Anemia and Iron Deficiency During Pregnancy

Pregnancy is a remarkable and transformative experience, but it comes with its unique set of challenges, and anemia is one that deserves our attention. In this episode, we'll explore the causes, symptoms, and potential risks associated with anemia during pregnancy. We'll also discuss practical tips for prevention and management, from dietary changes to the role of supplements.

View Episode Transcript

Featured Expert

Featured Expert


  • Ellement

    Ellement provides customized prenatal vitamins to fit your specific nutritional needs. You give them all the details — like if your fertility journey has been long, or you’re carrying multiple babies — and they can adjust your dosing to exactly what you need.

Episode Transcript

Sunny Gault 0:04
Pregnancy is a remarkable and transformative experience. But it comes with its unique set of challenges, and anemia is one that deserves our attention. In this episode, we'll explore the causes symptoms and potential risks associated with anemia during pregnancy. We'll also discuss practical tips for prevention and management, from dietary changes to the role of supplements. This is Preggie Pals!

Sunny Gault 0:32
Welcome to Preggie Pals. My name is Sunny, and I'll be your host today. If you haven't already, be sure to visit our website at And subscribe to our weekly newsletter, which keeps you updated on all the episodes we release each week. Another great way for you to stay updated is to hit that subscribe button on your podcast app. And if you're looking for a way to get even more involved with our show, then please check out our online community. It's called Mighty Moms. And that's where we chat more about the topics discussed here on our show. And it's also an easy way to learn more about our recording so you can join us live. So let's get started. We want to meet some of our guests today that are joining us for today's episode. We have two mamas who are joining us both have some experience with anemia during their pregnancy. And then we also have a couple of experts. So it is a full house today. We have Dr. Victoria Flores who is an OB/GYN who provides holistic prenatal care in Southern California and during block of element and that is a company allowing pregnant women to customize their prenatal vitamins. So this is exciting. Let's get started with our moms. And Rachael, can I have you introduce yourself and just tell everyone just a little bit about you and your family?

Rachael Terrio 2:21
All right. Hello, my name is Rachael. I have she's my first daughter. We're originally from Connecticut. So we live in Hawaii right now my husband got stationed here because of the Navy. I don't know what else.

Sunny Gault 2:35
Well, and you were anemic during your pregnancy, right? Can you just tell us just a little bit about that? Yeah.

Rachael Terrio 2:40
So I didn't know I had anemia during my pregnancy. It wasn't until I got blood tested during my first trimester. And my doctor was like, oh, yeah, you should have iron supplements. And I was like, What is she was like, you're anemic? And I'm like, Oh, okay. So I had to take iron as a supplement during the whole pregnancy. You know, I had like the typical symptoms. I was just super tired all the time. And so I try to take as much as I want as I could for my anemia. And that's about it.

Sunny Gault 3:11
Well, thank you so much for being with us. Welcome to the show. No need to be nervous. We're all friends here. And Kaylee is joining us. So Kaile, you know, I don't know if we've officially introduced you on a podcast episode before I don't think we have but Kaile is one of our new producers here at New Mommy Media and also has some experience with this topic. So Kaile, tell us a little bit about you and your family.

Kaile Hunt 3:36
Yes, I'm so happy to be a part of this podcast episode and I have a beautiful babbling seven month old now she's talking so much, which is a lot of fun. But I'm also a military wife and I currently live in Hawaii. And then in regards to anemia during pregnancy. I was anemic before I got pregnant. I was anemic for quite a few years. And so when I conceived I that was one of the first questions I asked my midwife team is okay, I've been anemic in the past, can we check our level or my levels? And so my levels were constantly checked, my iron levels are constantly checked during pregnancy. And what's really funny is, you know, pregnant women, we get cravings, right? My number one craving during pregnancy was always red meat, specifically steak, I would I would be the girl, the pregnant mom going out to a restaurant and ordering steak all the time. So I think my body just knew I needed more iron in my diet. So that is my little story.

Sunny Gault 4:37
Well, that's that's helpful because at least it wasn't something that you like regarding the steak. It wasn't something like you hate it, or you know what I mean? At least it kind of Yeah, no, I did. And I do believe our bodies know what our bodies need. And so yeah, that's a beautiful example of that. Welcome to the show. All right. And now for our experts. Like I said, we've got a couple of experts joining us today. So Dr. Flores, I want to start with you. How often do you see women in your practice with anemia during pregnancy?

Victoria Flores 5:08
Well, it's really interesting because every single physician and a midwife that's attending or assisting moms and prenatal care kind of has their own cut off for what is concerning to them. And there's different phases within a pregnancy, where anemia is absolutely normal, and phases where you really want it to be an elevated amount of blood supply and oxygenation to the tissues. So that you can withstand like a potential hemorrhage, or, or perhaps a little bit more blood loss, then maybe it's comfortable to the average person. So there's kind of an art to the numbers I so I can't really say that 50% of my girls or my mama's are anemic, because we're constantly working on blood supply. All the time, when we get women that are already anemic in their first trimester, it's relatively rare, honestly, perhaps maybe, I don't know 10 to 20% of women at the initiation of their pregnancy. And then when we find those numbers, we act on them really quickly, so then it doesn't really show up at the end of care. So it's really hard question answer.

