How much iron should a pregnant woman take?

How much iron should a pregnant woman take?

Pregnant women need significantly more iron than non-pregnant women. The recommended daily intake during pregnancy is 27 mg, nearly double the 18 mg recommended outside of pregnancy. This increase supports the dramatic expansion in blood volume and supports adequate oxygen delivery to the baby.

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Why iron needs increase during pregnancy

Your blood volume increases by 30-50% during pregnancy. All that extra blood requires more hemoglobin, and hemoglobin production depends heavily on iron. The baby also draws iron from your supply to build its own blood cells and iron stores.

Iron deficiency during pregnancy can lead to iron-deficiency anemia, which is associated with preterm delivery, low birth weight, and maternal fatigue. Severe anemia can increase the risk of complications during delivery. Iron status before pregnancy also matters: women entering pregnancy with low stores are more likely to develop deficiency as pregnancy progresses.

The form of iron matters

Not all supplemental iron is the same. Ferrous sulfate is the most commonly prescribed and least expensive, but it's also the most likely to cause constipation and nausea. Ferrous gluconate is somewhat gentler. Iron bisglycinate (chelated iron) is the best-tolerated form and is absorbed more efficiently, meaning your body gets more from each milligram.

The form also affects how iron interacts with other nutrients. Ferrochel® iron bisglycinate is ionically neutral, so it doesn't block the absorption of calcium or other minerals the way some iron forms can. This is especially important in a prenatal vitamin where multiple nutrients need to be absorbed at the same time.

How to boost iron absorption

Vitamin C significantly enhances iron absorption. Pairing iron-rich foods or your prenatal with vitamin C-rich foods - such as citrus fruits, tomatoes, or bell peppers - is a practical strategy. Calcium, coffee, and tea can reduce iron absorption, so try to separate these from your iron-rich meals or prenatal by at least an hour.

Signs of iron deficiency during pregnancy

Watch for persistent fatigue beyond normal pregnancy tiredness; other potential symptoms include pale skin, shortness of breath during light activity, dizziness, cold hands and feet, and unusual cravings for non-food items like ice or dirt (a condition called pica). Your provider should check iron levels at your first prenatal visit and again during the second or third trimester.

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A note from WeNatal on iron during pregnancy

WeNatal for Her contains 18 mg of Ferrochel® iron bisglycinate, a chelated form selected for its superior absorption and gentle stomach profile. Many women find they tolerate this form far better than ferrous sulfate, which means they're more likely to take their prenatal consistently throughout pregnancy. If you have confirmed iron-deficiency anemia, your provider may recommend additional supplemental iron on top of your prenatal.

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References

Adams JB, et al. (2022). Evidence based recommendations for an optimal prenatal supplement. Maternal Health, Neonatology and Perinatology, 8:4. DOI: 10.1186/s40748-022-00139-9