iron levels in twin pregnancy; need advice/opinions - Mothering Forums

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#1 of 5 Old 03-13-2008, 01:54 PM - Thread Starter
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I am hoping to get some good opinions/advice from any midwives out there regarding iron levels.

I am a third time mom, 39 weeks 2 days with a twin pregnancy. Due next Tuesday. Planning a homebirth with two DEM's. All of my stats have been great throughout the pregnancy -- bp, u/a sticks, etc. Babies are doing great, my weight gain has been great. The first time I was tested for hemoglobin was December (she forgot her tester the first couple of visits) and it was 10.5. She expressed concern, saying she likes to see moms around a level of 12. I started taking a tablespoon or two of blackstrap molasses a day (remembering my nutritionist grandmother's wisdom regarding the benefits of molasses!), in milk or water, and by the next visit (Jan), my level was 11.75. Continued doing the same thing, plus excellent nutrition throughout the pregnancy, and the following visit (Feb) it was down to 11.1. Last visit (Mar 6, last week) was down to 10.6.

After last week's "score", I started mixing 4 tablespoons of molasses in a quart of water and further diluting that with ice and water and sipping it throughout the day. Noticed my poops are not so loose (but not constipated either) and my energy is slightly up. My MW asked for a loose tally of my dietary iron sources, here are some of them:

fortified whole grain cereal 90-100% of DV
prenatals 200% of DV
sunflower seeds (raw, 1-2 servings) 10-20% DV
blackstrap molasses, 2+ servings 40+% DV
free range organic meats ? DV
legumes like black beans etc ? DV (organic black bean chili had 40% for example)

So I am getting well over 300% of my daily value iron needs; I do not slack in my diet. My MW then thought maybe it had something to do with iodine, since I use sea salt and don't eat processed foods (except boxed cereal). But my prenatals has 150 mcg of iodine, 100% of my DV.

I feel fine, other than chasing a 5 year old and 2 year old all day, carrying an extra 55+ pounds on my 5'2" frame and being at the very end of a twin pregnancy. I don't know what else to do regarding the iron --

I have read studies that indicate that there is not always a necessary correlation between iron levels and blood loss during delivery, and even my MW says she has had women at 10 and hardly bleeding, and others at 12+ who lost a lot of blood in delivery. She is wary of doing a home delivery for someone whose "score" is under 11. I am frustrated and unsure what more I can do. We talked about shepherd's purse tincture, which I can go pick up at the store and start taking but how quickly would that really get my iron levels up if I am just days (or hours) away from birthing at this point?

I have also read studies about how a lot of weight is placed on hemoglobin count in pregnancy but some of the drop in that number can be accounted for by the increase in blood volume (even moreso in a multiple pregnancy, I would guess), and also as the baby(ies) grow, they pull iron and your iron score can drop naturally every 8-9 weeks due to fetal growth needs.

Considering I am five days from my due date and really could give birth at any moment, does anyone have any recommendations on my situation?

I take lots of C when I eat anything with iron to enhance absorption, I avoid calcium with iron at the same time (although blackstrap molasses is a good source of non-dairy calcium, so I am getting some anyway when I use it) and don't drink tea (tannins) at the same time as iron consumption, for its inhibiting effects on absorption. My B vitamins are plentiful through my prenatals, diet and my C supplements (emergen-C).

We've made hot pepper tincture for excessive bleeding, I plan on sipping my dilution of molasses "tea" through labor, as well as good vitamin C stuff (grape juice, "green juice" with spirulina, chlorophyll, etc.) I also have homeopathic remedies on hand for different symptomology presentations of excessive bleeding during or after birth. We'll have some shepherd's purse on hand to take during labor.

Am I missing anything? Is there cause to worry? I know that I will have two placenta sites (or one big site if they are fused together) and so perhaps might be subject to a bit more blood loss but then again, I will be birthing two babies, not one.

My other pregnancies ended up as unnecessary c/s, and a woman loses considerably more blood during abdominal surgery than a vaginal birth. I had no transfusions.

My belief is that I am going to do great, I am not particularly worried about it but my MW's anxiety is starting to get to me a little, and I am frustrated because I don't know what else to do nutritionally at this point, I feel I am doing all I can.

Advice? Suggestions? Please keep in mind that I am very close to birth, so if you have a recommendation on a food or supplement or herb that will raise iron score rapidly, great -- if it would take a few weeks to see a difference, that won't help me now (if I need help).

Thanks in advance,

SAHM to ABC, 03/03/03; IRC, 03/18/06; due with 3 & 4 03/18/08
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#2 of 5 Old 03-15-2008, 07:44 PM
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You could try tissue salts. Or buy an iron supplementation. Sounds like you are doing very well on the non-pharmacological front.
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#3 of 5 Old 03-16-2008, 05:09 AM
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I think if your levels were 11.75 in January, your blood-building is pretty much done and the numbers should be at or higher by now. IMO, that's a high number considering you have twins. You've got great weight gain.

As for personal experience: I've always had low iron, and mine was 10.8 at 35 weeks. Higher than any of my singleton pregnancies! Have you tried Floradix? I totally attribute my higher numbers to that.

Maybe a more experienced midwife (I'm a student) can hop in here... My understanding is that the Hg isn't so much about actual hemmorhage but that if there is one, you will have a harder recovery.

Missionary, birth-worker, midwifery student
Mama to love.gif DD (9yr), DS luxlove.gif (3yr), & 2twins.gif UC twin DDs (5yr)

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#4 of 5 Old 03-16-2008, 06:44 PM
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I'm not a birth professional, and I don't know how quickly this would help, but I've read that the heme iron in red meat is absorbed 10-15 times better than non-heme iron from plant sources or supplements. The best source of heme iron is beef liver, so it might be worth it to figure out a way to eat tons of beef liver (or take a lot of dessicated/freeze dried liver capsules) until you deliver.
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#5 of 5 Old 03-17-2008, 11:45 PM
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I myself have always had boarder line iron levels even prior to pregnancy but am not worried as I have a very high platelet level. (platelets are the clotting factor in your blood) I have high enough platelets that prior to pregnency I was a regular doner for the Red Cross, about onec evey two to three weeks. I have never had bleeding issues in my life, so I am not overly stressed about birthing this May with lowish levels. I think their are a lot of other factors than just iron that determine bleeding issues. Good luck.

Livin' surf.gif Laughin' lol.gif Lovin' joy.gif - Just Me and Sammers, my homebirthin' little girl. 

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