Sunny Gault 6:21
Okay, all right. Do you find that this type of thing is increasing, like with our diet and stuff like that? Do you feel like more women are getting diagnosed with this, or this is something they're having to deal with? Or is it kind of on the same level that it's always been?

Victoria Flores 6:37
So I feel like it's kind of been at the same level since I've been practicing outside of medical school. So between 2016 to now, you know, whatever that is eight years, it hasn't really shifted from what I've seen. Historically. However, I'm sure that there's some argument for other other things that are happening with our blood, like a vitamin D deficiencies are now very prominent. We're seeing other things like other vitamin deficiencies, not necessarily anemia, but they all kind of tie in together because the entire body needs to be healthy to produce healthy blood. Yeah.

Sunny Gault 7:17
And before we started recording, Dr. Flores, you were telling us that you had anemia during pregnancy as well, correct?

Victoria Flores 7:23
Yeah, I did. Okay, and but it wasn't a severe anemia, because I did midwifery care. So in a midwifery care model, my midwife and most midwives kind of have the standard desire to see a hemoglobin above 10. More than the hospital world, we really didn't think about worrying about an anemia until someone was about eight. And a normal for a woman is about 1214. Occasionally 15 If they're a little dehydrated, and it's a little concentrated, or if they're, they're super built with iron, or if they have more testosterone in their blood from something like PCOS. So there's multiple reasons you can have an elevated or poli sci fi me other reasons you can have more iron present or hemoglobin around in the body that's not necessarily associated with health. So yes, but I wanted my goal was to be between 12 and 13. And so by the time I delivered, I was able to get myself to that point.

Sunny Gault 8:25
Yeah, awesome. Yeah. Okay. And durian, let's bring you into the conversation. So during block from element and during prenatal vitamins can certainly help with any kind of anemia, iron deficiency during pregnancy as well, right? Yes,

Victoria Flores 8:41
I am so excited to be here with all of you today. Just to share a bit about my background. I was in the data analytics space for a decade. And when I was pregnant, for the first time, back five years ago, I became really fascinated by how confusing quite frankly, prenatal supplements were, which led me on a three plus year journey to develop the first ever personalized prenatal supplements. And I'm very passionate in particular about the ability to better customize prenatal supplements as it relates to iron because I myself also experienced anemia during my first pregnancy. So it's something that's very near and dear. And quite frankly, I think when people do find out that they are anemic if they get that diagnosis from their OBGYN, or through their midwife care team, it can be very stressful because of course, we know that there's potential for a lot of blood loss or blood changes throughout the labor and delivery process. So I think for me, it was just very exciting to learn more about this space and I'm sure we will be able to share all of our learnings here with the community today.

Sunny Gault 9:55
Yeah, absolutely. And not to be left out. I was anemic during my pregnancies as well. So everybody here, we've got something in common ladies.

Victoria Flores 10:06
Yeah. And I was like I was saying there is a phase, a second, a second trimester phase when pretty much every woman is anemic. But it really is an intentional anemia of nature. Because what that does is it triggers your bone marrow to detect the anemia, and start really ramping up red blood cell production so that you are balanced out by the time you get to delivery. So there's actually a reason to be anemic during that second trimester. So it's kind of normal to be in. So it's not a it's not an illness at that point.

Sunny Gault 10:38
That's really interesting. So in the beginning, you don't want that. But towards the end, there's, there's a reason the body is doing it that way. That's interesting. Okay, well, we are going to take a quick break. And when we come back, we are going to really dive into this topic and learn all about anemia during pregnancy.

Sunny Gault 10:59
Today, we're talking about anemia during pregnancy. During this first part of our interview, we're going to chat with our experts learn more about what anemia is, and also discuss ways to overcome this type of deficiency, especially in that first part of pregnancy, what we were talking about before, and then in the second half, we are going to bring in our mamas because we definitely want to hear from their experiences. And they'll be able to share that with you guys. And we'll kind of go from there. So all right, Dr. Flores, let's start with you. I kind of want to get some of the basics here, just so everyone isn't on an even playing field and everything. So when we talk about anemia, there are different types of anemia and pregnancy, right? Can we go over that a little bit?

