According to a September 2006 article in "The Lancet," childbirth-related hemorrhage -- uncontrolled or abnormal bleeding -- is responsible for about 126,960 of the 529,000 mothers' lives lost globally to pregnancy-related causes every year, chiefly but not entirely in the developing world. Iron-deficiency anemia during pregnancy is a known risk factor for maternal hemorrhage during and following delivery. Good nutrition, including adequate iron intake, during pregnancy can help prepare you and your baby for the healthiest possible labor and delivery.
Hemoglobin
About 300 million molecules of the red-colored protein hemoglobin occur on the surface of every single red blood cell. Every hemoglobin molecule has four atoms of iron, each of which ferries an oxygen molecule from the lungs, unloads it somewhere in the blood stream, and transfers carbon dioxide back out the lungs.
Anemia
The World Health Organization defines anemia as a hematocrit test -- a measure of red cells in the bloodstream -- of less than 39 percent in men and less than 37 percent in women. Although there are many kinds of anemia with many causes, they all involve deficiencies of the healthy red blood cells necessary to meet the body's oxygen requirements. Iron-deficiency anemia generally arises from an iron-poor diet. Acute anemia is usually caused by a sudden, large loss of blood volume.
Blood System Changes in Pregnancy and Delivery
During pregnancy, the mother's blood plasma expands by 40 to 50 per cent and her red blood cell mass by 20 to 30 per cent, facilitating her body's transport of oxygen and nutrients to her baby along with removal of fetal wastes like carbon dioxide. These changes also offset normal maternal blood losses during childbirth: about 300 to 500 ml for vaginal delivery and 750 to 1000 ml for Caesarian section. Without sufficient iron in her body throughout pregnancy, the mother will develop iron-deficiency anemia and thus become more vulnerable to acute anemia during or shortly after delivery.
Prevention
The National Anemia Action Council recommends that expectant mothers take anemia tests at the start of prenatal care, follow iron-rich diets, take a prenatal vitamin with 30 mg of iron each day, and tell their doctors about any possible anemia symptoms such as fatigue or shortness of breath. The Cleveland Clinic publishes a fact sheet called "Increasing Iron in Your Diet During Pregnancy," which contains essential information. In the United States, the Women Infants Children, or WIC, program, the Supplemental Nutrition Assistance Program or food stamps and /or Medicaid might be able to help you with free or reduced-cost healthy food, prenatal supplements, and/or health care.
Care During Childbirth
NAAC reports that 5 percent of women hemorrhage during childbirth. Two-thirds of these mothers have no known nutritional or other risk factors. In the developed world, access to good health care, including such options as the drug oxytocin and blood transfusions, spares most of them from serious injury or death. Even in the developing world, where transfusions are often impractical, a low-cost treatment protocol called the Active Management of Third Stage Labor, or AMSTL, can prevent many cases of postpartum hemorrhage and thus save more mothers' lives.
References
- Cleveland Clinic; Increasing Iron in Your Diet During Pregnancy
- HealthCare.gov: Find Insurance Options
- "The Lancet"; Maternal Mortality-Who, When, Where and Why; Carine Ronsmans et al.; September 2006
- MayoClinic.com; Iron-Deficiency Anemia; March 4, 2011
- National Anemia Action Council; Women & Anemia: Increased Need for Iron During Pregnancy; September 19, 2008
- United States Department of Agriculture: Nutrition Assistance Programs
