Postpartum Anemia: Symptoms, Causes, And Treatment

Are you experiencing dizziness or weakness after delivery? This could be a result of poor diet or excessive blood loss during delivery. 

Postpartum healthcare is crucial. One condition that may arise after childbirth is postpartum anemia. In normal deliveries, up to 24% of women with no other major health concerns experience postpartum anemia. Understanding the causes and possible treatments of this condition is important for women who show signs of this type of deficiency.¹

What is postpartum anemia?

Anemia occurs when there are low levels of hemoglobin in a person’s blood, with iron deficiency as one of the most common types of nutritional anemia. During postpartum, or the approximate six week period immediately after childbirth, new mothers may experience postpartum anemia due to blood loss during delivery or due to continued anemia from before pregnancy. Insufficient iron consumption in your diet or through supplements can also contribute to postpartum anemia. 

Symptoms of postpartum anemia

The body undergoes massive changes if there is a drop in hemoglobin and iron levels. Common symptoms of postpartum anemia can include:

• Depression

• Weakness

• Pale skin

• Exhaustion and fatigue

• Confusion

• Shortness of breath

• Rapid heartbeat

• Dizziness

• Reduction in the quality and quantity of breast milk, possibly leading to low weight gain in babies

With treatment, these symptoms would be expected to disappear. 

What causes postpartum anemia?

Common causes of postpartum anemia include:

1. Antenatal anemia. Insufficient iron consumption before or during pregnancy can lead to postpartum anemia. The daily recommended iron intake during pregnancy is 27mg. However, if you can't get enough iron from diet alone, you can use iron supplements to boost your iron levels. Ensure you consult with your healthcare provider before using iron supplements when pregnant.

2. Peripartum blood loss. The body's iron reserve can get depleted due to blood loss during and after delivery. When blood loss is higher, the risk of postpartum anemia is also higher. 

C-section 

After both planned or unplanned cesarean deliveries, postoperative hemoglobin testing in asymptomatic women without anemia or excess bleeding is not needed and has not been shown to lead to better outcomes.

How is anemia after pregnancy diagnosed?

The diagnosis of postpartum iron deficiency anemia relies on a full blood count, including serum ferritin, hemoglobin, and serum soluble transferrin receptor. These appear to be proper indicators of anemia and iron status one week after delivery. On the other hand, serum transferrin saturation appears to be an unreliable indicator of anemia and iron status several weeks postpartum.

The most common method of diagnosing anemia is by running a complete blood count test to count the number of blood cells in a blood sample. The doctor can also conduct a test to determine the shape and size of your red blood cells. 

Who is at risk of iron deficiency anemia after pregnancy?

Common risk factors for iron deficiency postpartum anemia include:

• Prepartum iron deficiency or iron deficiency anemia (IDA)

• Excessive blood loss during delivery

Complications of anemia after pregnancy

Postpartum anemia should be treated as soon as possible to avoid risks and complications for the mothers. Postpartum anemia is linked with poor quality of life, depression, emotional instability, and reduced cognitive abilities. It also constitutes a serious health problem for women of reproductive age. 

How to treat postpartum anemia

Anemia resulting from low iron levels needed for red blood cell production necessitates supplementation. 

Alternatively, your doctor may recommend taking iron supplements to increase your iron intake. Treatment may come in the form of iron tablets or as a solution injected intravenously. 

If the anemia is acute and causes severe symptoms, an alternative treatment for postpartum anemia is restoring red blood cell levels via transfusion, using blood from a blood donor. However, this is only a temporary measure. 

It is important that the healthcare provider explains the different treatment options available and recommends the most suitable. 

The lowdown

Postpartum anemia is associated with fatigue, palpitations, and breathlessness. The common cause of postpartum anemia is excess blood loss and iron deficiency anemia before or during pregnancy. 

Common symptoms of postpartum anemia include fatigue, depression, pale skin, etc. Fortunately, postpartum anemia is treatable, mainly by iron supplementation. It’s recommended to visit your doctor immediately if you notice any signs and symptoms of postpartum anemia. 

Frequently asked questions

What is iron deficiency anemia?

Iron deficiency anemia is caused by a lack of sufficient hemoglobin, which is important for the transportation of oxygen throughout the body.

How does pregnancy affect iron deficiency anemia?

The body's plasma volume and red blood cell mass increase during pregnancy, and so does the required iron level. The body uses iron to produce more blood to supply oxygen to the fetus, among other things. Unfortunately, if one has insufficient iron levels, there is an increased risk of developing or worsening already-existing iron deficiency anemia. 

Does anemia cause postpartum hemorrhage?

Yes, pre-pregnancy anemia can increase the risk of postpartum hemorrhage. 

How long does postpartum anemia last?

There’s no set time period for the resolution of postpartum iron deficiency anemia. However, it’d be expected to last as long as sufficient iron is not restored to bring the hemoglobin levels back to normal.