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10 Symptoms of Anemia During Pregnancy to Never Ignore

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If your complete blood count (CBC) lab test shows you are low in healthy red blood cells or hemoglobin, you might have anemia. This condition affects nearly 40% of pregnancies worldwide. Anemia can leave you feeling drained, dizzy, or pale. Eating iron-rich foods can help boost iron levels. However, specific symptoms can indicate the need for additional medical treatment to keep you and the growing fetus healthy.

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1. Fatigue and Weakness

When you have anemia, your body is low in the red blood cells that supply oxygen to your muscles and organs.

Anemia can cause fatigue because your body isn’t getting enough oxygen. Hemoglobin, and iron-containing protein in red blood cells, carries oxygen to your muscles and organs. Your body needs iron to make hemoglobin, and pregnancy increases iron demands. If red blood cells, iron, or hemoglobin levels drop, oxygen delivery slows, making you feel exhausted even with plenty of rest.

2. Pale Skin, Lips, and Nails

Anemia reduces red blood cell levels, causing your skin, lips, and nail beds to appear unusually pale. This happens because hemoglobin, the protein that gives blood its red color, is lacking. Low oxygen delivery to tissues can also contribute to this paleness.

3. Shortness of Breath

Your body needs more blood and oxygen during pregnancy to support you and the growing fetus. If you have anemia, meeting these extra oxygen demands becomes more difficult and, in turn it forces your heart and lungs to work harder. Everyday tasks may feel like a workout, making it difficult to catch your breath.

4. Dizziness and Light-Headedness

If not enough oxygen is delivered to your brain, you may feel dizzy or light-headed. When oxygen levels drop, even briefly, you might experience a spinning sensation or feel faint, especially when standing up quickly.

5. Headaches

When oxygen levels drop, blood vessels in the brain widen, triggering headaches. These can feel like persistent pressure or a pounding sensations and may worsen with physical activity. While occasional mild headaches are common in pregnancy, frequent or worsening ones warrant medical attention.

6. Cold Hands and Feet

Poor circulation from anemia can make your hands and feet persistently chilly, even in warm environments. You might also notice numbness or tingling in your hands and feet, as reduced oxygen flow affects nerve function.

7. Sore Tongue and Mouth Ulcers

Iron deficiency anemia (the most common type of anemia in pregnancy) reduces saliva production, making your mouth dry and increasing the risk of a red or sore tongue and painful mouth ulcers (sores). Since low iron and oxygen slow healing, your mouth becomes more prone to irritation and infection. 

8. Difficulty Concentrating

Pregnancy can sometimes cause brain fog due to hormonal changes. However, anemia can worsen it as a lack of oxygen to the brain affects memory, focus, and mental clarity, leading to trouble concentrating or forgetfulness.

9. Heart Palpitations

Anemia forces your heart to work harder to pump oxygen-rich blood, which may cause an irregular or rapid heartbeat. It’s normal to experience occasional heart palpitations; however, persistent heart racing or fluttering warrants a consultation with your healthcare provider.

10. Pica (Craving Nonfood Items)

Pica causes cravings for nonfood substances like ice, clay, or paper. People with iron deficiency are twice as likely to have pica. Pagophagia (ice eating) affects 25% of people with iron deficiency.

Some experts believe pica develops to correct nutrient deficiencies. Others suggest that iron deficiency alters dopamine (chemical messengers in your brain) levels, leading to cravings.

Types of Anemia That Affect Pregnant People

The types of anemia that could affect a pregnant person include:

Your provider will likely order a CBC to check the type and severity of anemia. This test measures:

  • Red blood cells (RBC)
  • Hemoglobin (HGB)
  • Hematocrit (HCT) (percentage of blood made up of red blood cells)

They may also check iron and vitamin levels or a peripheral blood smear, which further examines the size and shape of red blood cells. 

Anemia Severity by Hemoglobin Levels
Anemia Severity Hemoglobin Levels
Mild 10–10.9 g/dL
Moderate  7–9.9 g/dL
Severe   Less than 7 g/dL
Hemoglobin is measured in grams per deciliter of blood (g/dL).

How Does Anemia Affect the Fetus During Pregnancy?

In extreme cases, anemia can contribute to pregnancy complications like preterm birth or low birth weight, but it typically does not cause miscarriage (spontaneous pregnancy loss before 20 weeks). Babies born to gestational carriers with low iron may also have low iron, which can affect growth, brain development, and learning.

Dietary Changes to Try

Pregnant people need 27 milligrams (mg) of iron daily. Eating the following iron-rich foods can help you get plenty of iron and prevent or treat anemia: 

  • Heme iron (easily absorbed): Lean red meats, liver, chicken, and eggs
  • Non-heme iron (plant-based, less absorbable): Lentils, beans, tofu, spinach, and quinoa

Other Treatment Options

Mild anemia usually improves with iron-rich foods and prenatal vitamins containing 27 mg of iron. If diet and prenatal vitamins are not helpful enough, your provider may suggest iron supplements or ways to improve absorption.

Pair iron-rich foods with vitamin C sources like citrus fruits, bell peppers, strawberries, tomatoes, and folate-rich foods like leafy greens to boost absorption. Some people like to drink smoothies with spinach, kale, chia seeds, and vitamin C-rich juice. Prune juice is another good option, as it provides iron and helps relieve constipation—another common pregnancy symptom.

Avoid consuming the following at the same time as iron-rich foods or supplements for better iron absorption; instead, space them out by at least one to two hours:

  • Calcium-rich foods (milk, cheese, yogurt)
  • Tea and coffee (tannins reduce iron absorption)

Severe anemia treatment may involve intravenous (IV) iron or blood transfusions.

When to Contact a Healthcare Provider

Your provider will likely screen for anemia three times during pregnancy: once in the first trimester (from the first to the 12th week), a second time between 24 and 28 weeks, and a third time at 36 weeks. Talk to your provider if:

  • You experience symptoms of anemia.
  • Your symptoms don’t improve after a few days of treatment.
  • Your symptoms worsen despite treatment.

Summary 

Anemia during pregnancy is common, but it deserves attention. Symptoms like fatigue, dizziness, and pale skin may signal low red blood cell and hemoglobin levels. Dietary changes, iron supplements, and following your healthcare provider’s advice can help manage anemia and ensure a healthy pregnancy. If symptoms persist or worsen, seek medical guidance promptly.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Brandi Jones MSN-Ed, RN-BC

By Brandi Jones, MSN-ED RN-BC

Jones is a registered nurse and freelance health writer with more than two decades of healthcare experience.

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