Victoria Flores 11:40
Yeah. So anemia has in like medical school, and you're learning your initial types of anemia, what causes the blood to be deficient in red blood cells? Not necessarily iron. I know we're talking about iron a lot when we talk about anemia. But there's other reasons why a blood test might not show enough red blood cells that we separate them out by the size of the red blood cell and the size of the red blood cell can kind of tell us the story of what's happening in the bone marrow. So there's the microcytic anemia has, there's the normocytic anemia is that might develop into a microcytic anemia, like they're going in that direction. There's a macrocytic anemia as well. And some of them are hereditary, like sickle cell anemia. Thalassemia, some are from organ disease like uremia, from kidney issues. There's also like destructive disorders from having weird shaped blood cells from just a moment of illness. Or sometimes it's genetic. It's messy, it's congenital, like a spherocytosis, that causes the red blood cells to pop as they pass through certain tight points in the body, leading to less red blood cells in the in the circulation that we're measuring. But the one that we always seem to bring up in pregnancy is the iron deficiency anemia, which is that doesn't necessarily mean that you don't have enough iron. And that's the interesting thing. Sometimes it's just that your body is hiding away the iron because you have an inflammatory process going on. And it believes your body believes that if it presents iron to these bacteria, then the bacteria are going to win the war against your body. So sometimes your body will just tuck away the iron. And then you'll you'll show an iron deficiency anemia, but it's not because you don't have enough iron deficient iron. It's because you're sick in a different regard. So, so yeah, those are the different types. And there's, you know, so many different sub classifications of thalassemia as different classifications of, you know, trait sickle cell versus disease, sickle cell, there's a lot of details, none of that really matters. But the point is that back in the old days to make maybe 1860, you know, they're looking at blood under a microscope, and they're like, some people's blood is really watery. Some people's blood is really thick, some people's blood is really bright red, some people's blood is really purple, what's the differences, and eventually, we were able to see that it was an oxygenation of a hemoglobin in an iron piece in a cell. And so we always talk about let's provide the iron to the body so that we can get rid of iron deficiency anemia in pregnancy, that seems to be the one that really matters that we can control in pregnancy.

Sunny Gault 14:16
Yeah, that's the common one that I feel like a lot of people associate with anemia during pregnancy is being iron deficient. Right, right. Okay. So how is that typically diagnosed then?

Victoria Flores 14:27
Well, there's a couple of ways. So if the surgeon will look at the hematocrit, and they're going to look for something over 32%. So they actually take the blood, they spin it down, they by doing that, you've dropped all the heavy elements to the body and you float the lighter elements to the top in a centrifuge. And then they look at the percentage of that body of liquid that is red blood cells and the part that is plasma, and the percentage of that tube of liquid is what you call your hematocrit. So if there's you know, there's different numbers that surgeons like 35 is our favorite for healthy individuals. 32 is considered on the low side. And they use a different cut off for when they're going to transfuse OB/GYN. Although they are surgeons, I will say it very bluntly, they are not necessarily trained with surgeons, which makes them kind of a different type of surgeon. And that's another podcast, I won't even go into that, but, but their numbers that they like to use are something over eight, and between 14 Eight to 14 to 15, as like a normal in an OB/GYN community. And midwifery community really wants someone to be over 11, to do home birth, or to do some type of birth without transfusion options available over 10. So when you show a midwife and number 10, they're going to start working on building your blood immediately. But the cutoff to receive a transfusion in a hospital comes from our information on traumas, and war. And that's the number six to seven. So if somebody is dropping to seven or below, then you're going to offer them a transfusion. So that's how we use and it doesn't mean that you're dead. After you get below seven, there's been history of people getting as low as two or three. And I mean, the only difference is that you're killing your body by not breathing oxygen to your organs, and the sensitive organs like your kidney, your heart, your brain, your liver, they're going to slowly die off and eventually when they hit their threshold for function will spiral into what we call a death pattern. So that is very low. And we really don't see people getting that low that often.

Sunny Gault 16:44
So this blood work that you're talking about, is this common, because I remember it's been a while it's been a hot minute, you guys have been pregnant. Okay. But I do remember getting a lot of bloodwork done, like in that early, you know, those early stages. Is this a common task that is done? Or is it only done, you know, if they see some issues?

Victoria Flores 17:05
Yeah, it's done on every panel that we do, we do usually two or three panels in a pregnancy. The first panel in your first trimester, it's your CBC, your complete blood count with a platelets and a differential. So it will be in there it'll be your hemoglobin, which is also called HB, like HB A and C for people with diabetes. And then Hema, hematocrit is is shortened to HCT.

Sunny Gault 17:33
Okay, all right. And you said these tests are done is that standard, like having a few times throughout a pregnancy that this type of bloodwork is done?

Victoria Flores 17:40
Yeah, we do that. So we did initially so that there's an opportunity to catch an early anemia and change the result. And then we do it again, in the second trimester to see if there's a anemia to see if we can turn something around. It takes about four weeks for there to really be a turnaround just due to diet and supplementation. So we want to catch things early. And then we also do one, if you're in a hospital, you'll get a hemoglobin hematocrit or just a CBC in general, upon admission to see what you're going into labor with at a homebirth model, they wouldn't do that they would use, they would just assume you're getting better from your second trimester one. And if there was a serious concern, you could also get a third trimester CVC, just to make sure that you're moving in the right direction.

