Q: I am living in the UK. I have come to India for my delivery. I had a blood check and my haemoglobin (Hb) level was found to be 9.6 g/dl. Though the doctor says this is enough, they are giving injections to boost my Hb to reach 10 g/dl. I am in the first week of the 9th month. My delivery date is October 24. My question is why are the doctors checking my blood before delivery? If at all I reach the level of 10 g/dl, will this be enough? Should I clarify with my hospital whether they have a blood bank?

A:Anaemia is inadequate level of haemoglobin appropriate for age & sex. A Hb value of less than 11.5 g/dl in a pregnant woman is defined as anaemia. The most common cause of anaemia in pregnancy is deficiency of iron (~85% cases) and folic acid. Even if a woman is not anaemic at the time of pregnancy, she may still develop anaemia as the pregnancy progresses due to increased demands of the developing baby. There are certain risk factors for women being anaemic and these include: poor nutrition, inadequate gap between pregnancies, persistent nausea or vomiting in early pregnancy and twin pregnancy. The loss of iron (elemental) with each normal menses is around 12-15 mg. A normal diet must include 1.5-2 mg/day of elemental iron to compensate for menstrual losses alone. In pregnancy, 500 mg of additional iron is needed by the mother (to expand her red cell mass) while another 500 mg is needed for the baby and placental tissues. Thus, on an average, an additional 3 mg/day of elemental iron must be absorbed from dietary sources. The amount of iron absorbed by the body is only 10% of the total amount consumed, thus 30 mg/day needs to be consumed to meet the requirement. An iron deficient mother can have premature labour, intrauterine growth retardation (poor development of baby), severe anaemia due to normal blood loss during delivery and increased susceptibility to infection. The likelihood of postpartum transfusion may be reduced if a woman enters the birth with a higher haemoglobin level. Please discuss these issues with your doctor, as he/she would be best placed to advise.