Anemia During Pregnancy
Medically reviewed by Dr. Lisa Okafor, MD, FACOG · Board-Certified OB-GYN
Content reviewed against published ACOG, WHO, NIH guidelines
Last reviewed:
Your health matters just as much as your baby's. If you are dealing with anemia during pregnancy, here is what you need to know.
The short answer
Anemia during pregnancy is very common, affecting up to 40% of pregnant people worldwide. It is most often caused by iron deficiency due to the increased blood volume and iron demands of pregnancy. Symptoms include extreme fatigue, weakness, pale skin, dizziness, and shortness of breath. It is treatable with iron supplementation and dietary changes.
Key takeaways
- Anemia during pregnancy is very common, affecting up to 40% of pregnant people worldwide. It is most often caused by iron deficiency due to the increased blood volume and iron demands of pregnancy. Symptoms include extreme fatigue, weakness, pale skin, dizziness, and shortness of breath. It is treatable with iron supplementation and dietary changes.
- Usually normal when: Mild anemia detected on routine blood work without significant symptoms
- Call your doctor if: Severe dizziness or fainting
- Varies by age — see the age-by-age breakdown below
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What Parents Should Know
According to ACOG, WHO, NIH guidelines, anemia during pregnancy is very common, affecting up to 40% of pregnant people worldwide. It is most often caused by iron deficiency due to the increased blood volume and iron demands of pregnancy. Symptoms include extreme fatigue, weakness, pale skin, dizziness, and shortness of breath. It is treatable with iron supplementation and dietary changes. At First trimester, your provider will check your hemoglobin at your first prenatal visit. Even if levels are normal initially, anemia can develop later. Take your prenatal vitamin (which contains iron) consistently. Iron-rich foods include lean red meat, spinach, beans, fortified cereals, and lentils. Vitamin C helps iron absorption. It is generally considered normal when mild anemia detected on routine blood work without significant symptoms. However, you should contact your pediatrician promptly if severe dizziness or fainting.
Normal vs. Concerning
By Age
What to expect by age
First trimester
Your provider will check your hemoglobin at your first prenatal visit. Even if levels are normal initially, anemia can develop later. Take your prenatal vitamin (which contains iron) consistently. Iron-rich foods include lean red meat, spinach, beans, fortified cereals, and lentils. Vitamin C helps iron absorption.
Second trimester
Blood volume expands significantly in the second trimester, naturally diluting red blood cells (physiologic anemia of pregnancy). Your provider will recheck hemoglobin levels, typically around 24-28 weeks. If anemia is detected, additional iron supplementation may be prescribed. Take iron supplements with vitamin C and away from calcium-rich foods for best absorption.
Third trimester
Iron demands are highest in the third trimester as the baby builds iron stores for the first months of life. Severe anemia can increase risks of preterm birth, low birth weight, and postpartum hemorrhage. If oral iron is not sufficient, IV iron infusions are a safe and effective option during pregnancy.
What to Tell Your Pediatrician
- Describe when you first noticed anemia during pregnancy and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if extreme fatigue beyond normal pregnancy tiredness.
- Mention if persistent dizziness, weakness, or shortness of breath with minimal exertion.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Mild anemia detected on routine blood work without significant symptoms
- Fatigue that is typical of pregnancy and responds to rest
- Hemoglobin levels that improve with iron supplementation
- Extreme fatigue beyond normal pregnancy tiredness
- Persistent dizziness, weakness, or shortness of breath with minimal exertion
- Pale skin, lips, or nail beds
- Heart palpitations or racing heart
- Severe dizziness or fainting
- Chest pain or severe shortness of breath
- Signs of severe anemia: extreme weakness, confusion, or rapid heartbeat at rest
What You Can Do at Home
- Keep track of when you notice anemia during pregnancy — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that mild anemia detected on routine blood work without significant symptoms — this is generally within the range of normal.
- At First trimester, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Prioritize your own rest and nutrition. Accept help when offered, and do not hesitate to reach out to your healthcare provider.
- While monitoring at home, seek immediate care if severe dizziness or fainting.