Sunny Gault 18:25
Okay. Now, not to scare anyone, but I do want to talk briefly about the risks. So it sounds like these tests are normally done to catch this. But if someone for some reason didn't have these tests done, and it got further along in their pregnancy, what are some of the potential risks for pregnant women and their babies if anemia is not caught.

Victoria Flores 18:44
Of course, all tissues in our human body are in the life condition. We're, we're incarnate needs oxygen, that's what makes us creatures of meat versus plants. So we need oxygen, not co2, which we you know, give to plants and they give us oxygen. And without it, our tissues die off. And so we want to make sure that we have enough gas, oxygen gas in all of the tiniest vessels and spaces of our body that are every organ is functioning at its optimal peak so that moms don't get tired, they don't get nauseous, and their body doesn't do funny things like increased blood pressure, or maybe even attack itself. I mean, anemias can really push your body into some sick positions. For a baby, if a baby has anemia, they're not going to grow, they can develop a an intrauterine growth restriction. They can in that could be an asymmetric one where the head is where all the blood goes to because that's where the seat of life is run by the brain and the body will be a small thing hanging off of this large head, or the entire body and head will shrink down that's a you know another it's a symmetric form of IUGR. There is also the say a mom just right And Emily had a traumatic wound in a car accident and her baby's already grown to a good size. And then the baby will have less blood in its body, it will show heart rate abnormalities, which shows stress in the baby's body and can lead to a weak child that cannot withstand a labor. So you, you'll see that if a mom goes into a labor with a baby that has an anemia, those baby's heart rates will do decelerations more sooner and faster and deeper than someone who has a baby that's been amped up with with a good, nutritious blood supply. Yeah, so those are kind of the more obvious ones.

Sunny Gault 20:38
Okay. And a final question for you, Dr. Flores. How is anemia typically treated in pregnancy? You did mention transfusions, I didn't even think of that. I mean, I've heard of blood transfusions and things like that before, when is that needed versus other treatments that aren't as invasive.

Doreen Bloch 20:55
Right. And so the transfusion is not the same as an infusion, I see a lot of people mixing those two words up. So when it's a transfusion, they're actually getting blood that's been collected through a blood bank tested, treated, so that it's, you know, devoid of anything bad, maybe even separated from certain components. And that happens at a hemoglobin of seven or less. And that's based on trauma data. For something like an infusion and iron infusion. Some people will go like nine or eight, they'll recommend an iron infusion, I think that's mostly just because of cost. Because really, you could do it at any point, even at 10. And it would be very helpful you but you'd bypass the gut. And for people that are very nauseous, or can't tolerate food, like in that first trimester, you want to bypass the gut, or else you're gonna make them sicker by throwing up all their water and food. So those are other times that you would give an infusion of iron. And those are becoming more common, because so many women just have heavy periods and have anemia is just, that's just what happens to us. And the older, we get some, you know, we get more chances of fibroids and polyps and other reasons to bleed more. So. So iron infusions are ways to treat for really sick people that want to go that way, or just people that just want to bypass the gut and hit themselves hard at the beginning and not have to worry about it. But usually, we do iron supplementation with ferrous sulfate, which is just a pill, and it absorbs the best in an acidic environment. So we recommend that people take it either on an empty stomach in the morning, three times a day. Or just make a point to avoid like milk or a yogurt or something with a calcium or lactose component that could bind to the iron and bring it down into your colon where you can excrete it as opposed to having it absorbed. So that's the standard medical version. Because I work in a more holistic world, we always integrate leafy greens and the diet and we want to make sure people are are, are utilizing real meats. And sometimes we recommend livers of chicken frozen, or pieces of raw meat that you cut into cubes and you eat along with food just like medicine, because nobody really wants to think about that. So we just tell people to take it almost like a pill, freeze it, pop it back, throw it back with maybe even a little bit of Coca Cola because it's acidic to break it down and get the best absorption as possible. Of course, Coke is not healthy. So don't be I'm not recommending that. Exactly. I'm saying get some acid in with that iron to help it break down and absorb other things. We use micro allergies, spirulina we use. Well, there's a brand called Blood builder that we always recommend. And it has beets, and it has carrots and it's got spinach and kale, freeze dried, broken down, powdered and impacted compacted with iron to help with absorption. But of course, everything absorbs best as food. And so that's where we tend to begin, unless somebody can't tolerate those foods or really just has a lifestyle where they absolutely can't be buying those foods because of poverty, or whatever the situation is. And then we then we go through the prescriptive means later.

Sunny Gault 21:01
Well, they say food is medicine. I believe that I really need 2% Yeah, absolutely. So I mean, if you can get it from the things that you're eating, that's That's amazing. I know, sometimes it's really hard to do that.

