I’m Anemic….Now What??

Pregnancy changes just about everything in your body, including your blood! Mild changes in blood counts are common during pregnancy, but true anemia should be addressed.

If you've been told your hemoglobin is low, your ferritin is dropping, or you need to increase your iron intake, you probably have questions. Do you need an iron supplement? Can you improve your levels through food? How are you still anemic if your prenatal vitamin includes iron?

What Is Anemia During Pregnancy?

Anemia happens when your blood doesn't have enough healthy red blood cells or hemoglobin to carry oxygen efficiently throughout your body.

Hemoglobin is the iron-containing protein in red blood cells that transports oxygen to your tissues and your growing baby.

During pregnancy, your body changes significantly in order to support your baby's development. Your blood volume increases dramatically, and the amount of iron you need increases to support your growing red blood cell supply, placenta, and baby.

The liquid portion of your blood (plasma) actually increases more than your red blood cell mass. This can make your hemoglobin and hematocrit appear lower, even when your body is adapting normally to pregnancy. While you gain more blood volume, you do not gain extra red blood cells.

This process is called physiologic hemodilution, sometimes referred to as the physiologic anemia of pregnancy.

However, not every decrease in hemoglobin is normal pregnancy dilution. Nutritional deficiencies and other medical conditions can also cause anemia, so it’s important to monitor your labs.

Why Does Anemia Matter?

Iron and healthy red blood cells are essential for a healthy pregnancy.

Adequate iron supports:

• Oxygen delivery throughout your body

• Placental function and fetal development

• Your baby's developing brain and nervous system

• Your body's ability to tolerate the normal blood loss associated with birth

• Recovery and replenishment of iron stores postpartum

Untreated iron deficiency anemia has been associated with increased risks of preterm birth, low birth weight, and postpartum anemia. More severe anemia can also reduce your body's ability to tolerate blood loss during delivery, especially if you bleed heavily.

The good news? Many cases of pregnancy-related anemia are manageable once we understand the underlying cause.

Signs and Symptoms of Anemia During Pregnancy

Some people with mild anemia experience no noticeable symptoms; this is why it’s standard to check everyone for anemia early in the third trimester. Others may notice changes that are easily mistaken for typical pregnancy discomforts.

Common symptoms include:

• Extra severe fatigue

• Dizziness or lightheadedness

• Headaches

• Shortness of breath with activity

• Heart palpitations or a faster heart rate

• Pale skin or pale inner eyelids

• Difficulty concentrating

• Feeling unusually cold

• Restless legs

• Craving ice or nonfood substances (called pica)

Since fatigue, breathlessness, and occasional dizziness can be common in healthy pregnancies as well, labs should be run to assess for anemia.

Important: Chest pain, fainting, significant shortness of breath at rest, or persistent racing heartbeat should be evaluated promptly instead of assumed to be caused by low iron.

Understanding Your Pregnancy Blood Work

Hemoglobin (Hgb)

Hemoglobin measures the oxygen-carrying protein in your red blood cells.

Depending on the source, you are typically considered anemic in pregnancy if your Hgb drops below 11-11.5 g/dL. For those planning a home birth, we need your levels to be at least 11.5 g/dL.

Hematocrit (Hct)

Hematocrit measures the percentage of your blood that is made up of red blood cells.

Low hematocrit can accompany anemia, although it must be interpreted alongside other laboratory findings.

Ferritin: Your Iron Stores

Ferritin is one of the most helpful measurements when checking for iron deficiency.

Think of hemoglobin as the iron that is currently being used to transport oxygen and ferritin as a marker for how much iron you have stored.

Your hemoglobin could still be within the normal range, even when your iron stores are becoming depleted.

In pregnancy, a ferritin level below roughly 30 ng/mL is commonly used to identify iron deficiency. Ideally, ferritin is 45 ng/mL or higher.

This means you can have low iron stores, therefore being iron deficient, without yet developing anemia.

Ferritin can also rise during inflammation or infection, so a normal or elevated ferritin result doesn't always completely rule out iron deficiency.

MCV and Other Red Blood Cell Measurements

Your complete blood count (CBC) also includes measurements describing the size and characteristics of your red blood cells.

MCV, or mean corpuscular volume, can help guide further evaluation:

• Low MCV: Often associated with iron deficiency or thalassemia

• High MCV: May suggest vitamin B12 or folate deficiency

• Normal MCV: Can occur with early iron deficiency, blood loss, inflammation, or mixed nutritional deficiencies

Additional testing may include Transferrin Saturation, Iron Studies, Vitamin B12, Folate, or hemoglobinopathy screening.

The Different Types of Anemia During Pregnancy

1. Iron Deficiency Anemia

Iron deficiency anemia is the most common nutritional anemia during pregnancy.

Your body needs iron to manufacture hemoglobin. When your iron stores become depleted, your body can eventually struggle to produce enough healthy red blood cells.

Iron deficiency can develop from the increased demands of pregnancy, low dietary iron intake, depleted iron stores before conception, previous blood loss, or difficulty absorbing iron.

People carrying multiples, experiencing closely spaced pregnancies, or following diets with limited iron sources are at increased risk.

What helps: Iron-rich foods, iron supplementation, improved absorption strategies, and addressing any underlying causes.

If you’ve been anemic for a long time, dietary changes alone often aren’t enough to replenish iron stores quickly.

2. Folate Deficiency Anemia

Folate (Vitamin B9) is essential for making DNA and healthy red blood cell production.

Pregnancy increases the amount of folate needed since your body supports rapid cell growth and fetal development.

Folate is also critical early in pregnancy for neural tube development.

Food sources include leafy greens, asparagus, beans, lentils, avocado, and fortified grains.

What helps: Adequate folate intake through food and prenatal supplementation, with additional treatment when a deficiency is confirmed.

Folate deficiency should be evaluated alongside Vitamin B12 status when appropriate, since high-dose folic acid can correct some blood abnormalities while leaving an underlying B12 deficiency untreated.

