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Low Blood Count
by Nancy Sullivan, CNM, MS, FACNM

Nancy SullivanQ. My doctor did routine blood tests, and he telephoned me to say that my blood count is low. I would like to know if this is dangerous in pregnancy . He has given me an iron supplement to take everyday up until I give birth.

A. What is your blood count? This is another word for "hematocrit," a measurement of the number of red blood cells in your blood. It is a percentage of the total blood volume. In pregnancy, it is a little lower than when you are not pregnant. That is because you increase your total blood supply quite a bit. The fluid part (the serum) increases first, and it takes the red blood cells awhile to catch up. So, your blood count or hematocrit falls and you are usually "anemic" by standards for non-pregnant women. The current thought is that this is probably a good thing. Thinner blood can cross the placenta and get to your baby easier, increasing the oxygen and nutrients he or she receives. However, if your hematocrit drops too low (I use 30% as a cut-off), it's not so good. RBCs need iron to carry oxygen around your body, so if you are iron-deficient, you will have "iron-deficiency anemia." This is probably what your doctor is talking about.

Taking iron will boost your RBCs. There is some iron in your prenatal vitamin, but if you are really anemic, you should take some additional iron. I suggest the vitamin (with juice or water) in the morning and an iron tablet (with juice or water, not milk) in the evening. If the iron upsets your stomach or causes constipation, try Floradix, an herbal iron supplement that is much less likely to have these side effects. You can find it at the health food store or on the Internet. Try my website, www.midwifeinfo.com.

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