Victoria Flores 24:30
Bone broth. I mean, that's a trend, right. I mean, in LA it's a huge trend, right. So we just need to remind people that yeah, when you eat animal marrow, you're giving yourself the building blocks, blocks to do what it's supposed to do and knows what to do with. So that's what we encourage on as the first line.

Sunny Gault 24:47
All right, wonderful. Well, Doreen, let's get you into the mix here. I want you to, you know, inform us about prenatal vitamins because moms obviously find out they're pregnant or even, you know, pre pregnancy they're told well if you're trying to conceive You know, take a prenatal vitamin. And so I know that you said earlier that you had some experience with this and your pregnancy. And so I would imagine going into, you know, creating elements and customizing vitamins for women, that this would be really important for you to figure out. Okay, how do we do this? And how do we help moms in this whole process?

Victoria Flores 25:18
Absolutely. Well, first, I just want to say, Dr. Flores, that was such an incredible foundation for this conversation. And I agree wholeheartedly with everything that you said, except maybe swapping Coca Cola eliminate or something like that. But

Victoria Flores 25:35
I shouldn't just say lemonade from now on, there we go.

Victoria Flores 25:39
There we go. So, I mean, I'm also just so thrilled that you provided all of that context around the importance of really centering diet, first and foremost, because that is absolutely the case that, you know, throughout my learnings, and throughout my experience, and my process in building the element prenatal option, it's always been first and foremost about making sure that your diet is supporting your process throughout pregnancy, and even preconception and postpartum as well. And then this supplement should be just that a supplement. I think that what is so, so seldom talked about is exactly what you mentioned about the timing of taking iron supplements, it absolutely should be something that is taken on an empty stomach, and with maybe some sort of acid, like a lemonade or an orange juice, something like that. And right now, when you look at the shelf of prenatal supplement options, it is so hard to find an option like an off the shelf prenatal, that has iron separated out, if you look at, I would say 95% of prenatal vitamins on the shelf today, they have iron, oftentimes, it's 27 milligrams daily, that is included in the same set of capsules where you have calcium and all of your other nutrients. So I think that my hypothesis has kind of been that and then I experienced this with my first pregnancy, that it's like so many people think, Well, I've been taking iron all this time. Why am I suddenly deficient in the third trimester? Well, it's because it's been combined with all of these other nutrients and the bioavailability just hasn't been as optimal. So what we do at element, it's the first of its kind ever available as we have a twice daily packet. It's a very beautiful biodegradable packet. So there's low environmental impact. But the am side of the packet is when you take your iron, and it's with vitamin C, and then that is completely separated out from your afternoon or evening. Vitamins which would include your calcium. So there is within that all sorts of customizations that we can do, we often start people off with 10 milligrams daily, or even 10 milligrams every other day, just to keep that consistency, but without necessarily being at the dosages that we see in most of these off the shelf prenatals. And then we can always increase from there. So we have some mamas who come to us who are very deficient in iron, and they have a start them off with the kind of approval of their doctors at 30 or 40 milligrams daily. So there's a whole range of customizations that can be done through the element brand in particular, I don't know of anyone else who's offering that.

Sunny Gault 28:28
That's incredible. And then one of the things I love about this tutorial is that, obviously things can change throughout your pregnancy. And the same, you know, if you guys are grabbing prenatals off the shelf or whatever, well, if you're sticking with the same brand and everything, it's the same thing that you're going to be taking throughout your pregnancy. But Dorian, can we talk a little bit more about if things need to change and what that process looks like and how you can help pregnant mamas throughout their trimesters?

Victoria Flores 28:53
Absolutely. I mean, with element we are checking in with our customers every month. And so to the point that Dr. Flores made about how there's these checkpoints in sort of a typical pregnancy structure with your OBGYN or with your midwife care team, where they're going to be doing certain bloodwork, presumably, at certain checkpoints, and if they're not doing that, by the way, certainly recommend folks reach out to their practitioners and ask about that and kind of understand the cadence at which there would be that testing. But we have our customers when they do get their blood work back as it relates to their iron levels, we can then make those adjustments. Again, I would say typically, we see people preconception and in the first trimester, at 10 milligrams daily or every other day, and then scaling up from there as needed to 20 milligrams or even 30 milligrams in the third trimester. The other thing that we haven't tackled yet in this conversation is the side effects that can sometimes appear with taking iron supplements. A lot of people complain about nausea. That's certainly one, but also constipation. And so this is where the form factor also can play a role. In particular, and I'm curious if Dr. Flores has thoughts on this as well, but we use the ferrous bisglycinate. That's made by Farah shell, it's, it has some studies that show that it can reduce some of those gastrointestinal side effects, and not sacrifice the bioavailability. But that's another thing that we encourage people to look at is that iron forms are not all created equal. And so making sure that if you are taking iron, do you have the most optimal form that is supporting bioavailability and minimizing those digestive discomforts?

