Birthing Ayurveda: Week 28—Anemia and its Consequences in Pregnancy

Welcome to Birthing Ayurveda, where we follow one woman's pregnancy experience week by week—from a positive home pregnancy test all the way to delivery.

I had my third trimester labs done late last week, which included my gestational diabetes screening and complete blood count (looking at my red blood cells, platelets, amongst other things). Luckily everything was just fine… except for the fact that I was significantly anemic.

Looking back, I am not super surprised. I have been feeling more sluggish and slow. I just attributed it to getting larger. My digestion has also been a little bit more off with more bloating and decreased appetite. My enthusiasm level, now that I think about it, is not quite at par to what is normal for me. These were all signs of poor prana (life force) flowing through my body.

I listened to an interesting talk by a friend and incredibly bright midwife and physician, Aviva Romm, MD (for those who do not know who she is, please do check her out at avivaromm.com) at the Midwife Alliance of North America Conference (MANA 2015) in Albuquerque this week. She had this one slide that absolutely made sense to me.

Anemia in pregnancy is not something to be dismissed, nor is it something that is only relevant to delivery and preparing for the blood loss. Anemia has been connected to a number of consequences, including but not limited to:

• Preterm labor
• Intrauterine infection
• Low birth weight
• Postpartum depression
• Need for transfusion during delivery
• Child with developmental delays
• Spine or neurological defects (particularly with folic acid deficiency)

Around this time, coincidently or not, I noted symptoms that felt like the start of a urinary tract infection, decreased tolerance to stressors on the body (slightly increased blood pressure and a bit more swelling), and more fatigue. In addition to feeling anemic, I felt inflamed.

This is a time of incredible change and growth of the baby. The baby needs reserves and nutrients now more than ever as its growth increases dramatically. Charlie (what we call the baby) is putting on fat, bones are growing, size is growing, and all of this requires nutrients and oxygen (blood!).

To build blood this is what I have started to do.

1. I began taking an iron supplement. Floradex is a great plant-based source of iron. But, personally, it leaves my mouth tasting like a mouthful of iron, so I chose tablets. Instead of plain iron, I am taking chelated-iron, as it is easier on the digestive tract and causes constipation less frequently.
2. I also increased iron in my diet through carrots, beets, raisins, pomegranate, and leafy green vegetables.
3. Being a vegetarian, I also started a B12 and folic acid supplement. Note here that there is a significant portion of our population with a genetic mutation (called the MTHFR mutation) that decreases their ability to convert folic acid to its active form through methylation. Either get tested for this mutation or simply take methyl-folate instead of folic acid. If you are going to take folic acid, make sure it is folic acid and not folate.
4. To support oxygenation and prana in the body, I continued my pranayama. As my uterus grows, my breaths are noticeably more shallow. I have continued my practice of Full-Yogic Breathing, Anuloma Viloma, Brahmari, and Ujjayi breathing.
5. For the inflammation in my body, I started vitamin C supplementation (taken with the iron to help with absorption of the iron) and increased the amount of antioxidants in my diet (it is pomegranate season and I also bought a ton of berries and leafy greens) and increased the amount of organic ghee I was taking in. I took an overall anti-inflammatory approach to my diet.
6. Because of the blood pressure changes (which responded beautifully to a couple nights of solid sleep—go figure), leg and foot cramps, and restless legs that I was feeling, and because I wanted to be preventative towards any true blood pressure issues during my pregnancy, I started a magnesium citrate supplement. 

(Note: As always, be sure to work with your care provider for any changes in your pregnancy!)