Anemia in Pregnancy

Hemoglobin is a protein in red blood cells which binds with iron to transport oxygen to all the parts of the body needing oxygen. Normal levels of hemoglobin for a woman would be from13 to 16 grams per deciliter.

The body takes about three months to produce hemoglobin. However, in pregnancy, the volume of plasma (amber colored liquid without blood cells) in your body increases by 1.5 liters. Your body can increase the volume of plasma quickly, but it takes your body three months to make a red blood cell.

Blood volume expansion is the most important aspect of a normal healthy pregnancy. Additional circulating blood volume is needed to supply blood to the enlarged uterus, the placenta, and the baby. Because it takes three months to make a red blood cell, plasma volume increases faster than red cell production during pregnancy. Since anemia is a measure of the hemoglobin part of blood, in pregnancy you will test lower during the period your body is trying to produce hemoglobin to catch up with the volume of plasma. In pregnancy, a hemoglobin result of 11 to 13 gram/deciliter (g/dL) would be normal except in the first three months of pregnancy, when your hemoglobin level may fall to 11 g/dL and even 10.5 g/dl in the second trimester.

You can also develop too much hemoglobin in pregnancy. If your hemoglobin reaches 14 or above, it is higher than normal. In my experience, if a woman is pregnant with a hemoglobin level of 14, 15, or 16, this indicates a failure to expand maternal blood volume. Without an expanded blood volume, preeclampsia and eclampsia are the most common conditions associated with an elevated hemoglobin level.