3. Vitamin B12 Deficiency Anemia

Vitamin B12 helps your body produce healthy red blood cells and supports normal nervous system function.

Deficiency can occur with limited animal-product intake, certain gastrointestinal conditions, prior bariatric surgery, or impaired absorption.

Symptoms include fatigue, weakness, numbness, tingling, balance issues, or changes in memory and concentration.

Food sources include meat, fish, eggs, dairy products, and fortified foods.

What helps: B12 supplementation or injections, depending on the severity and underlying cause.

B12 deficiency is especially important to recognize since neurological complications can happen, even without significant anemia.

4. Anemia Associated With Inflammation or Chronic Illness

Some medical conditions can interfere with the body's ability to use stored iron or produce red blood cells.

Chronic inflammation, kidney disease, certain autoimmune conditions, and other illnesses can also contribute.

In these cases, the body may have iron, but less of it is available for red blood cell production.

What helps: Identifying and addressing the underlying condition, evaluating the availability of iron, and developing an individualized treatment plan.

Taking an additional iron supplement may not help in this case.

5. Inherited Anemias: Thalassemia and Sickle Cell Disease

Some forms of anemia are inherited, not caused by nutritional deficiencies.

Thalassemia affects hemoglobin production and can cause small red blood cells that resemble those seen in iron deficiency.

Sickle cell disease affects hemoglobin’s structure and function and can cause significant pregnancy complications.

These conditions may require additional monitoring, specialist involvement, and genetic counseling.

What helps: Individualized care based on the specific condition.

Importantly, people with thalassemia should not automatically be given high-dose iron just because their red blood cells are small. Iron supplementation may be appropriate if iron deficiency is also present.

6. Anemia From Blood Loss or Red Blood Cell Destruction

Less commonly, anemia can develop from bleeding or conditions that cause red blood cells to break down faster than they can be replaced.

These situations require additional medical evaluation, and treatment is directed to the cause.

How Much Iron Do You Need During Pregnancy?

The standard recommended dietary allowance for iron during pregnancy is 27 mg daily.

This amount meets normal nutritional needs; you may need more if you are treating a confirmed deficiency.

Many prenatal vitamins contain about 27 mg of iron, but some contain less, and certain gummy prenatals contain no iron at all.

If you have confirmed iron deficiency, you may need additional supplementation beyond your prenatal.

The right amount depends on your lab results, symptoms, gestational age, supplement formulation, and response to treatment.

One important detail when comparing supplements is the amount of elemental iron.

For example, a supplement containing 325 mg of ferrous sulfate typically provides approximately 65 mg of elemental iron.

When reviewing iron supplements, always look at the amount of elemental iron provided per serving.

Iron-Rich Foods to Include During Pregnancy

Nutrition plays an important role in preventing iron deficiency and supporting healthy iron levels.

Dietary iron comes in two forms.

Heme Iron: More Easily Absorbed

Heme iron comes from animal foods and is generally absorbed more efficiently than plant-based iron.

Good pregnancy-appropriate sources include:

• Lean beef

• Dark-meat poultry

• Sardines

• Low-mercury, fully cooked fish

• Fully cooked shellfish

While liver contains iron, it is also very high in preformed vitamin A (retinol), which can be harmful in excessive amounts during pregnancy. It is not a preferred routine iron source for pregnant individuals.

Non-Heme Iron: Plant-Based Sources

Non-heme iron is found in plant foods and fortified products. Note: Plant-based iron is absorbed less efficiently.

Excellent options include:

• Lentils

• Chickpeas

• Black beans and kidney beans

• Pumpkin seeds

• Quinoa

• Spinach and other leafy greens

• Iron-fortified cereals

• Fortified oatmeal

• Nuts and nut butters

How to Improve Iron Absorption

Sometimes, it's not just about how much iron you're consuming. It's also about how well your body absorbs it.

Pair Iron With Vitamin C

Vitamin C can significantly improve the absorption of non-heme iron.

Try pairing iron-rich meals or supplements with things like:

• Oranges or orange juice

• Strawberries

• Kiwi

• Bell peppers

• Tomatoes

• Broccoli

Separate Iron Supplements From Dairy and Calcium

Calcium can temporarily interfere with iron absorption. For this reason, avoid taking your iron supplement at the same time as milk, yogurt, cheese, or calcium supplements.

When possible, separate iron supplements from calcium-rich foods or supplements by about two hours.

This doesn't mean you need to avoid dairy during pregnancy! Calcium is important, too. The goal is to give your iron supplement a better chance of being absorbed.

Avoid Taking Iron With Coffee or Tea

Coffee and tea contain compounds that can reduce the absorption of non-heme iron. Try taking your iron supplement at a different time from your morning coffee or tea. This is especially important when you're actively working to improve low iron stores.

Timing Your Medications

Antacids, acid-reducing medications, thyroid medications, and certain other prescriptions can affect iron absorption or interact with iron supplements. If you take regular medications, review your supplement schedule with your healthcare provider or pharmacist. Some medications require more than a two-hour separation.

Empty Stomach or With Food?

Iron is generally absorbed best on an empty stomach. However, certain iron supplements can cause nausea, abdominal discomfort, constipation, or reflux.

If taking iron without food makes you miserable, a small, non-dairy snack may be a reasonable compromise. Ultimately, consistency matters. A supplement you can tolerate and take regularly is more useful than one that sits untouched because it makes you sick.

Should You Take Iron Every Day or Every Other Day?

You may have heard that taking iron every other day can sometimes improve absorption. There's a reason for that!

Iron supplementation stimulates a hormone called hepcidin, which helps regulate how much iron your intestines absorb.

After an iron dose, hepcidin can temporarily increase, which potentially reduces absorption from subsequent doses.

Research in nonpregnant populations has shown that alternate-day dosing can improve fractional iron absorption under certain conditions.

Pregnancy-specific evidence is still developing, but newer obstetric recommendations recognize alternate-day dosing as a reasonable option for some people, especially when daily iron causes side effects.

This doesn't mean every-other-day supplementation is automatically better for everyone. The total iron dose, severity of deficiency, time remaining before birth, and response to treatment all matter. Speak with your provider about what is recommended for you.

