Iron Deficiency Anaemia During Pregnancy

This is a common problem. It occurs in about a third of women in the third trimester. