Are you feeling tired, lightheaded or dizzy? Have you been experiencing a racing heart or shortness of breath? While feeling tired is a perfectly normal part of recovering from pregnancy and birth, it’s important not to ignore symptoms that could point to a common but serious postnatal issue: postnatal anemia.
Postnatal anemia indicates low hemoglobin in the red blood cells, which is most commonly caused by iron deficiency (De Benoist, 2008). Iron plays an important role throughout women’s lives, especially during pregnancy and the postnatal period. It’s a vital component of hemoglobin, which helps to carry oxygen throughout the body. Women, however, are at high risk of being deficient due to the demands of pregnancy as well as blood loss from menstruation and delivery.
Iron deficiency after birth is especially common. Studies have found that the prevalence of anemia 1 week postpartum for women who had normal vaginal births is 24%-26% in those who did not take any supplements. This percentage rises to a staggering 50-80% for women in developing countries (Milman, 2011). If you delivered via C-section, you are also more likely to suffer from anemia because you tend to lose double the amount of blood during delivery.
What are the symptoms of postnatal anemia?
Any combination of the following symptoms could be a sign that you have anemia. The symptoms can last 6 to 12 months.
Shortness of breath
Emotional instability, in particular extreme irritability
Postnatal anemia can also lead to higher risks for postpartum depression and urinary tract infections and can lead to reduced production of breastmilk. Since fatigue and depression can greatly affect the daily routine of a mother and her ability to care for her children, iron deficiency is an important issue to address for both mother and baby.
What causes postpartum anemia?
The biggest causes of postpartum anemia are iron deficiency during pregnancy, and blood loss and hemorrhage during and after delivery, particularly for women who have had multiples or Cesarean sections.
If you’ve been diagnosed with anemia during pregnancy, you are at higher risk of developing anemia after birth as well. During pregnancy, the body’s demands for iron increases threefold to provide enough nutrition for the growth of the fetus and placenta. For many women, it is challenging to keep up with these demands, and their iron stores become depleted, resulting in about 25% of Western women who suffer from iron deficiency anemia. In fact, anemia from iron deficiency accounts for 75% of all anemia that women experience during pregnancy (Horowitz, 2013). For women who carry multiples, the risk of developing anemia is even higher, since the iron requirements increase with each baby.
Postpartum hemorrhage. A typical delivery results in about 500 ml of blood loss and a Cesarean can yield in 1000 ml of blood loss. An estimated 2.9% of women in the U.S. experience postpartum hemorrhage, where she experiences excessive bleeding during or after delivery (Bateman, 2010). Typically after birth, the uterus contracts to expel the placenta and compress the blood vessels in the area where it was attached. Of the various ways postpartum hemorrhage can occur, the main cause is uterine atony, a condition in which these contractions fail to restrict the vessels after delivery. The result is that the uterus continues to bleed, leading to hemorrhage. It’s not surprising then, that the more blood you lose during this process, the more iron you lose as well. A small study on women who experienced postpartum hemorrhage found that 80% of the women who needed emergency hysterectomies as a result of severe uterine atony were anemic during pregnancy. So it’s a bit of a catch-22: if you’re anemic during pregnancy, you’re at higher risk of experiencing postpartum hemorrhage. If you experience postpartum hemorrhage, you’re likely to develop postnatal anemia.
It’s clear that maintaining the necessary levels of iron is important for both you and baby.
So how can you help your body increase iron?
Nutrition plays a big role in the prevention and treatment of postpartum anemia. The best way to nourish your body is through iron-rich foods. You can get dietary iron through two forms: heme and non-heme. Heme iron is highly bioavailable, with 15-35% available to be absorbed by the body with little effect from other dietary factors, while the non-heme form has a much lower bioavailability at 2-20% (Hurrell, 2010). I recommend eating foods that are rich in heme-iron and boosting absorption with vitamin C. You can also cook using a cast-iron skillet to fortify your food with iron.
Foods that are high in heme-iron:
What about supplements?
Increasing your iron stores through diet alone can be challenging, so supplementation may be necessary depending on your level of depletion. A great option that Mother Nutrient offers is to take grass-fed beef liver capsules that are easy to take, high in heme-iron, and are easily absorbed. The liver is nutritionally potent, packed with iron and vitamin B12, and has been traditionally used to aid postpartum women to restore their energy and nutrient stores after pregnancy and birth.
In more serious cases of iron deficiency anemia, you may be prescribed a supplement from your medical provider. While ferrous sulfate and ferrous fumarate are commonly prescribed iron supplements, I recommend taking ferric triglycinate or ferrous bisglycinate, which studies indicate results in fewer gastrointestinal issues (which is already common in the postnatal period) while being equally effective (Milman, 2014). Mother Nutrient offers an easy-to-take chewable iron chelate supplement that is highly bioavailable, great-tasting, and non-constipating.
It’s always recommended to consult with a medical professional to determine where your iron levels are. For recommendations about ways to boost your iron intake and address other related postnatal issues you may be experiencing, Mother Nutrient can provide practical, valuable, natural and holistic solutions.
Mother Nutrient Can Help!
In addition to the range of supplements, superfoods and probiotics we offer, Mother Nutrient also has a free Wellness Quiz that creates a customized nutrition report based on your answers to questions about your diet, lifestyle, and pregnancies. You will get recommendations on specific products, diet, and lifestyle changes that may help you.
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Did you have iron deficiency after your birth? What helped you? Tell me in the comments!
Bateman B, Berman M, Riley L, Leffert L. The Epidemiology of Postpartum Hemorrhage in a Large, Nationwide Sample of Deliveries. Anesthesia & Analgesia. 2010;110:1368-1373.
De Benoist B, McLean E, Egli I, Cogswell M, editors. Geneva: WHO Press, World Health Organization; 2008. WHO/CDC. Library Cataloguing-in-Publication Data. Worldwide prevalence of anaemia 1993-2005: WHO global database on anaemia; p. 40.
Horowitz KM, Ingardia CJ, Borgida AF. 2013, Anemia in pregnancy. Clin Lab Med. 2013;33:281–91.
Hurrell R, Egli I. Iron bioavailability and dietary reference values. The American Journal of Clinical Nutrition. 2010;91:1461S-1467S.
Milman N. Postpartum anemia I: definition, prevalence, causes, and consequences. Annals of Hematology. 2011;90:1247-1253.
Milman N, Jønsson L, Dyre P, Pedersen P, Larsen L. Ferrous bisglycinate 25 mg iron is as effective as ferrous sulfate 50 mg iron in the prophylaxis of iron deficiency and anemia during pregnancy in a randomized trial. Journal of Perinatal Medicine. 2014;42.