Anaemia and Postpartum Haemorrhage

Anaemia in Pregnancy

Anaemia is a reduction in the quantity or quality of red blood cells which carry oxygen around the body. It can be detected by measuring haemoglobin (Hb) levels in the blood.

During pregnancy, the volume of blood circulating around the body increases, which causes the red blood cells to become more dilute. Therefore haemoglobin levels in pregnant women are usually lower than in non-pregnant women, especially in the last three months of the pregnancy.

The World Health Organisation defines anaemia in pregnancy as a haemoglobin below 11.0 g/dl, although investigations may not begin until Hb levels have dropped to 10-10.5. Whilst levels remain above this, evidence suggests that this drop is normal in pregnancy and there is no need for treatment.

Below these levels, anaemia may produce symptoms of tiredness or possibly dizziness or fainting. When the drop in Hb levels is more severe, there may be breathlessness and palpitations.

The commonest cause of anaemia in pregnant women is iron deficiency, although there are other forms of anaemia caused by folic acid deficiency or inherited conditions such as sickle cell anaemia and thalassaemia.

Iron-deficiency anaemia in pregnancy can be treated with iron tablets and/or an increase in iron-rich foods in the diet.

Antenatal Anaemia and PPH

Research has shown that women who are severely anaemic are not at a greater risk of PPH than women who are not anaemic. However they are much less able to tolerate any blood loss after the birth.

Because of this, in developing countries where severe anaemia is widespread, there can be serious consequences for labouring women. In Europe, haemoglobin levels are more likely to be monitored throughout pregnancy and any severe anaemia treated.

If you are anaemic when your baby is born and you experience a PPH, you may find it harder to recover and be more likely to need iron tablets and/or a blood transfusion.

For more information about anaemia in pregnancy go to our links page which has links to other websites giving useful information.