
According to the book The Nourishing Traditions Book of Baby and Childcare, an easy way to take 1-2 tablespoons of blackstrap molasses each day is in a mug of hot water. Add a tablespoon of coconut oil (virgin or expeller pressed) and 1/2 teaspoon of ground or fresh ginger if you are in need of a pick-me-up (who doesn’t during pregnancy?). This healthful beverage also makes a good coffee substitute during pregnancy as well if you are trying to avoid caffeine.
Other natural ways to combat anemia in pregnancy include:
- Eat liver! Liver is very high in organic iron. Check out this delicious liver pate recipe with video tutorial. It is wonderful to spread on toast. Sourdough and sprouted crackers work well too. Liver also contains plentiful natural Vitamin A which is necessary for proper absorption of iron. If you can’t stomach liver for whatever reason, desiccated liver capsules are an excellent alternative. My family and I use this brand which is made from certified organic liver from cows grazing on grasslands in the United States. Be wary of some desiccated liver brands that remove the fat which denatures the product. You only want desiccated liver with nothing added and nothing removed!
- Don’t be scared of red meat. A juicy grassfed steak is good for improving iron levels and is not going to harm your health (3).
- Avoid refined carbs, sugar, and antibiotics (and the Pill before getting pregnant) as this encourages gut imbalance and the development of abnormal gut flora. According to Natasha Campbell-McBride MD, an unbalanced gut can frequently thwart efforts to resolve anemia naturally because a particular group of pathogenic bacteria that thrive in this type of intestinal environment love iron! These strains (Actinomyces spp., Mycobaterium spp., Corynebacterium spp., and others) consume whatever iron a person gets from the diet leaving them deficient and sometimes anemic. Iron pills actually make the problem worse as they provide food for these pathogenic strains making their hold in the gut ever stronger with no resolution of the anemia and sometimes worsening of the condition.
- If the blackstrap molasses approach doesn’t appeal to you, Floradix makes a product with organic iron and herbs to assist absorption (sources). It also serves as a digestive aid. The dosage is .34 ounces (10 mL) twice each day. It can also be used throughout pregnancy as a preventative for anemia, not just when the condition has already become a problem.
Did you have a problem with low iron or anemia during pregnancy? What natural approaches for resolving this nutritional deficiency did you use that worked?
Sarah, The Healthy Home Economist
Sarah Pope has been a Health and Nutrition Educator since 2002. Her work is dedicated to helping families effectively incorporate the principles of ancestral diets within the modern household. She is a sought after lecturer around the world for conferences, summits, and podcasts.
Her work has been covered by major media including USA Today, ABC, NBC, and many others.