Sunny Gault 30:43
Dr. Flores? Did you want to comment on that at all?

Victoria Flores 30:46
Yeah, I mean, that was perfect. There's absolutely the complaint of constipation and nausea when you take any prenatal capsule actually, and but the iron itself is is the component that makes a lot of people constipated. And that's why when you're postpartum in a hospital environment, they'll send you home with a prescription for iron with Dulcolax, or with cold laced to try and keep the liquid in your stool to soften it as it comes out despite the constipating iron the drying of the iron. So yeah, I totally agree with her in that. And yeah, I mean, the absorption of iron from the gut is supposed to be what better with the fairest glucan? I believe that's what it is, versus the ferrous sulfate. And so I would recommend that absolutely. But you're right, the tab that is most likely prescribed is the ferrous sulfate. Maybe it's cheaper. I don't know why that is. One is liquid, and one is a tab. I think that could also be one of the reasons.

Victoria Flores 31:44
Yeah, it's so many of these decisions like over the past, you know, three years before even launching element, learning about all of those manufacturing decisions that go into what ends up on the shelf. So much of that is driven by cost. And so really understanding the not only the dosages, but the form factors of the different ingredients. I think we hear a lot about this in terms of like folate and folic acid versus methyl folate, we won't even go there in this conversation. But it's not just with folate, right? It's also with iron, it's with calcium, choline. There's all different forms. And so we have information on our website about the quality of each of the ingredients that we include, but encourage the community to really lean into better understanding those different form factors.

Sunny Gault 32:30
All right, well, let's go ahead and we're going to take a quick break. I'm excited to bring our mamas in here. And they can kind of share their experience with anemia during pregnancy. So we'll get to that right after this quick break.

Sunny Gault 32:47
Welcome back to Preggie Pals. Now, before the break, we were talking with Dr. Flores and during blog about anemia, what it is what causes it, how can it be treated? And now we're gonna bring our mamas back into the conversation because I want to hear more about their personal experiences. So we've got again, two Mama's that are joining us. Actually, we all have experience with this. So I'm not picking on the mamas will probably all participate in this in some manner. But specifically for our moms. How did you know that you were a Mnemic when you were pregnant? Let's start with Rachael.

Rachael Terrio 33:19
So I knew I was anemic when I had my it wasn't my first trimester is my second trimester, I was a high risk pregnancy anyways, I had high blood pressure, just add on to anemia. And then, and then just his diabetes, that was a whole thing too. So anemia wasn't really on my radar. And so the doctor was like, oh, like you should take iron because you're anemic. And I didn't really know what that meant. So I did some research and found out like iron does help with it. But there like, there was like a lot of things that I didn't know, like the symptoms that were happening. Like, I had no idea that constipation could be one of the symptoms. I remember being super like constipated. And like, just couldn't go to the bathroom. And like, I remember just taking forever in the bathroom. My husband was like, What are you doing? I'm like, I'm in the bathroom. Let me just go. And I just remember always just being nauseous and I had a really hard time taking my prenatals so I just opt out to do the with like the pill form. I just did the gummies because it was just what my body could stomach and I found that most of the prenatals I took just made me not feel good because what was in them? Yeah, finding out I wasn't made with a blood test. That's how I found out.

Sunny Gault 34:45
I have a follow up question for Doreen. So when we have these prenatals that make us not feel so well like what is going on there because I totally identify with what Rachel's talking about. I had to search and search and search until I found something And that didn't make me want to throw up the moment that I took it. Yeah, what's going on there?

Victoria Flores 35:05
Hopefully, this is something that we hear this is something that I experienced as well. And it's like playing this game of whack a mole of like, what is in this prenatal that I that I'm not tolerating. And so, as Dr. Flores also said, you know, the most common culprit in these kind of off the shelf prenatals is the iron. And so to the point that Rachel was making, oftentimes, we see people switching to gummies at that moment, because gummies rarely have iron in them just because it's kind of hard to manufacture a gummy that tastes okay, that has iron in it, because iron just doesn't taste that good. And so, but then you run into this issue of, okay, you're switching to the gummy and you're getting the folic acid or the folate that you need, but now you're not getting the iron, right, so. So that's where I mean, it's so powerful to have a doctor or midwife or any kind of practitioner in your corner who can help you to really understand the most optimal supplement. And, unfortunately, and I think we talked about this in a previous podcast. And I'm curious, also Dr. Flores, his take, but so few OBS that I meet, are really trained or confident in the nutritional aspects of pregnancy, preconception or postpartum. And so it's kind of left for us as mamas to try to figure this stuff out on our own. And that was so much of the labor of love that led me to start element because I felt so alone when I was dealing with this, you know, back five years ago, and really creating a space for people to level up their understanding. So I know that's a long answer to the question, but I think you know, it could very well be the iron. And that's something that you should all of us mamas should have more support to figure out. We shouldn't just be left alone to figure it out by yourself.

