What are the symptoms of anaemia in pregnancy?

It goes without saying that growing a new baby is pretty tiring.

But - with so many changes - it might be harder to recognise the symptoms of anaemia.

Anaemia is most often caused by low iron, and it’s very common in pregnancy. Almost 1 in 4 people will develop it when they’re expecting.¹

Even though it’s so common, it can still affect you and your baby - so it’s important to stay informed.

Skip to:

• What is anaemia?
• What causes iron deficiency in pregnancy?
• Signs of anaemia in pregnancy
• Risks and side effects
• Importance of iron and folic acid
• Foods rich in iron for pregnancy
• Treating low iron in pregnancy
• The final say

What is anaemia?

Iron deficiency anaemia is a condition caused by a lack of iron in the blood.

Without enough iron, you won’t have enough haemoglobin, a protein in your red blood cells that transports oxygen around the body.

Iron deficiency anaemia is the most common type, but you can also be anaemic due to:

•  B12/folate deficiency
• Chronic conditions, i.e. sickle cell anaemia (which affects the shape of red blood cells) and thalassemia (which causes your body to have less haemoglobin than usual).

Because your tissues aren’t receiving oxygen properly, you might have low energy, feel weak, or get short of breath easily.

Anaemia is usually easy to remedy with supplements and dietary changes.

However, it can have dangerous effects if ignored or not given the correct treatment - so you should always consult with your GP and follow their advice if you suspect you have low iron levels.

What causes iron deficiency in pregnancy?

When you’re pregnant, your body produces up to 50% more blood to look after you and your baby.²

However, your red blood cell count only increases by 15-30^2. This means you’ll have fewer red blood cells - and therefore a lower haemoglobin level - than you need, and you can quickly become anaemic.

Other factors like morning sickness might also affect how much iron you’re getting, if you can’t keep your food or supplements down.

Signs of anaemia in pregnancy

Anaemia symptoms (such as tiredness, lightheadedness, and muscle weakness) can be harder to spot during pregnancy, as they’re all fairly normal from time to time.

It’s vital to look for the signs and see your GP immediately if you think your iron, B12, or folate levels might be low.

Signs of anaemia in pregnancy can include:

• Feeling tired or weak
• Feeling dizzy or lightheaded
• Shortness of breath
• Headaches
• Heart palpitations
• “Brain fog” or difficulty concentrating
• Pale skin (and sometimes lips, nails, or inner eyelids)

Will anaemia have any side effects for me or my baby?

Anaemia isn’t usually dangerous in mild cases. However, if it’s severe or left untreated for a long period, it can pose dangers or complications to you and your unborn child.

Severe or untreated anaemia can increase your chance of:

• Having a premature or low-weight baby
• Postpartum depression
• A baby with anaemia
• Complications from blood loss during labour

Untreated folate deficiency may also increase your risk of having a baby with neural tube defects.

Importance of iron and folic acid

1. Importance of iron

Getting plenty of iron in both your pregnancy, and in general, will help reduce your risk of iron deficiency anaemia and the risks associated with it.

You should aim to include plenty of iron-rich foods in your diet - but, if you think you still have low iron in pregnancy, you should speak to your GP.

They may suggest an iron supplement to help restore your iron levels.
 

2. Importance of folic acid

Folic acid is another extremely important supplement for pregnancy, as not getting enough can increase your unborn baby’s risk of development problems.

Low folic acid has been connected to the neural tube defect spina bifida.³

In 2021, the government announced that they will be adding folic acid to non-wholemeal wheat flours to help prevent folate deficiency.⁴

But you must still have a balanced diet, as well as taking a 400μg supplement every day until you’re 12 weeks pregnant.⁵

It’s safe to continue taking folic acid after 12 weeks, but by this time the baby’s spine is fully formed and the risk of complications are much lower.

Foods rich in iron for pregnancy

It’s important to take iron supplements if your GP recommends them, but try to focus on getting iron through your diet where you can.

Eating plenty of iron-rich foods during pregnancy can help to reduce your risk of iron deficiency and anaemia. Try to include at least 3 servings per day of foods like:⁶

• Red meat
• Beans
• Leafy greens (like spinach, kale, and broccoli)
• Oily fish like tuna, mackerel, and haddock
• Dried fruit
• Nuts and seeds
• Fortified breakfast cereals

Liver is high in iron, but you should not eat it during pregnancy due to its high vitamin A (retinol) content. Too much vitamin A can harm an unborn baby.⁵

If you’re having trouble keeping food down during your pregnancy, it might be easier to get your iron in liquid form.

Add a handful of spinach to your favourite smoothie recipe and blitz up. Eating foods high in vitamin C can increase your iron absorption, so throw in some oranges or strawberries for an extra boost.⁷

Handpicked content: Iron sources: Foods high in iron

Treating low iron in pregnancy

You’ll be tested for anaemia in your first prenatal appointment, and usually once again in your second or third trimester.

If you’re experiencing any of the symptoms of low iron during your pregnancy, your GP can advise you on what’s best to do next.

They’ll likely check your iron levels with a blood test, but they might also look to see if you have low haemoglobin, low folate levels, or low ferritin in your pregnancy, as these can cause anaemia too.

In most cases, your GP will suggest you take an iron supplement for pregnancy, and they will keep an eye on your iron levels over the next few weeks. You’ll then have to return for another blood test to make sure your levels are increasing.

With the right amount of iron, your symptoms should ease and your iron levels should return to normal.

If you find it difficult to swallow iron tablets, you might be able to take a liquid iron supplement instead.

The final say

This is a time full of changes and precautions - but it shouldn’t be a scary one.

Staying informed and watching out for the signs of low iron can help you have a safer pregnancy.

To summarise:

• Anaemia is caused by a lack of iron, folate, or B12
• When this happens, your blood cells can’t effectively transport oxygen around your body
• You might feel dizzy, lightheaded, have heart palpitations, or look pale
• Almost 1 in 4 people develop anaemia during their pregnancy
• If left untreated, it may increase the risk of complications during pregnancy and birth
• However, anaemia is usually easy to treat with supplements, lifestyle changes, and the advice of your GP
• As well as taking iron supplements (only if prescribed by your GP), be sure to include lots of iron-rich foods in your diet
• With these changes, your anaemia symptoms should go away

The advice in this article is for information only and should not replace medical care. Please check with your GP or healthcare professional before trying any supplements, treatments or remedies. Food supplements must not be used as a substitute for a varied and balanced diet and a healthy lifestyle.

Last updated: 13 September 2022