Iron in pregnancy: keeping your levels up

During pregnancy your body makes a lot more blood to support your growing baby, and iron is the mineral that lets that blood carry oxygen. Demand for it rises steeply, which is why low iron (anaemia) is one of the most common things midwives pick up, it's checked through the blood tests offered early in pregnancy and again around 28 weeks.

Iron from food comes in two forms. The kind in meat and fish (red meat, chicken, sardines) is absorbed easily. The kind in plant foods, lentils, beans and chickpeas, dark leafy greens like spinach and callaloo, dried apricots, fortified breakfast cereals, tofu, is absorbed less easily, but you can boost it. Pairing plant iron with vitamin C at the same meal (a squeeze of lemon, peppers, tomatoes, oranges, a glass of fruit juice) helps your body take up much more.

A couple of everyday habits work against absorption: tea and coffee with meals, and very high-calcium foods eaten at the same time as your main iron sources. You don't need to cut these out, just try to have your tea or coffee between meals rather than alongside your iron-rich plate.

It's worth knowing how low iron tends to feel, because the signs are easy to brush off as 'just pregnancy': unusual tiredness, breathlessness on stairs that didn't used to bother you, dizziness, headaches, or a fast-thumping heartbeat. A classic sign in guidance is 'pale skin', but on brown and Black skin, paleness doesn't show the same way. Instead of looking at the face, look at the places where the natural colour is lighter: the inside of the lower eyelid (which may look pale pink or whitish rather than a healthy red), the gums, the lips, the tongue, and the nail beds and palms. If these look washed-out, mention it.

If your blood tests show your iron is low, your midwife or doctor may suggest an iron supplement. These can cause tummy upset or constipation in some people, taking them with a little vitamin C, with food if your stomach is sensitive, and keeping your fluids and fibre up can all help. Don't start a separate iron supplement on your own without advice, as too much isn't helpful either.

If you feel persistently exhausted, breathless, or dizzy, don't wait for your next routine appointment, tell your midwife. Low iron is very treatable, and sorting it out helps you feel more yourself and supports a healthier pregnancy and recovery.