Victoria Flores 37:00
Yeah, and I'll and I'll follow up on that. You're absolutely right, that nutrition is not taught very well, in the training of an obstetrician. A lot of things are not taught very well in the training and obstetrician. A lot of the stuff that I had to learn came from my own passions, just like you women, and having to go out on my own to understand it for my own pregnancy, as well as for my friends and family who really saw the medical model failing them. And it's really unfortunate how little the obstetrician doesn't realize that they don't know as well, because they are told everyday that they are the experts in pregnancy. But they're missing so much information in that education and training in order to accommodate the vast number of women that they've usurped from community practitioners, that they've given way to slowing down and reading about nutrition. And it's really not even on any of the examinations for the board. It's not on any examinations for the obstetricians, yearly exams. It's it's very random How ignorant the obstetrical training model is, which is one reason why I'm very proud to although I am an MD, so that I can do some things that, you know, as a midwife, I couldn't do like breeches and twins at home and register them. I don't necessarily align. And I never really did work out so well with that model of training. And so yes, you're absolutely right during. I would also like to say that, that is not just the iron that is making moms nauseous, but I often see women taking fish oils that make them really nauseous to and instead they can use something like a flax oil replacement and get the same levels of oils for their body or you're using it in a food format obviously is the best but if that's unaffordable or not able to be accommodated in your busy life as a mother, which I absolutely have myself as a mother, you can't cook three meals a day any longer. Then you need a supplementation or supplement just like during was offering.

Sunny Gault 39:03
Let's see, Kaile, let's bring you into this. Let's talk about your pregnancy. And I know you were dealing with anemia as well. So tell us your story.

Kaile Hunt 39:10
Yeah, really quick. I just want to hop on the Dr. Flores train. If you are my care provider. I have learned so much in this however long we've been recording then my nine months of pregnancy. It's insane. But yeah, so I was anemic before I got pregnant before I conceive. So that's always been in the back of my mind. I've always at my routine screenings every year when I go see, you know, my my GP or my OB, every few years, they would ask about my anemia, you know, so I knew that when I conceived. It would be a topic and so when I did go in for I think it's the 12 week test. I'm not really sure but when I got my first set of bloodwork done, it did show that I was borderline anemic and they of course wanted it to be a little higher. And I already liked to do things more not true. And so I told my OB up The time like, you know, I think I'm gonna work on my nutrition and then you know at the next set of blood results, we'll take a look and see if I actually do need to get on some iron pills. So that's exactly what I did in the first trimester. And kind of halfway through the second trimester is I ate spinach. I tried to eat more red meat. I tried the chicken liver and I never really liked it. It's kind of understandable. Yeah, I just don't I just don't have the good recipes for it. I will say I even tried it in like Taco me and like Chili's and I was like, Nope, I can still taste this chicken. So maybe second round second pregnancy I'll try it again. Um, but anyway, anyway, I tried to really do well with my diet. And I just continued that and then I so I never really took iron pills however, at every routine pregnancy prenatal appointment, I was you know, getting checked for my anemia levels, and they never they would never dropped too low where I needed to go on iron pills. However, it was always a little bit of a conversation like, hey, you know, your levels are a little bit low. What are you doing with it? How are you feeling? And I was, I don't know if anyone else experienced this, but I actually had H G throughout my entire pregnancy, it was really a lot. So I was already very sick. I'm barely keeping down my prenatal vitamin. So I think my OB slash midwifery team, they knew that I couldn't even stomach that. Until whatever I could start MC would would be good enough. And it ended up being good enough. So yeah, I really worked on just diet. And then it's funny I mentioned it in the beginning of the episode, but my number one pregnancy craving was steak was red meat, I would be the girl getting the burger and only eating the meat. Honestly, I would take out the lettuce and the tomato. And then I would be getting the steak at dinner. So I really I think my body which was talked about earlier, my body kind of knew I needed some more iron. I tried to eat the leafy greens and the later trimesters, but steak was my number one thing that I probably had every day for my second and third trimester.

Victoria Flores 42:09
Kaile, you're giving me a flashback to when I was pregnant five years ago, I just am remembering that I was actually on a vegan diet before I got pregnant. And because of those very strong red meat cravings, I ended up you know, not becoming vegan anymore during my pregnancy.

Kaile Hunt 42:27
I just second deal with that. That is so funny. The body knows I was vegetarian before for like years. And I think that's why my iron levels were so low. I wasn't being a smart vegetarian. I'll say that. I wasn't supplementing. But yeah. And then as soon as I conceived, I'm like, oh, red meat steak. Yes, please. So yes, very funny.

