The one size fits all solution that comes up in midwifery care frequently relates to anemia and low ferritin. There are different types of anemia, each with a different cause. Pernicious anemia is caused by a deficiency of vitamin B12. Other types of anemia can be caused by environmental exposure to toxins, chronic inflammation, genetic factors, autoimmune issues and the list goes on. Telling someone they just need to get more copper or B vitamins in their diet may help some people, but it won’t fix the issue for everyone.
In pregnancy, we don’t necessarily have time to figure out the root cause of anemia or low ferritin. We have to treat the symptoms to prevent IUGR, premature labor, an anemic baby with corresponding IQ loss, postpartum hemorrhage, PP depression, pre-eclampsia and other associated risks. What we can do is focus on what I consider the big rocks. The biggest one in my opinion is diet. By dialing in nutrition with a focus on increasing iron absorption, we will also be including other trace minerals and vitamins needed for absorption such as copper, magnesium, vitamin A, B vitamins and more. Exercise, getting quality sleep, reducing environmental exposures to things such as pesticides, and lowering stress levels are other big rocks to work on. Every one of these things will reduce inflammation and in turn lead to a healthier Mom and help baby to thrive before and after birth. Because of the limited time for improvement, we may need to supplement with oral or IV iron to get ferritin to a healthy place for birth.
Working on nutrition and lifestyle, along with supplements including IV infusions are the tools we have to optimize hemoglobin and ferritin throughout pregnancy, and sometimes we need to use all the tools.
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