Iron Deficiency in Pregnancy
Iron is an essential element in the development of healthy babies! Iron is present in all the cells in the body and is particularly needed for the development of blood and muscles. The World Health Organization recognizes that iron deficiency is the most common nutritional deficiency world-wide. It is estimated that in developing countries 50% of pregnant women are iron deficient, while in developed nations 15-20% of women are iron deficient in pregnancy.
Iron is a mineral found in many common foods. Animal sources ("heme iron") include meat, fish, and poultry. Plant sources ("non-heme iron") include dried beans, peas, lentils and some fruits and vegetables. Grain products such as flour, pasta and breakfast cereals are fortified with iron in Canada. Heme iron is more easy absorbed than non-heme iron.
Iron is needed right from the start of pregnancy as the pregnant mother's blood volume increases and as the placenta and fetus forms. The CDC recommends starting iron supplementation at the first prenatal visit. In the second and third trimester, in particular, the placenta accumulates iron to release to the fetus later. Between 28-38 weeks of pregnancy the fetus grows from 1kg to 3.4kg.
The average intake by women in Canada is 12mg per day. Women require on average 27mg of iron per day throughout pregnancy. When you are pregnant you should chose iron rich foods, and also supplement your intake. Most prenatal vitamins contain 20-30mg of iron per tablet.
Certain foods (such as calcium containing foods) will inhibit the absorption of iron.
For information about iron containing foods go to the Health Link BC website: http://www.healthlinkbc.ca/healthfiles/hfile68d.stm
In the first trimester and again at 26-28 weeks lab tests including a hemoglobin will be drawn. If this is low it can indicate iron deficiency, at which point your care provider may suggest further testing of body iron stores (a ferritin test.) Your care provider will suggest further iron supplementation if you are found to be iron deficient.
Iron supplements are usually oral tablets which are taken once to 3 times daily depending on degree of iron deficiency.
Occasionally the degree of iron deficiency will be sufficient that intravenous iron will be recommended. This is ordered by the physician and administered in the hospital in the Medical Daycare.
Taking Folic Acid During Pregnancy
Debbie Kennedy, MD; Anne Pastuszak, MSC; Gideon Koren, MD, FRCPC
Recent medical research has shown that taking folic acid supplements during pregnancy could reduce the risk of neural tube defects (NTDs) in babies. Two disorders account for most NTDs: the first, spina bifida, results from failure of the spine to develop normally; the second, anencephaly, results from abnormal skull and brain development.
Every baby has a small chance of having a birth defect; birth defects occur in about three of every 100 liveborn infants. Neural tube defects account for some of these defects, occurring in two to four of every 1000 babies born in Canada.
Folic acid (also called folate or folacin) is a B-group vitamin. Foods rich in folic acid include grains, green vegetables (spinach, broccoli), meat (liver), and legumes (lentils and kidney beans). Although folic acid is present in these foods, it is often difficult to get the daily requirement of folic acid from diet alone.
Because NTDs occur 25 to 29 days after conception, before many women even realize they are pregnant, it is important for women to begin taking folic acid supplements before conception (ideally, when birth control measures are discontinued). Since a woman's folic acid requirements increase during pregnancy and breastfeeding, it might be beneficial for her to continue taking folic acid supplements throughout pregnancy, even though crucial development of the spine and brain is complete 5 weeks after conception.
Most healthy women should supplement their diets with 0.4 mg of folic acid daily. Women who have diabetes or epilepsy, women with a family history of NTDs (in a sibling, parent, cousin), and women who have had previous liveborn or stillborn infants with NTDs should supplement their diet with 5 mg of folic acid daily. Women should contact their physicians for confirmation of the correct dosage.
Tests available to all pregnant women can detect NTDs during the second trimester of pregnancy.
Further Reading: http://www.motherisk.org/women/folicAcid.jsp
Centering Pregnancy Overview
Posted by Dr. Morrison from the centering pregnancy website
CenteringPregnancy is a multifaceted model of group care that integrates the three major components of care: health assessment, education, and support, into a unified program within agroup setting. Eight to twelve women with similar gestational ages meet together, learning care skills, participating in a facilitated discussion, and developing a support network with other group members. Each Pregnancy group meets for a total of 10 sessions throughout pregnancy and early postpartum. The practitioner, within the group space, completes standard physical health assessments.
Through this unique model of care, women are empowered to choose health-promoting behaviors. Health outcomes for pregnancies, specifically increased birth weight and gestational age of mothers that deliver preterm, and the satisfaction expressed by both the women and their providers, support the effectiveness of this model for the delivery of care.
CenteringPregnancy groups provide a dynamic atmosphere for learning and sharing that is impossible to create in a one-to-one encounter. Hearing other women share concerns which mirror their own helps the woman to normalize the whole experience of pregnancy. Groups also are empowering as they provide support to the members and also increase individual motivation to learn and change. Professionals report that groups provide them with renewed satisfaction in delivering quality care.
posted by Dr. Morrison from http://www.motherisk.org/women/morningSickness.jsp
Nausea and vomiting in pregnancy (NVP), also referred to as "morning sickness," is very common. It afflicts up to 80% of pregnant women, to a greater or lesser extent.
Though usually limited to the first 7 to 12 weeks of pregnancy, approximately 20% of women experience NVP for a longer period of time. Some women may suffer from NVP until the end of the pregnancy.
For some, nausea and vomiting can have serious adverse effects. If severe enough, NVP can cause dehydration, with associated salt and vitamin imbalances. These and other effects can be harmful to the health of the woman and the well-being of her baby. The severity of NVP symptoms can also be related to factors such as a multiple pregnancy.
For these and other reasons, it is important to get the right information, care and treatment.
Nausea and vomiting in pregnancy can also impact on personal relationships. That means that partners and family need information, too.
Care based on research
Motherisk researchers have interviewed thousands of women, gathering detailed accounts of their experience with NVP. Many have describe it as a time of acute suffering, worry and frustration.
This and other research have helped us understand the extent of the suffering, determine possible causes and deterrents, and establish recommendations on how to treat the condition.
We continue to collect information about the effects of NVP and its treatment, paying special attention to NVP's impact on the quality of women's lives.
NVP can and should be treated if persistent or disruptive to a woman's physical, mental or social health.
Sick of Morning Sickness?
Get support from the Motherisk Nausea and Vomiting of Pregnancy (NVP) Helpline.
VISIT OUR NVP FORUM
We occasionally post information and articles that we hope will benefit you during your pregnancy.