Sunny Gault 42:49
All right. And our final question. I know, we could talk about this stuff all day long. But our final question for everyone is, do you have any advice for moms who might be going through this now, you know, maybe it's the first pregnancy, we have a tendency to maybe overthink things a little bit. So any final thoughts for moms that are listening to this,

Victoria Flores 43:08
I guess I'll start, it might not be necessarily anemia of iron deficiency. I think that's something that we often forget when we are pregnant or talking to our Opie's. So reminding your OB to look at your MCV to make sure that it is either a microcytic anemia or normocytic anemia that's trending towards a microcytic anemia. And they can tell you that based on a range of cell sizes, they have a measurement for that as well. And then also just considering how inflammation is affecting your iron availability, like I had mentioned earlier that the body will tuck away a ton of iron, even if you have enough, and you will look like your iron deficiency deficient, but it's really just an inflammatory process occurring. So just overall health is important and avoiding inflammatory diets. I mean, we all know it, the sugar, the corn syrup, you know, whatever it is that you are allergic to, because of whatever happened, you know, you're sometimes it's avocado, even I've had some people allergic to pork, random things, whatever it is, just make sure you're avoiding all the little allergens, so that your body can function and use the iron that you give it.

Victoria Flores 44:17
Yeah, and I would just jump in to say that, you know, this is quite prevalent. And so you don't have to feel alone in the diagnosis or if you're worried about a diagnosis like this. Just make a plan and really talk to different practitioners or different people in your network about how they were able to improve their numbers. Because there are just these different strategies as we've discussed throughout this podcast around how you can really create an action plan to get those numbers up.

Kaile Hunt 44:48
Yeah, I'll hop on and say a couple of things really is especially if the numbers look okay, what I love that I feel like a lot of pregnant mamas are doing now is the realizing that yeah, maybe the numbers for a museum is in the threshold of being okay. But if you're still not feeling, okay, ask questions. And sometimes there's an optimal level that works for one body, that doesn't work for the other. For instance, I was on the lower end, and I felt like I was functioning fine. However, someone else and other pregnant mom could be on the lower end and need a little bit more support. So I think that's really important to kind of advocate for yourself. And if, you know, your OB, or midwife care team is like, you know, your numbers are low, but I think you're okay, if you don't feel okay, definitely keep pushing and keep asking questions. And then finding, you know, that perfect prenatal vitamin that's fit for you would just be perfect that gets you over the hump and make you feeling good, because pregnancy in and of itself is definitely a marathon.

Victoria Flores 45:43
And I'm gonna just follow up on that, too. So, you know, we aren't treating numbers. And I think that a lot of people forget that in the even midwives and medical providers, do they look at the numbers and they tell you, but really how you feel? How do you feel? Sometimes people cannot tolerate an anemia with a hemoglobin of 10. And that's a really good number. Some people, they get symptomatic at that number, and some people get have no symptoms at eight, you know, so how do you feel that's really important?

Rachael Terrio 46:14
I just wish that I when I was pregnant, that I had more like research and more like, resources, because I actually didn't know how common you know, anemia was during pregnancy. You know, it didn't really hit me until I was actually in the hospital giving birth to my daughter. They told me, Oh, you have to have another IV done just in case if you need a transfusion. And when I heard that I like, I paused for a second. I was like, Oh my God, oh to my husband, why'd I like what is going on? Like what's happening, but I didn't know that how common it was going to be. But now I know for next time to do it. And I know what what type of prenatals take what type of other stuff to do the next one and just be more cautious, I guess.

Sunny Gault 47:01
All right. Well, thank you guys. This was amazing. I love chatting with you guys. I think we gave out some really good information. Hopefully, all of our listeners feel the same way as well. But we really appreciate you guys being with us today. For more information, you can check out new mommy We have done kind of similar episodes and some of the topics that we talked about today. So that's where all of our podcasts episodes are. We've got some videos on their blog posts, so be sure to check that out.

Sunny Gault 47:34
That wraps up our show for today. Thank you so much for listening. If you love Preggy Pals as much as we do, then please consider checking out the amazing businesses that sponsor our shows week after week. And we would also love for you just to tell another pregnant mama about this resource because it's free, right? We all love stuff. It's free. So pass the word along. That would be amazing. And if you want to check out some of our other podcasts that we've produced, we've got Newbies, which is for moms and babies during that first year of life. We've got Parents Savers for parents of toddlers, The Boob Group, which is all about breastfeeding and sharing breast milk, and Twin Talks for parents of multiples. Again, all of that information is at Thanks for listening to Preggie Pals- your pregnancy your way.

Disclaimer 48:22
This has been a New Mommy Media production. The information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of new mommy media, and should not be considered facts. Will such information and materials are believed to be accurate. It is not intended to replace or substitute for professional medical advice or care and should not be used for diagnosing or treating healthcare problem or disease, or prescribing any medication. If you have questions or concerns regarding your physical or mental health, or the health of your baby, please seek assistance from a qualified health care provider.

Love our shows? Join our community and continue the conversation! Mighty Moms is our online support group, with parenting resources and helpful new mom stories you won’t find anywhere else! You’ll also have a chance to be featured on our shows.

Become a Mighty Mom!