Managing Constipation and Other Iron Supplement Side Effects

Iron supplements can be hard on the digestive system, especially during pregnancy. Common side effects include constipation, nausea, abdominal discomfort, and darker stools.

Some strategies that may help include:

• Drinking adequate fluids throughout the day

• Including fiber-rich foods like fruit, vegetables, oats, and legumes

• Staying physically active as tolerated

• Trying a different iron formulation

• Adjusting the dosing schedule with your provider

• Taking iron with a small snack if necessary

Some individuals may tolerate iron bisglycinate and other formulations better than traditional ferrous salts, although the effectiveness and tolerability vary.

Dark stools can be normal with iron supplementation. However, black, tarry, sticky stools that are accompanied by concerning symptoms should be evaluated to make sure there’s nothing else causing these changes.

What About Chlorophyll for Anemia?

Chlorophyll is the green pigment that helps plants capture energy from sunlight.

Chlorophyll supplements and chlorophyllin products are often recommended for blood health because the chlorophyll molecule structurally resembles heme.

Chlorophyll is not a substitute for iron, but it can work alongside iron as an additional blood builder.

When Is an Iron Infusion Necessary?

Sometimes oral supplementation isn't enough.

Intravenous (IV) iron may be considered when:

• Iron deficiency anemia is significant

• Oral supplements are not tolerated

• Laboratory values fail to improve with appropriate oral treatment

• A medical condition interferes with absorption

• Delivery is approaching, and iron stores need to be replenished more quickly

IV iron is generally considered after the first trimester and when it is clinically indicated.

Iron infusions deliver iron directly into the bloodstream, bypassing the digestive tract.

They can replenish iron stores more rapidly than oral supplementation, but they still require appropriate medical evaluation and monitoring.

How Long Does It Take to Improve Iron Levels?

Improving iron deficiency takes time.

With effective oral treatment, your hemoglobin may begin improving within a few weeks. Typically, you'll repeat blood work to track your body’s response to treatment.

Rebuilding depleted iron stores can take several months, even after hemoglobin returns to normal. Follow-up testing helps determine whether your current approach is working and how long you should continue supplementation.

Don't Forget About Postpartum Iron Recovery

Your body's iron needs don't magically disappear when your baby is born!

Pregnancy, childbirth, and postpartum blood loss can leave iron stores depleted, particularly if you entered birth with anemia.

Postpartum iron deficiency can cause fatigue, weakness, dizziness, and slower physical recovery.

While caring for a newborn is exhausting for almost everyone, significant or persistent symptoms shouldn't automatically be dismissed as normal new-parent fatigue. Depending on your pregnancy lab results, birth experience, and postpartum symptoms, additional testing or continued supplementation may be recommended.

My Favorite Iron Supplements and Supportive Products

There are many iron supplements available, but not all products contain the same type or amount of iron.

Some formulations contain additional nutrients involved in red blood cell production, while others focus on providing iron in a form that may be easier to tolerate.

For my clients, I make recommendations based on their lab results, pregnancy history, dietary intake, and individual needs.

Here are a few products I commonly discuss as part of individualized care.

Hema-Plex

Hema-Plex is a multinutrient iron supplement that combines iron with other nutrients involved in healthy red blood cell production.

Depending on the specific formulation, these may include vitamin C, B vitamins, and other supportive nutrients.

Because some Hema-Plex products contain relatively high amounts of iron and additional vitamins, it's important to review the exact product label and account for nutrients already present in your prenatal vitamin.

Hemaplex on Amazon

OptiFerin-C

OptiFerin-C combines iron with vitamin C, which supports the absorption of non-heme iron.

It can be a convenient option when additional iron supplementation is appropriate.

As with any iron supplement, the amount of elemental iron and total daily intake should be considered alongside your prenatal vitamin and individual needs.

OptiFerin-C on Fullscript

Chlorophyll

Chlorophyll products are sometimes included in broader nutritional wellness routines.

However, chlorophyll should not be considered an iron supplement or a proven treatment for anemia.

Because pregnancy-specific evidence for concentrated chlorophyll supplements is limited, I evaluate their use individually rather than recommending them as a routine anemia treatment.

Chlorophyll on Amazon

Please remember that these are products I may discuss with clients, not a recommendation for every pregnant person to begin all three. The appropriate supplement, amount, and schedule depend on individual circumstances.

**Affiliate Disclosure: Some links in this article are affiliate links, including links through Amazon Associates and Fullscript. If you make a purchase through these links, I may earn a commission at no additional cost to you. I only share products I personally trust and believe may be beneficial for my clients. Affiliate relationships do not influence my clinical recommendations, which are always based on individual needs and evidence-informed care. As an Amazon Associate, I may earn from qualifying purchases.

References and Further Reading

American College of Obstetricians and Gynecologists. (2021, reaffirmed 2024). Anemia in pregnancy. Practice Bulletin No. 233. https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2021/08/anemia-in-pregnancy

FIGO. (2025). Good practice recommendations on anemia in pregnancy, to reduce the incidence and impact of postpartum hemorrhage. International Journal of Gynecology & Obstetrics. https://doi.org/10.1002/ijgo.70529

Haematology in Obstetrics and Women's Health Collaborative. (2025). Iron optimisation in pregnancy: A consensus statement. https://pmc.ncbi.nlm.nih.gov/articles/PMC11817901/

National Institutes of Health, Office of Dietary Supplements. Dietary supplements and life stages: Pregnancy—Health professional fact sheet. https://ods.od.nih.gov/factsheets/Pregnancy-HealthProfessional/

National Institutes of Health, Office of Dietary Supplements. Iron—Health professional fact sheet. https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/

World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience: Nutritional interventions. https://www.ncbi.nlm.nih.gov/books/NBK409099/

Educational disclaimer: This article is intended to provide general pregnancy education and does not replace individualized medical evaluation, diagnosis, or treatment. Supplementation and laboratory follow-up should be guided by your maternity care provider.