Related Conditions
Extreme Tiredness During Pregnancy
Extreme fatigue is one of the most common and earliest symptoms of pregnancy, affecting nearly all pregnant people at some point. It is caused by surging progesterone levels, increased blood production, metabolic changes, and the enormous energy demands of growing a baby. Fatigue is typically most intense in the first and third trimesters.
Craving Non-Food Items During Pregnancy (Pica)
Pica is the craving and sometimes consumption of non-food items during pregnancy, such as ice, dirt, clay, chalk, or laundry starch. It affects an estimated 28% of pregnant people worldwide and may be associated with iron deficiency or other nutritional deficiencies. It should always be discussed with your provider.
Dizziness and Fainting in Pregnancy
Dizziness is common during pregnancy, affecting many pregnant people at various stages. It can be caused by low blood pressure, blood pooling in the legs, low blood sugar, anemia, dehydration, or the growing uterus compressing major blood vessels. While usually benign, fainting should always be reported to your provider.
Related Resources
Postpartum Recovery Guide
Week-by-week postpartum recovery timeline and warning signs.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is anemia during pregnancy normal?
When should I call the doctor about anemia during pregnancy?
When is anemia during pregnancy normal?
What causes anemia during pregnancy?
What should I mention to my pediatrician about anemia during pregnancy?
Is anemia during pregnancy normal at First trimester?
Is anemia during pregnancy normal at Second trimester?
Should I go to the ER for anemia during pregnancy?
Does anemia during pregnancy go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Anemia During Pregnancy.
Things to mention
- Describe when you first noticed anemia during pregnancy and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if extreme fatigue beyond normal pregnancy tiredness.
- Mention if persistent dizziness, weakness, or shortness of breath with minimal exertion.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- Extreme fatigue beyond normal pregnancy tiredness
- Persistent dizziness, weakness, or shortness of breath with minimal exertion
- Pale skin, lips, or nail beds
Urgent signs to report immediately
- Severe dizziness or fainting
- Chest pain or severe shortness of breath
- Signs of severe anemia: extreme weakness, confusion, or rapid heartbeat at rest
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of anemia during pregnancy are normal. Talk to your pediatrician if severe dizziness or fainting.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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Related Maternal Concerns
Extreme Tiredness During Pregnancy
Extreme fatigue is one of the most common and earliest symptoms of pregnancy, affecting nearly all pregnant people at some point. It is caused by surging progesterone levels, increased blood production, metabolic changes, and the enormous energy demands of growing a baby. Fatigue is typically most intense in the first and third trimesters.
Craving Non-Food Items During Pregnancy (Pica)
Pica is the craving and sometimes consumption of non-food items during pregnancy, such as ice, dirt, clay, chalk, or laundry starch. It affects an estimated 28% of pregnant people worldwide and may be associated with iron deficiency or other nutritional deficiencies. It should always be discussed with your provider.
Dizziness and Fainting in Pregnancy
Dizziness is common during pregnancy, affecting many pregnant people at various stages. It can be caused by low blood pressure, blood pooling in the legs, low blood sugar, anemia, dehydration, or the growing uterus compressing major blood vessels. While usually benign, fainting should always be reported to your provider.
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An abnormal prenatal screening result can be terrifying, but it is important to understand that screening tests are designed to cast a wide net and have significant false-positive rates. Most people with abnormal screening results go on to have healthy babies after further testing confirms the baby is fine. An abnormal screening is a reason for more information, not a diagnosis.
Pregnancy Over 35 (Advanced Maternal Age)
While pregnancy after 35 carries some increased risks (including chromosomal abnormalities, gestational diabetes, and hypertension), the vast majority of people over 35 have healthy pregnancies and healthy babies. The term "geriatric pregnancy" is outdated and does not reflect reality. With appropriate prenatal care and monitoring, outcomes are excellent.
Amniocentesis Questions and Fears
Amniocentesis is a diagnostic test performed between 15-20 weeks that analyzes amniotic fluid to detect chromosomal conditions and genetic disorders with over 99% accuracy. The risk of pregnancy loss from the procedure is approximately 1 in 500-1,000 when performed by an experienced provider. Understanding the actual risks can help you make an informed decision.