What Is Maternal Anaemia?
Anaemia is a low level of haemoglobin, the protein found in red blood cells, that is too low to carry the amount of oxygen required by your body. In cases where the absorption and intake of iron becomes limited, anaemia may occur.
Most cases are related to iron deficiency, but may be attributed to a lack of folate or vitamin B12. Mild anaemia is extremely common during pregnancy and should be fairly easy to treat; however, severe to moderate anaemia can cause complications with childbirth, particularly if it is not recognised before labour.
How Does Anaemia Affect the Body During Labour?
Labour is physically demanding on your body and can take significant energy and push hard on your systems, especially the heart, lungs, and blood pressure. It affects the labour in the following way:
Fatigue During Labour
As the energy your blood can carry is halved when you are anaemic, labour can become a lot more physically exhausting for you. Fatigue during labour can lead to having less stamina to continue pushing during the second stage of labour, which will naturally make for more difficulty pushing and can often lead to added emotional strain. This will not prevent you from having a positive labour and birth experience; however, it requires attention from your healthcare team.
Blood Loss During Delivery
There is typically some bleeding during labour and after delivery that is to be expected by the body. Bleeding can put a woman with anaemia in a more precarious position because their body is less equipped to handle the loss of fluids. More serious bleeding complications can result, particularly a higher likelihood of postpartum haemorrhage, though studies do point to a greater likelihood of blood transfusion needed during labour when anaemic, as the body's ability to stop bleeding is decreased. Your doctor should be aware and prepared.
Risk During Caesarean Section
As caesarean sections usually mean greater blood loss, a C-section when you are already anaemic significantly increases the surgical risk. While both planned and unplanned caesareans can affect you with added risks of greater loss of blood and need for transfusion, prolonged recovery time is also a factor in delayed healing. Anaesthesia also has certain risks during an anaemic pregnancy. If a planned C-section is on the horizon, your doctor may prescribe iron therapy before your due date to elevate your levels.
Postpartum Complications
Pregnancy and birth can affect your iron levels even after your baby is born. As stated earlier, your body will naturally lose blood during the birthing process, further compounding anaemia symptoms and possibly even intensifying them. While normal postpartum fatigue is always to be expected, you will feel significantly more tired. Wounds may take longer to heal, especially the perineal portion and caesarean incisions, and the immune systems will generally be weakened and more vulnerable to infection; this means there will be a greater chance of post-birth infections, such as urinary tract and wound infections. You may face difficulty establishing breastfeeding due to this weakness.
Signs You Should Watch Out For
If you feel extremely short of breath, experience heart palpitations, severe dizziness, look visibly pale, or have persistent weaknesses after childbirth that just will not improve, notify your doctor or midwife immediately-these could all be indications that your anaemia is causing you significant health problems.
Anaemia Management During Pregnancy & Childbirth
Before Childbirth
The ideal thing to do would be to manage anaemia before you give birth. These are some of the recommendations to control anaemia during pregnancy:
- Consuming iron tablets, the first choice will be iron tablets in the prescribed dosage by your healthcare provider.
- Iron-enriched diet-finding out what kinds of food have iron, such as beans, leafy greens, and whole grains.
- Undergo intravenous iron therapy if oral supplements are not effective or suitable, or if anaemia is detected late and requires rapid correction.
- Treat the cause of the anaemia-it may be due to a deficiency of B12 or folate.
But always consult your healthcare provider before consuming any medications.
During and After Labour
- Your labour care team will take active steps in the management of the third stage, which is the delivery of the placenta, to prevent excessive bleeding.
- A blood transfusion-if you are severely anaemic and bleed heavily, this may be necessary.
- Continue with oral supplements if your doctor encourages you to continue with iron for some weeks after giving birth to rebuild your stores.
- Have a check of your haemoglobin levels-this is often repeated, particularly after heavy bleeding.
When Should You Worry?
If you have been diagnosed with anaemia during pregnancy, remain in close contact with your antenatal care provider, especially as your due date approaches. If you:
- Feel your condition is worsening, or if you are concerned by any aspect of your symptoms or the treatment you are receiving.
- You are approaching your due date, but have not had your haemoglobin checked recently.
- Have the above symptoms of breathlessness and weakness, and feel they are severely impeding your daily life.
- You are concerned about the amount of bleeding you have following the delivery, or the amount of fatigue you are experiencing postnatally and not improving.
Please seek medical help promptly. There is no need to wait and see; anaemia is highly treatable, and preparing for your baby is far less stressful when you feel healthy.
Anaemia during pregnancy is a condition that deserves to be managed actively, not because it is necessarily dangerous, but to ensure you and your baby are at their healthiest to meet each other, for birth and beyond. You are not alone, and medical help is readily available.
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FAQs on Can Anaemia Affect Labour? What Pregnant Women Should Know
- Will the anaemia affect my child during labour?
If the anaemia is severe, there could be a risk of low oxygen reaching the baby during delivery, which could lead to issues with the baby’s heart rate. - Do I need a blood transfusion if I have anaemia?
No, you will likely be perfectly fine without a transfusion, depending on how severe your anaemia is and if you experience heavy bleeding. If you are very ill, the likelihood of a transfusion would increase, but the doctors and midwives are experienced in handling every case separately. - How long will it take for iron levels to return to normal?
This usually takes about 4-8 weeks of consistent iron intake and healthy eating. In some cases of significant blood loss, it may take longer.