Affiliate Disclosure: Some links in this article are affiliate links, including links through Amazon Associates and Fullscript. If you make a purchase through these links, I may earn a commission at no additional cost to you. I only share products I personally trust and believe may be beneficial for my clients. Affiliate relationships do not influence my clinical recommendations, which are always based on individual needs and evidence-informed care. As an Amazon Associate, I may earn from qualifying purchases.

Choosing Home Birth: A Guide to Safe and Personalized Care

Choosing Home Birth with a midwife

The decision to bring a child into the world is a deeply personal and transformative journey. With the evolving landscape of maternity care, many expectant parents are choosing midwives who specialize in home birth to guide them through this sacred experience. Home birth midwives offer a unique blend of medical expertise and personalized care, ensuring a safe and empowering birth experience.

Types of Midwives

Certified Nurse Midwives (CNMs): These midwives are registered nurses with specialized training in midwifery. They have completed advanced education and hold a master's or doctoral degree in nursing. CNMs are licensed to provide care across various settings, including hospitals, birth centers, and homes.

Certified Midwives (CMs): These midwives earn a graduate degree in midwifery from a program accredited by the Accreditation Commission for Midwifery Education (ACME). CMs differ from Certified Nurse-Midwives (CNMs) only in that they are not also licensed as nurses. Only a few states recognize the CM credential.

Certified Professional Midwives (CPMs): CPMs are trained specifically in out-of-hospital settings, making them a popular choice for home births. They acquire education through accredited midwifery programs and gain hands-on experience through apprenticeships. CPMs focus on providing holistic and family-centered care.

Direct-Entry Midwives (DEMs): Direct-entry midwives have typically not undergone nursing training. They receive education and training directly in midwifery. Regulations and requirements for DEMs vary by region, which can affect their scope of practice and legality.

Traditional Midwives: Traditional Midwives may have studied midwifery through an apprenticeship, but they often do not have additional formal schooling. They have not gone through any skills testing and are often unregulated and/or practice illegally.

Checking Credentials and Qualifications

Certification: Regardless of the type of midwife, it's crucial to ensure they hold a valid certification from a reputable organization. CNMs are certified by the American Midwifery Certification Board (AMCB), CPMs are certified by the North American Registry of Midwives (NARM), and DEMs may have certification from other organizations. CMs are certified through the American Midwifery Certification Board (AMCB).

Licensing and Regulation: Research the licensing and regulatory requirements for midwives in your state or region.
In SC, CNMs can practice under the supervision of a physician. CPMs are able to obtain a license to become a LM and practice independently.
In GA, CNMs can practice independently. GA does not offer licensure for non-nurse midwives.

Experience: Inquire about the midwife's experience; this may include asking about the number of births attended and the specific settings they have worked in.

Continuing Education: A commitment to staying up-to-date with the latest advancements in midwifery and childbirth care is essential. Ask about the midwife's participation in continuing education programs and workshops. All credentialed midwives are required to attend a minimum amount of continuing education each certification/licensure cycle.

Choosing the Right Midwife

Interview Midwives: Many midwives offer free or low-cost consultation appointments to help you find the one who aligns with your values, preferences, and birthing goals. Ask about their approach to childbirth, emergency protocols, and postpartum care.

Collaboration with Healthcare Providers: A midwife should have a network of collaborative relationships with medical professionals and/or hospitals. This ensures a smooth transition in case of emergencies or the need for a higher level of medical intervention.

Open Communication: Choose a midwife who actively listens to your concerns, answers your questions, and involves you in the decision-making process. A strong sense of trust and communication is vital throughout your journey.

Choosing a midwife is a significant decision that directly impacts your birth experience and the well-being of both you and your baby. By understanding the different types of midwives, checking their credentials, and carefully evaluating their qualifications, you can confidently select a midwife who will provide safe, personalized, and empowering care. Remember, your midwife is not just a healthcare provider but a partner in your journey to welcoming a new life into the world.

Group B Strep in Pregnancy

Group B Strep (GBS) in Pregnancy

Pregnancy is a time of anticipation and preparation, but it's also a period when healthcare considerations are of utmost importance. Group B Streptococcus (GBS) is a common bacterium that can affect pregnant individuals and their newborns. In this blog post, we'll delve into the significance of GBS testing during pregnancy, the standard treatments available, potential complications for newborns, and the implications of GBS disease.

The Importance of Testing

Group B Streptococcus is a naturally occurring bacterium that can be present in the genital or gastrointestinal tracts of adults. While it doesn't usually cause problems in healthy adults, it can pose a risk to newborns during childbirth. GBS testing during pregnancy, typically conducted between weeks 35 and 37, helps identify whether the bacterium is present in the mother's body. This information is crucial in determining the best course of action to prevent its transmission to the newborn.

Standard Treatments and Interventions

Intravenous Antibiotics During Labor: If GBS is detected, the standard approach is to administer intravenous antibiotics to the pregnant individual during labor. This treatment helps prevent the transmission of GBS to the baby during birth.

Risk Factors and Considerations: The decision to administer antibiotics also takes into account risk factors, such as preterm labor, prolonged rupture of membranes, and fever during labor.

Possible Complications for the Newborn

GBS infection in newborns can lead to serious health complications, including:

Early-Onset GBS Disease: This occurs within the first week of life and can lead to sepsis, pneumonia, and other life-threatening conditions.

Late-Onset GBS Disease: This occurs between the first week and the third month of life and might result in sepsis, meningitis, and related complications.

Signs and Symptoms: Newborns with GBS disease might exhibit symptoms such as fever, difficulty feeding, breathing problems, and lethargy.

GBS Disease and its Implications

While GBS disease in newborns is relatively rare thanks to effective testing and preventive measures, it underscores the importance of early detection and treatment. Left untreated, GBS infection can lead to severe health consequences, making timely testing and administration of antibiotics during labor vital.

