Anaemia after childbirth
What is anaemia?
Anaemia is a condition where the amount of iron (ie haemoglobin) present in your body’s red blood cells is lower than it should be. Where these iron levels drop below their normal levels, this is called iron-deficiency and it is the most common cause of anaemia in the UK.
Your blood is made up of a fluid called ‘plasma’ which contains proteins in the form of red blood cells and white blood cells, as well as other cells that have a range of specific functions. These include cells that attack and fight off any infections that enter your body and others that help your blood to clot if you cut or injure yourself. Haemoglobin in your red blood cells helps transport oxygen around your body. However, if you are anaemic, your red blood cells do not work as effectively at carrying oxygen to your vital organs, such as the heart and lungs. This is why people who are anaemic sometimes find that they become tired and breathless more easily.
How would you know if you were anaemic?
It is not always easy to tell if you have anaemia, especially when you are coping with a newborn baby and sleepless nights. There are however, a number of common signs and symptoms. Fair-skinned women tend to look paler than usual and may complain of tiredness, headaches and feeling generally ‘washed-out’. Women with much darker complexions report these symptoms too and anaemia can be confirmed by looking at the colour of the skin inside their mouth, in their skin creases, and on the inner surface of their eyelids. Looking at these will show that their skin looks paler than it should be. If your haemoglobin is very low, you may also feel dizzy and could even faint. You are also likely to feel breathless when climbing the stairs, or walking uphill; this might also lead to ‘palpitations’ (abnormally rapid heart beats that you are aware of) and, more rarely, a pain in the area of your ‘heart’ – this symptom is referred to as ‘angina’.
However, the most reliable way to find out whether or not you are anaemic is to have a simple Haemoglobin blood test; this involves taking a small amount of blood from a vein in your arm. This sample of blood is then sent to a blood-testing laboratory (Haematology Lab) where specially trained staff will check the quality and quantity of the red blood cells circulating around your body. If you are showing signs of being anaemic your midwife or GP may suggest this test to help them make a firm diagnosis.
Things that might make a difference
Which foods you eat and what type of clothing you wear might seem unlikely partners; however, anaemia has been linked to diets that lack iron-rich foods, and also to a lack of exposure to sunlight which provides vitamin D. This may arise because of your personal food tastes and preferences, as with vegetarian and vegan diets, or because you are unaware of the foods that are needed as part of a healthy balanced diet. Or, it might be because your culture requires you to keep your skin completely covered, or because you spend most of your time indoors.
Foods that have high iron content include: red meats, green leafy vegetables and fortified cereals. However, even when you are eating iron-rich foods and are getting enough vitamin D from natural sunlight, poor absorption of iron by your body can still occur. This can be the case if you drink too much tea and coffee, whereas if you eat foods that are rich in vitamin C around the same time that you eat iron-rich foods, this helps your body absorb the iron it needs much better.
For additional information look at our section on ‘healthy eating’.
If you are found to be anaemic your GP will prescribe iron tablets; these are also available as a liquid mixture if you’d prefer this to taking tablets. A well-known side-effect of iron tablets is that you are more likely to become constipated and that your stools (poo) become much darker, often black in colour. This can be quite alarming if no-one has warned you what to expect! Your doctor or pharmacist can suggest a gentle laxative to help to relieve any constipation. Some women can also feel a bit nauseous (a feeling of sickness) when taking iron supplements, but this usually lessens as you get used to them. There are different types of iron preparations available, so if the one you have been prescribed does not suit you, tell your GP so that a different preparation can be tried. It is important that you don’t just stop taking your iron supplements because of the way it is affecting you.
Anaemia caused by heavy blood loss
Another reason why some women become anaemic is because of the amount of blood that is lost around the time of the birth. If there has been a large blood loss, this can affect your recovery from the birth, as well as your ability to care for your new baby. Your doctor can prescribe iron tablets for you to take for a few months; however, if the anaemia is more severe and is affecting your ability to function normally, a blood transfusion may be recommended. This restores your iron levels back to normal over a short period of time, so you start feeling better a lot quicker. If you have already been discharged home, you may be offered the option of returning to hospital to receive a blood transfusion. Being re-admitted to hospital can be unsettling for you, your baby and the rest of the family, so if you are feeling unwell while in hospital tell the midwife or doctor, so you can be checked before you go home.
For additional information see our section on ‘Postnatal bleeding’.
What else is helpful?
Where women breastfeed exclusively and the baby receives only their breast milk for the first six months, the circulating hormones in the woman’s body will delay her menstrual periods restarting. Therefore, continuing to breastfeed for this length of time will delay additional blood loss through menstrual bleeding and will give both you and your baby the maximum level of health benefit.
For additional information about the benefits associated with choosing to breastfeed look at our section on ‘Infant feeding’.