Anemia is a lack of red blood cells, which can lead to a lack of oxygen-carrying ability, causing unusual tiredness.The deficiency occurs either through the reduced production or an increased loss of red blood cells. These cells are manufactured in the bone marrow and have a life expectancy of approximately four months.

To produce red blood cells, the body needs (among other things)iron vitamin B12 and folic acid. If there is a lack of one or more of these ingredients, anemia will develop.

Blood is the life-maintaining fluid that circulates through the body’s heart, arteries, veins, and capillaries. It carries away waste matter and carbon dioxide, and brings nourishment, electrolytes, hormones, vitamins, antibodies, heat, and oxygen to the tissues.


Women often become anemic during pregnancy because the demand for iron and other vitamins is increased. The mother must increase her production of red blood cells and, in addition, the fetus and placenta need their own supply of iron, which can only be obtained from the mother.

In order to have enough red blood cells for the fetus, the body starts to produce more red blood cells and plasma. It has been calculated that the blood volume increases approximately 50 per cent during the pregnancy, although the plasma amount is disproportionately greater. This causes a dilution of the blood, making the hemoglobin concentration fall. This is a normal process, with the hemoglobin concentration at its lowest between weeks 25 and 30. The pregnant woman may need additional iron supplementation, and a blood test called serum ferritin is the best way of monitoring this.

Other causes include:

  • a diet low in iron. Vegetarians, and dieters in particular, should make sure their diet provides them with enough iron.
  • lack of folic acid in the diet, or more rarely, a lack of vitamin B12.
  • anemia is more common in women who have pregnancies close together and also in women carrying twins or triplets.


If the woman is otherwise healthy, she will rarely have any symptoms of anemia unless her hemoglobin (red pigment) is below 8g/dl.

  • The first symptoms will be tiredness and paleness.
  • Palpitations – the awareness of the heartbeat, breathlessness and dizziness can occur, though they are unusual.
  • Difficulty in breathing, palpitations and angina.
  • Severe anemia due to loss of blood after the delivery. If this occurs, then a woman may be advised to have a blood transfusion.

Folic Acid

Folic acid is one of the most important nutrients to have during the first trimester of pregnancy and before conception, as women deficient in folic acid have a greater risk of having a baby with a neural tube defect such as spina bifida.

Ideally, folic acid supplements should be taken from the time you’re trying to conceive (if it’s a planned pregnancy) to until the end of week 12 of your pregnancy. The recommended daily supplement dose is 400mcg, but women who’ve had a history of neural tube defects are usually prescribed a dose of 5mg. In addition to taking folic acid supplements, you should try and eat as much as you can each day, by eating plenty of foods rich in folic acid.

Good folic acid foods to eat include:

  • Green leafy vegetables
  • Citrus and kiwi fruit
  • Peas
  • Beans
  • Cauliflower
  • Fortified breakfast cereals
  • Fortified bread
  • Other fortified foods

It’s useful to note that folic acid is lost when food is cooked, so it’s advisable to only boil vegetables for a short period of time or steam them, to retain as many nutrients as possible.

Sources: Net Doctors, Baby and Pregnancy

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