Group B Streptococcus is a prime example of the critical role that prenatal testing plays in ensuring the well-being of both pregnant individuals and their newborns. Testing for GBS during pregnancy, along with standard antibiotic treatments during labor when necessary, can significantly reduce the risk of GBS transmission and associated complications in newborns. By staying informed, seeking regular prenatal care, and discussing GBS testing with your healthcare provider, you're taking proactive steps to ensure a healthy start for both you and your baby.

Safe and Supported: The Role of Midwives in Modern Maternity Care

Safe and Supported: The Role of Midwives in Modern Maternity Care

The landscape of maternity care is evolving, with an increasing number of expectant parents seeking alternative options that align with their desires for a personalized and empowering birth experience. In this context, the role of midwives has gained increasing recognition as a choice that provides both safety and emotional support.

Ensuring Safety Through Expertise

Comprehensive Prenatal Care: Midwives are trained healthcare professionals who provide thorough prenatal care to monitor the health and progress of both the mother and the baby. Through regular check-ups, we identify potential risks and complications early on, ensuring appropriate interventions are taken when needed.

Continuous Monitoring: During labor, midwives closely monitor the progress of labor and the well-being of the mother and baby. We are skilled at recognizing signs of complications and are equipped to handle emergencies or to make the decision to transfer to a hospital if necessary.

Emergency Preparedness: Home birth midwives undergo rigorous training to handle emergencies that might arise during childbirth. We carry medical supplies and equipment to manage common complications, and we will communicate directly with the hospital if a transfer becomes necessary. We renew our Neonatal Resuscitation certifications at least every two years.

Risk Assessment and Transparency: Midwives conduct thorough risk assessments to determine if a home birth is a safe option for each individual. We maintain open and honest communication with each client, discussing potential risks and benefits and ensuring that everyone is well-informed before making decisions.

Providing Unwavering Emotional Support

Creating a Trusting Relationship: Home birth midwives focus on building strong relationships with expectant parents. We invest time in getting to know our clients, understanding their values, fears, and aspirations for childbirth. This relationship of trust fosters a sense of emotional security during the birth process.

Empowerment Through Education: Midwives are educators as well as caregivers. We provide comprehensive information about the birthing process, available options, and potential interventions. This empowers parents to actively participate in decision-making, contributing to a more positive and confident birth experience.

Holistic and Family-Centered Approach: Midwives consider the emotional and psychological aspects of childbirth. They create a supportive environment that includes partners, family members, and even older siblings, fostering a sense of unity and comfort during labor and delivery.

Emotional Well-being: We are attuned to the emotional needs of expectant parents. We offer reassurance, encouragement, and personalized comfort measures, helping to alleviate anxiety and promoting a more relaxed birthing atmosphere.

The resurgence of interest in home birth with midwives reflects a growing desire for a birth experience that values both safety and emotional support. These skilled professionals bridge the gap between medical expertise and compassionate care, ensuring that expectant parents are well-prepared for the transformative journey of childbirth and the first several weeks postpartum. By embracing the holistic approach of certified and licensed midwives, modern maternity care melds with the importance of personalized care, informed decision-making, and the emotional well-being of both parents and newborns. As the trend of pursuing a home birth continues to gain momentum, more families are discovering the profound impact that the partnership with a midwife can have on their birthing experience.

Empowering Your Birth Experience: How Home Birth Midwives Can Make a Difference

Empowering Your Birth Experience: How Midwives Can Make a Difference

Bringing a new life into the world is a transformative journey that holds immense significance for expectant parents. As the birthing landscape evolves, more individuals are seeking ways to take control of their birth experiences, embracing options that align with their values and desires. Midwives have emerged as key figures in this movement, offering a unique approach to childbirth that empowers parents and celebrates the natural process of bringing a child into the world. Let’s explore how home birth midwives can make a profound difference in empowering your birth experience.

Personalized Care and Relationship Building

Home birth midwives prioritize building strong relationships with their clients, cultivating an environment of trust, comfort, and respect. Unlike the often impersonal setting of a hospital, midwives take the time to understand your personal preferences, concerns, and aspirations for your birth journey. This personalized approach ensures that you are an active participant in every decision, fostering a deep sense of empowerment.

Education and Informed Choices

One of the remarkable aspects of home birth midwives is their commitment to education. Throughout your prenatal care, midwives provide comprehensive information about various birthing options, potential interventions, and the natural progression of labor. Armed with this knowledge, you are empowered to make informed choices that resonate with your values and wishes. This educational aspect of midwifery care enables you to approach childbirth with confidence and a clear understanding of what to expect.

Honoring the Natural Process

Home birth midwives have a profound respect for the natural process of childbirth. They believe that birth is not just a medical event but a deeply transformative and emotional experience. Midwives work with your body's innate wisdom, allowing labor to unfold naturally whenever possible. This approach minimizes unnecessary interventions and medical procedures, allowing you to embrace the innate strength and capability of your body.

Creating a Supportive Environment

The familiar surroundings of your own home can significantly contribute to a positive birth experience. Home birth midwives curate a calming and supportive environment that promotes relaxation and confidence. You have the freedom to move, eat, and labor in ways that feel most comfortable to you, enhancing the natural progression of labor. Additionally, having your loved ones close by can provide invaluable emotional support, further enriching the experience.

Empowerment Through Active Participation

Home birth midwives encourage active participation in the birthing process. They guide you through the stages of labor, offering encouragement, comfort measures, and various positions that can facilitate labor progression. This hands-on approach empowers you to be an integral part of your birth story, creating a lasting sense of accomplishment and pride.

The role of home birth midwives goes far beyond providing medical care; they are champions of empowerment, education, and holistic experiences. By choosing a home birth attended by a skilled midwife, you are embracing an approach that values your unique needs and desires, while celebrating the beauty of childbirth. The empowerment you gain from actively participating in your birth journey, supported by the expertise of a midwife, can set the tone for your parenting journey ahead. As this trend continues to grow, more individuals are discovering the transformative impact that home birth midwives can have on the sacred journey of bringing new life into the world.

