Iron deficiency in pregnancy is extremely common, but the approach to treating it is often too simplistic. Many women are given high-dose iron supplements without addressing the underlying reasons why their iron is low in the first place.
Low iron in pregnancy is not always about not getting enough iron—it’s about whether the body is absorbing and using it properly.
Why Does Iron Drop in Pregnancy?
During pregnancy, blood volume increases by up to 50%, meaning the demand for iron is significantly higher. Iron is essential for:
-
Foetal development and oxygen transport
-
Preventing maternal anaemia and fatigue
-
Placenta and blood vessel formation
Iron naturally decreases in pregnancy, but if levels drop too low, it can lead to complications like:
-
Extreme fatigue and dizziness
-
Higher risk of preterm birth
-
Low birth weight in infants
-
Postpartum depletion and poor recovery
Despite this, not every woman needs iron supplements in pregnancy, and too much iron can actually increase inflammation and digestive issues.
Why Some Women Struggle to Absorb Iron in Pregnancy
1. Low Stomach Acid & Digestive Changes
Pregnancy hormones slow down digestion, and many women experience reflux, nausea, or bloating. This reduces stomach acid, which is essential for absorbing iron.
💡 Solution:
-
Take iron supplements with vitamin C to enhance absorption.
-
Support stomach acid with lemon water or apple cider vinegar before meals.
2. Inflammation & Hepcidin Blocking Iron Absorption
Hepcidin is a hormone that regulates iron metabolism. When inflammation is high, hepcidin increases, blocking iron absorption and trapping it in storage.
Hepcidin levels naturally rise in pregnancy, making iron absorption harder—especially if inflammation is present.
💡 Solution:
-
Reduce inflammatory foods like processed sugar and seed oils.
-
Check CRP levels to see if inflammation is affecting iron metabolism.
-
Consider Lactobacillus plantarum 299v, a probiotic shown to improve iron absorption.
3. The Wrong Type of Iron Supplements
Many women are given high-dose ferric iron, which is poorly absorbed and more likely to cause constipation and nausea.
💡 Better Iron Options in Pregnancy:
-
Ferrous bisglycinate – Gentle and well-absorbed.
-
Lactoferrin-based iron – Less inflammatory and easier to tolerate.
-
Haem iron supplements – Ideal if dietary intake is low.
Iron-Rich Foods for Pregnancy
Iron in food comes in two forms:
✔ Haem iron (animal-based) – Found in red meat, liver, poultry, and fish. More absorbable and ideal for pregnancy.
✔ Non-haem iron (plant-based) – Found in lentils, spinach, tofu, and nuts, but needs vitamin C for better absorption.
Best Iron-Rich Foods for Pregnancy:
-
Grass-fed red meat & liver (best absorbed form of iron)
-
Wild-caught fish & seafood (also rich in omega-3s)
-
Leafy greens & cruciferous vegetables (support liver detox and iron absorption)
-
Pumpkin seeds & tahini (great for snacking)
-
Lentils & chickpeas (combine with vitamin C for better uptake)
Iron in the Third Trimester & Postpartum Recovery
Many women lose iron rapidly in the third trimester and struggle with postpartum depletion.
✔ The placenta draws heavily on iron stores in late pregnancy.
✔ Blood loss during birth can significantly reduce iron levels.
✔ Breastfeeding increases the need for iron and other minerals.
If postpartum iron levels are not restored, this can contribute to:
-
Postpartum fatigue and anxiety
-
Low milk supply
-
Hair loss and poor recovery
💡 What to do:
-
Test iron levels in the third trimester to avoid postpartum depletion.
-
Continue iron-rich foods & supplements for at least 6-12 weeks postpartum.
-
Support gut health to improve absorption (probiotics and digestive enzymes can help).
Struggling with Low Iron in Pregnancy? We Can Help
If you’re pregnant and struggling with low iron, or your iron supplements are making you feel worse, there’s a reason why. Instead of just pushing more iron, I help women:
-
Find the best iron supplement for their body.
-
Support gut health & reduce inflammation to improve iron absorption.
-
Balance iron intake with other key nutrients for pregnancy.
If you’re waiting for an appointment, start by:
-
Taking iron with vitamin C to enhance absorption.
-
Checking inflammation markers if iron levels aren’t improving.
-
Choosing a gentler, more bioavailable form of iron to avoid side effects.
If you’re ready for a personalised iron plan, book a consultation at Her Earth Medicine and let’s make sure your iron levels are optimised for pregnancy and postpartum recovery.