Maternal Health

Anemia During Pregnancy

Medically reviewed by Dr. Lisa Okafor, MD, FACOG · Board-Certified OB-GYN

Content reviewed against published ACOG, WHO, NIH guidelines

Editorial policy

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
About 1 in 8 women experience symptoms of postpartum depression. If you have symptoms of depression that last longer than 2 weeks, tell your health care provider.
Depression During and After Pregnancy, Centers for Disease Control and Prevention (CDC)

Thousands of parents search for this exact thing. You are not alone.

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.

Sources: [1], [2], [3]

Normal vs. Concerning

Usually Normal
Worth Discussing
Mild anemia detected on routine blood work without significant symptoms
Severe dizziness or fainting
Fatigue that is typical of pregnancy and responds to rest
Chest pain or severe shortness of breath
Hemoglobin levels that improve with iron supplementation
Signs of severe anemia: extreme weakness, confusion, or rapid heartbeat at rest

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

Probably normal when...
  • 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
Mention at your next visit when...
  • 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
Act now when...
  • 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.

Frequently asked questions

Is anemia during pregnancy normal?
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.
When should I call the doctor about anemia during pregnancy?
Severe dizziness or fainting Chest pain or severe shortness of breath Signs of severe anemia: extreme weakness, confusion, or rapid heartbeat at rest
When is anemia during pregnancy normal?
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
What causes anemia during pregnancy?
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. Common explanations include: Mild anemia detected on routine blood work without significant symptoms. Fatigue that is typical of pregnancy and responds to rest.
What should I mention to my pediatrician about anemia during pregnancy?
You should mention anemia during pregnancy at your next visit if: Extreme fatigue beyond normal pregnancy tiredness. Persistent dizziness, weakness, or shortness of breath with minimal exertion. Pale skin, lips, or nail beds.
Is anemia during pregnancy normal 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.
Is anemia during pregnancy normal at 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.
Should I go to the ER for anemia during pregnancy?
Seek emergency care if severe dizziness or fainting, or if chest pain or severe shortness of breath. When in doubt, call your pediatrician's after-hours line for guidance.
Does anemia during pregnancy go away on its own?
In many cases, anemia during pregnancy resolves on its own, especially when mild anemia detected on routine blood work without significant symptoms. By 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.

References

  1. [1]American College of Obstetricians and Gynecologists. Anemia in Pregnancy. ACOG Practice Bulletin No. 233, 2021. ACOG
  2. [2]World Health Organization. Anaemia in Pregnancy. WHO, 2023. WHO
  3. [3]National Library of Medicine. Iron Deficiency Anemia in Pregnancy. StatPearls, 2023. NIH

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

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.

Share:FacebookX

Was this page helpful?

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.

Dealing with Abnormal Prenatal Screening Results

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.