Bringing Birth Back Home: The Rising Trend of Home Birth Midwives

Bringing Birth Back Home: The Rising Trend of Home Birth

In recent years, there has been a noticeable shift in the way many individuals approach childbirth. With a desire for a more personalized and holistic birthing experience, the trend of home births attended by midwives has been steadily gaining momentum. This movement signifies a departure from the traditional hospital setting, highlighting a return to the roots of childbirth.

The Role of Midwives

Home birth midwives play a crucial role in ensuring a safe and supportive environment for expecting mothers who choose to give birth at home. These skilled professionals bring a wealth of knowledge and experience in providing prenatal care, assisting with labor and delivery, and offering postpartum support. Their primary goal is to empower and educate mothers, promoting a sense of ownership and confidence in the birth process.

Benefits of Home Birth with Midwives

1. Personalized Care: One of the standout advantages of home birth midwives is the individualized attention they offer. Unlike the often fast-paced hospital environment, midwives take the time to build strong relationships with their clients, tailoring their care to the specific needs and preferences of each mother.

2. Comfort and Familiarity: Giving birth at home provides a comfortable and familiar setting for the mother, reducing anxiety and stress. This can contribute positively to the progression of labor and the overall birth experience.

3. Reduced Medical Interventions: Home births with midwives tend to have lower rates of medical interventions such as cesarean sections, epidurals, and induced labor. Midwives emphasize natural birthing processes and intervene only when medically necessary, promoting a more holistic approach.

4. Family Inclusion: Home births allow for greater involvement of family members, partners, and even older children in the birthing process. This can foster a stronger family bond and a more inclusive experience for everyone involved.

Challenges and Considerations

While the trend of home birth midwives is on the rise, there are certain challenges and considerations to keep in mind:

1. Safety Concerns: Critics argue that home births might carry increased risks in cases of emergencies or complications. However, trained midwives are well-prepared to identify potential issues and take appropriate actions. If medical concerns arise, the midwife will facilitate transfer to the hospital for continued care.

2. Legal and Regulatory Factors: The legality and regulation of home births vary from region to region. Some areas have well-defined guidelines and support for home birth midwives, while others have stricter regulations or even outright bans. In SC, midwives are eligible for licensure after earning the Certified Professional Midwife (CPM) credential. On the other hand, GA does not license midwives unless they are Certified Nurse Midwives (CNMs), who are nurses with additional training in pregnancy and birth.

3. Access to Resources: Availability of resources such as emergency services can be a concern in remote or rural areas, affecting the feasibility of home births.

4. Client Choice: It's essential to remember that home birth is a personal choice. Not all individuals are suitable candidates for home births, and some might prefer the controlled environment of a hospital setting.

The rising trend of home birth reflects a growing desire for a more personalized, natural, and family-centered approach to childbirth. These skilled professionals offer individualized care, emphasizing the importance of empowering mothers and promoting a sense of agency during the birthing process. While challenges exist, the increasing popularity of home birth midwives underscores the need for a diverse range of options that cater to the diverse preferences and needs of expectant parents. As this trend continues to gain traction, it will be interesting to observe how healthcare systems and policies adapt to accommodate and support this evolving approach to childbirth.

Debunking Pregnancy Myths

Debunking Common Pregnancy Myths: Separating Fact from Fiction

Pregnancy is often a wonderful journey filled with excitement and anticipation, but it's also accompanied by a plethora of information, some of which might not be entirely accurate. In this post, we'll take a closer look at some common pregnancy myths and provide evidence-based insights to help you navigate this special time with confidence.

Myth 1: "You Should Eat for Two"

One of the most prevalent myths is the idea that pregnant women should eat twice as much to support their growing baby. In reality, an increase in caloric intake is required, but it's nowhere near double the amount. The emphasis should be on nutrient-dense foods to provide essential vitamins, minerals, and energy for both mom and baby. For most women, 1/2 of a PB&J sandwich would fill the small calorie increase needed during pregnancy.

Myth 2: Morning Sickness Only Happens in the Morning

While the term "morning sickness" suggests that it only occurs in the early morning hours, many women experience nausea and vomiting at any time of day. It's essential to understand that this symptom varies widely and can affect women differently.

Myth 3: You Should Avoid Physical Exercise

Pregnant women are often advised to rest and avoid physical activity, but moderate exercise is actually beneficial for both the mother and the baby. Staying active can help manage weight gain, improve mood, and enhance overall well-being. Of course, it's important to consult your healthcare provider before starting any exercise routine during pregnancy.

Myth 4: Caffeine Must Be Completely Eliminated

While excessive caffeine intake should be avoided during pregnancy, moderate consumption is generally considered safe. The key is moderation—limiting caffeine to around 200 milligrams per day, which is roughly equivalent to one 12-ounce cup of coffee.

Myth 5: You Shouldn't Travel During Pregnancy

Traveling during pregnancy is possible, but it's important to plan ahead and prioritize comfort and safety. Consult your doctor before embarking on any trips, especially if they involve long flights or remote destinations. Adequate hydration and regular stretching during travel are essential.

Myth 6: Heartburn Means Baby Has Hair

The idea that heartburn during pregnancy is linked to the amount of hair the baby will have is just an old wives' tale. While there may be some anecdotal correlations, scientific research doesn't support a direct connection between the two.

Myth 7: Pregnant Women Shouldn't Eat Fish

Fish is an excellent source of omega-3 fatty acids, which are vital for the baby's brain and eye development. While some types of fish should be limited due to their mercury content, incorporating low-mercury options like salmon, sardines, and shrimp can be highly beneficial.

Ultimately, pregnancy myths often stem from well-meaning advice, but it's crucial to separate fact from fiction. Rely on evidence-based information, consult your healthcare provider, and trust your instincts. Every pregnancy is unique, and by debunking these common myths, you can make informed choices that contribute to a healthy and joyful pregnancy journey.

Prenatal Infections

Navigating Prenatal Infections: Understanding Risks and Common Treatment Options

Bringing a new life into the world is a beautiful journey, but it's essential to be aware of potential risks along the way. Prenatal infections are a concern for expectant mothers, as they can pose risks to both the mother and the developing baby. In this blog post, we'll delve into the risks associated with common prenatal infections and explore treatment options to ensure a healthy pregnancy.

