Hemoglobin Levels in Pregnancy?

[dovey]

I'm 28 weeks pregnant, and yesterday my midwife tested my hemoglobin level. Right now it's at 14.2 g/dl. At the beginning of the pregnancy it was at 14.7 g/dl. She seemed a little bit concerned about this since perhaps my blood volume wasn't expanding enough. I've gained ~20 lbs so far, and my fundal height is increasing in a typical way....She told me to eat more food, which sort of makes sense - more weight gain would = more blood volume, I guess...I was wondering if I should stop taking my prenatal, which has a lot of iron in it. I am also vegan, so maybe it's the lack of milk products (which can cause people to absorb less iron) causing this.

I looked at some research on the web, and although there isn't a whole lot on the subject, there were several studies that indicated a significantly higher rate of stillbirth/other problems for mother/babies with high hemoglobin levels. Normal hemoglobin at this point in pregnancy is around 12 g/dl. I don't really know how much to worry about this. I don't have any health insurance, so I only want to go to a doctor if really necessary. I trust my midwife, but sometimes I feel like she's not up to date on certain things. Not that this is a common problem she would know about - lots of people have low hemoglobin levels. Also, maybe she just didn't want to scare me. Are there any people out there who have any advice to offer?

[MamaChel]

Mine was 13.4 around that time in the pg. Normal is between 12-16 so I don't understand her concerns?

My levels dropped from 13.4 to 8.5 by 36 weeks and I brought them back up to 11.3 by 37 weeks by eating a ton of iron rich foods.

i am presently 4 pounds below my prepg weight so I've lost not gained.

Ayway that is my story I would ask specifically why your MW is concerned that number seems perfectly normal to me.

[Heart.Revolution]

Like Mamachel already said that number is very good, better than most people from what I was told by my midwife. Mine was 11.4 at like 28 weeks or something.

[dovey]

Thanks for responding! It is normal to have lowered hemoglobin at this point in pregnancy. I think that while 12-16 g/dl is the normal level for non-pregnant women, most pregnant people's hemoglobin level goes down significantly after the 2nd trimester. If it doesn't go down very much, than it can be a sign that your blood volume isn't expanding properly, or maybe something else. Physiological anemia is a normal part of pregnancy. Maybe my levels aren't high enough to be concerned about though. My DP thought that I was being paranoid to be so worried about it. From your responses, maybe I am being overly worried. It's just this second pregnancy thing, I guess. I'm always concerned that there's something odd going on. I will talk to my midwife about it though...See what she says.

[cjcolorado]

The altitude you live at may have an effect on this as well (my DH is a physiologist who specializes in altitude acclimatization and such)--the higher your altitude, the higher your Hg and Hct will be at each stage of pregnancy (unless you start out somewhat anemic), compared to someone at sea level....just a thought!

[cjcolorado]

Actually, thinking about this further (and talking with my DH), it doesn't make sense that your Hct and Hg would change much at all throughout pregnancy--you are increasing your blood volume, but not diluting it. So, if there is rationale to expect decreased numbers, I'm curious to know why.

[dovey]

Hmmm...yeah, that doesn't really make sense to me either. I'm not sure why the hemoglobin level would go down if the blood volume is just expanding. I just read it on some medical website. Maybe the hemoglobin part of the blood doesn't expand at the same rate as the other parts of the blood? I don't know.

Actually, we do live at relatively high altitude; ~5200 ft. That could definitely have something to do with it. cjcolorado - do you know if the higher hemoglobin levels in pregnancy for high altitude mamas have anything to do with the higher rates of jaundice in babies born at high altitudes? I'm kind of curious about that too, because my first babe (born at sea level) became pretty yellow, and we had to take him in to the hospital every few days to have his bilirubin levels tested. I'm hoping to avoid all of the worry about that this time around...

Sorry I'm so long in replying - I haven't been able to get to the computer in a while.