Iron toxicity plus anemia

[harli]

My sister just called me. She currently lives in Georgia and is in the military. She's about 7 months pregnant and is seeing a military 'midwife'(I use the term loosely because the more I hear about her the more I realize she is a wannabe OBGYN.

This is my sisters first baby and by her 6th month she realized that the over the counter prenatal vitamins were giving her iron toxicity. She thought the constipation and vomiting were simply due to her being pregnant but she forgot to take her vitamins for a day or two and the symptoms went away. I had the same problem with my pregnancies and so did our mother. After about a week off the pills she started taking them again but once every other day rather then once a day. She's had no constipation or nauseousness since then.

Sis just had some routine bloodwork done that showed she was mildly anemic. 'Midwife' wants her to go on prescription prenatals twice daily PLUS an iron supplement twice daily. Sister mention how sick she got earlier from just over the counter vitamins and 'midwife' told her that being sick is a part of being pregnant and that she should get over it. . If she does get constipated (from too much iron) to call in and she will prescribe her a stool softener.

This just seems incredibly backwards to me. I don't think it's wise for her to take so much iron (neither does she) but besides eating high iron foods is there anything else she can do? Sister is planning on still taking some vitamins just not as much as the 'midwife' is suggesting.

Also want to add another vent about this lady... I suggested my sis hire a doula because she will most likely be laboring and delivering by herself (no family or friends are currently down there with her as her DH and her platoon are currently deployed) I will try to make it down there but with a 14 hour drive there is no guarantee. She spoke to the 'midwife' about this and 'midwife' said that since she is a 'midwife' you can't get any more natural then that and hiring a doula would be "overkill and a waste of money"

[mambera]

OK, constipation and nausea aren't necessarily indicative of iron toxicity. Iron supplements are notoriously difficult for your digestive system to handle whether your iron is low or not. The best way to manage that if you need the iron is to split up the doses: if you get sick from a 2x daily dose, halve the pills and take them 4x/day. Anemia in pregnancy is a bad place to start in case of PPH and has also been linked to milk supply problems.

That said, did the midwife order a CBC (complete blood count) before prescribing that iron pill?

If not, tell your sister to ask for a CBC and specifically for her MCV (mean cell volume, it's part of the CBC panel). If the MCV is very low (like under 70), meaning the blood cells are very small, or if the cells have weird shapes, she could have a thalassemia or other hereditary anemia. People like this will always have low iron and should not take iron supplements because they will be toxic.

Regarding the doula, if your midwife is thinking the doula's job is to protect the mom from intervention-happy OBs then her advice makes sense. Maybe she didn't get the part about there not being any friends or family for labor support. Did your sis explain that she does not have any guaranteed support people for the birth?

[harli]

Thanks I'll definitely pass the info along to my sister. I just had a CBC done for unrelated issues and haven't yet heard the results so I will check into that when I have my appt. Unfortunately Mom passed 2 years ago at 51 due to a neurological disease.