Understanding Prenatal Infections

Prenatal infections are caused by various bacteria, viruses, and parasites that can be transmitted to the baby during pregnancy or childbirth. These infections can lead to complications such as preterm birth, birth defects, developmental delays, and even miscarriage. Being informed about the risks can empower mothers to take proactive measures.

Common Prenatal Infections:

1. Cytomegalovirus (CMV): This virus can be passed to the baby through contact with body fluids, such as urine or saliva. CMV infection during pregnancy may result in hearing and vision problems, as well as developmental delays.

2. Rubella (German Measles): If a pregnant woman contracts rubella, it can lead to severe birth defects, including deafness, heart defects, and intellectual disabilities.

3. Toxoplasmosis: Caused by a parasite found in undercooked meat, cat feces, and contaminated water, toxoplasmosis can lead to serious health issues in the baby, including vision and hearing problems.

4. Group B Streptococcus (GBS): This bacterium is commonly present in the birth canal. While it doesn't usually harm the mother, it can cause severe infections in newborns, including pneumonia, sepsis, and meningitis.

Prevention and Treatments:

1. Hygiene and Food Safety: Practicing good hygiene, such as washing hands regularly, and following proper food safety guidelines can reduce the risk of infections like CMV and toxoplasmosis.

2. Regular Prenatal Care: Attending regular prenatal check-ups allows healthcare providers to monitor your health and the baby's development. Routine screenings can detect infections early and guide appropriate treatment.

3. Antibiotics and Antiviral Medications: In cases where prenatal infections are detected, healthcare providers may prescribe antibiotics or antiviral medications to manage or minimize the impact of the infection on both mother and baby.

4. Counseling and Support: It's important to receive emotional support if diagnosed with a prenatal infection. Health professionals can provide guidance on managing stress and anxiety associated with the condition.

Conclusion:

Knowledge is a powerful tool when it comes to ensuring a healthy pregnancy. By understanding the risks associated with common prenatal infections and familiarizing yourself with preventive measures and treatment options, you can take proactive steps to protect yourself and your baby. Regular prenatal care, open communication with your healthcare provider, and practicing good hygiene can contribute to a smoother and healthier pregnancy journey. Remember, you're not alone—there's a network of support available to guide you every step of the way.

COVID-19 and Maternity Care in Columbia

Coronavirus. COVID-19. SARS-CoV-2.

These words are relatively new for most of us, but they’ve had a huge impact on local businesses and medical care. As the wave of Coronavirus cases grows, the look of maternity and labor care is starting to rapidly change. If you are due within the next few months, you may want to stay up to date as local hospital policies change to prevent further spread of the virus.

What’s Changed?

Some providers have begun rescheduling prenatal visits and may be limiting visitors and children present during visits. As of this post (3/20/20), all local hospitals have imposed limits to the number of visitors a patient may have, and this includes limits during labor. Currently patients at any Prisma Health area hospital (including Prisma Health Richland, Prisma Health Baptist, and Prisma Health Parkridge) are limited to one support person for the duration of their stay. That one designated visitor cannot swap out with anyone else, and the visitor will be screened for illness prior to admission. Lexington Medical Center has now implemented a no visitors policy, other than the primary support person, who must have a bracelet. They are also asking the support person to stay on the floor to minimize the risk of transmission, but that is not absolutely required. All visitors here will also be screened prior to admission. I will attempt to keep this post updated as any policies continue to change.

These limits can clearly change your plans for labor. Extra family and friends are no longer allowed. This limit also eliminates the possibility of of bringing a doula or birth photographer unless there is not a birth partner present. This was no an individual physician decision, and at this time the hospitals report that your physician cannot overrule this limit. If you are due in the next few months and were planning to have a doula and/or birth photographer, now is the time to work with your support to create a backup plan.

COVID-19 Risks in Pregnancy

Thus far, there have been no changes in birth outcomes if the mother has COVID-19, and it is not recommended to change protocols regarding care during birth due to this virus. Research has shown that the virus is not present in the placenta or amniotic fluid, and if baby is found to test positive soon after the birth, then the infection was caused by another person present or contact with a positive mother- the baby was not ill in utero and was not made sick in the birth process.

There is limited research that suggests pregnancy can be in some ways protective against this virus. This does not mean that pregnant people are not getting sick, but they often are showing only fewer symptoms or develop a weaker infection.

The World Health Organization (WHO) recommends that families still do skin to skin care after birth, breastfeed (if desired) , and keep baby in the parents’ room even if there is a suspected or confirmed case of COVID-19.

Babies who contract COVID-19 have thus far had no severe illness. A few have mild cold/flu symptoms, but the majority have been asymptomatic. This applies for all children under 10 years old.

COVID-19 and Breastfeeding

The CDC and World Health Organization (WHO) recommend continuing breastfeeding even if the mother and/or baby has COVID-19. Tests have not found the virus present in any tested milk samples from patients who are known to be positive. Continuing breastfeeding can help support baby’s immune system and help baby fight off the virus if it is present.

Changes in Our Services

Here at Little Orchids, we are trying to adapt to still support our clients under these new hospital policies. As part of social distancing, we are encouraging families to schedule a virtual or phone consultation with us instead of coming to meet in our office. This allows us to still chat and answer any questions while reducing any possible virus spread.

We have also begun offering Virtual Doula Support. If your hospital is not allowing doulas during your birth, we’re offering completely remote pregnancy and labor support via phone and video calls. You can find more information about all virtual and remote support options on on our website.

Evidence Based Birth® released a completely online option for their Childbirth Class series. We are happy to help provide this option to families in our service area. We are also waiving the additional fee for booking a private class vs a group class. This online class option covers all the same information as the normal group class; learn more about the Evidence Based Birth® Childbirth Class here, and please contact us if you would like to book a class.

Several families have recently reached out to discuss how to possibly deliver at home instead of going to the hospital. We are doulas, and as such we have to maintain support roles only; we are not medical providers. We can attend births at home with you, as long as you also have a licensed provider present. If you need recommendations for local midwives, please send us a message! Some midwives are even accepting late transfers at this time due to the Coronavirus pandemic.

Hoping you all stay well!

Do WHAT With My Placenta??

So you're expecting a baby, and everyone is giving you advice. 
"You need this stroller; it's a lifesaver!" 
"Make sure baby eats every 2 hours!"
"Don't use that brand of diaper! You'll have poop explosions; they leak!"
"You have to encapsulate your placenta! I did, and it was wonderful!"

Wait, what was that about a placenta? 

Placenta Encapsulation is a way of ingesting the placenta, and it's a decision that's gaining popularity. It may sound bizarre, but the placenta is filled with hormones that many people believe may benefit new mothers. 

Generally, Placenta Encapsulation involves processing the placenta into a dry, fine powder. The powder is then put into empty capsules so that the client can take the capsules just like a vitamin. There are also other ingestion options which may include taking the placenta as a tincture or in raw smoothies. 

Why would someone eat their placenta? 
Many new moms report benefits from ingesting their placentas. Benefits can vary person to person, but some of the most common reported include an increase in energy levels, balanced mood, increased milk supply, and lower incidents of postpartum depression. It is important to note that there have been little to no scientific studies into these benefits; most of the information available is anecdotal. One of the main theories is that since the placenta is partially the mother's hormones, these can help balance her hormone levels after the sudden drop that occurs after the birth. Again, results may vary, and the FDA has not researched or approved placenta encapsulation as a way to treat or prevent anything. 

Are there any negatives or side effects?
The majority of our clients never have any issues. In the general population of people who try placenta encapsulation, a small percentage do report that they have a decrease in milk supply. It is also possible that one may experience a burst of shaky energy (similar to caffeine jitters) if they are taking too much placenta at once. Again, this is not common and can normally be eliminated by taking fewer capsules at once. 

Raw Prep, Heated Capsules, Traditional Chinese Method...What's the difference?
There are multiple ways to prepare the placenta prior to making it into capsules. Each has their own pros and cons, and preparation methods may vary encapsulator to encapsulator. 
Raw preparation means dehydrating the placenta at temperatures between 115-118F. Heating at these lower temps is thought to preserve more of the nutrients since heat can denature some of the beneficial nutrients, but these temperatures are not high enough to kill off potentially harmful bacteria. Because of the bacteria risk, Little Orchids does not offer raw preparation. 
The Traditional Chinese Method (TCM) involves steaming the placenta prior to dehydration. Adding more heat by steaming is thought to add hot "yang energy" to help balance the cold "Yin energy" thought to be prevalent postpartum. Depending on the practitioner, some will add herbs to the steaming placenta thought to help promote postpartum healing. The placenta is then dehydrated at temperatures that vary by practitioner. Steaming can help kill more of the surface bacteria on the placenta. Steaming the placenta may produce fewer capsules since the processing loses additional mass. At Little Orchids, we do not add anything to your placenta, and we dehydrate at 160F to maintain food safety guidelines. 
Heated preparation means that the placenta is dehydrated at temperatures high enough to kill off any bacteria. This is normally done for a longer period of time than other preparations - usually 12-24hours. This can produce a safer product, but the additional heat can very slightly lower the nutritional benefits. This is the default preparation method at Little Orchids unless TCM is requested. 

How do I plan to encapsulate my placenta? 
The first step would be to locate a local placenta encapsulator. It is beneficial to do your research; placenta encapsulation is completely unregulated, so training and processing standards vary wildly. At Little Orchids, our encapsulator is a Certified Postpartum Placenta Encapsulation Specialist who maintains ServSafe Foodhandler certifications as well as Bloodbourne Pathogens certification. Safety is our number one consideration, and we want to ensure a safe product for our clients. 
Once you've chosen your encapsulator and confirmed they're available for your due date, you can start their booking process. At Little Orchids we offer the options of meeting for a consultation or just directly booking online through our website. 
After you've booked, your encapsulator will follow their specific procedures for pick up and processing of your placenta. At Little Orchids, we give clients a handout of instructions for safely storing the placenta until pickup as well as how and when to contact us for pickup. Placenta products are completed promptly and are returned directly to you.

Placenta Encapsulation can be beneficial for many mothers, and it can be a great thing to consider. If you do choose to ingest your placenta, it is important to find an encapsulator you're comfortable with who provides the processing options you want, so begin your search in advance whenever possible. Have any questions for our encapsulator? Contact us today! 

BRAINED: Decision Making for Labor (and Life)

Labor can be an intense, stressful time. Many people go into the birth process with a "birth plan," or a list of ideals they wish to stick to. These are often well researched ideas the family is comfortable with. But what happens when suddenly your doctor comes in and says those ideas need to change? Whether the doctor suggests additional interventions or even talks about changing the type of delivery, sometimes births do not go as planned. How can you make such a potentially huge decision during a high-stress, vulnerable time? 

We like to use the BRAINED pneumonic to talk through these situations. It can be helpful to have a neutral third party (like a doula) to help walk through these steps, but it can be a handy tool for anyone to use for any decision.

So what is BRAINED?

B: Benefits

What are the benefits of the suggested choice? Are there more benefits than there would be with the current plan? Are the potential benefits worth changing plans?

R: Risks

What are the risks of the suggested choice? Does the risk level increase or decrease with the new choice? Do the benefits outweigh the risks? How severe are the potential risks?

A: Alternatives

Are there any other alternatives to consider? What are the alternatives? How do the alternatives compare to the current options?

I: Intuition

What does your gut feeling say? Intuition can be a powerful thing, and it is there for a reason.

N: Nothing

What happens if we decide to do nothing or stick with the original plan?

E: Evaluate

Evaluate these considerations as well as any other questions you have.

D: Decide

Decide what is the best option for you.

The BRAINED tool is most often used for labor decisions, but it's also great for really any life choice. Using this tool helps prevent making quick, emotional decisions by breaking down different considerations logically.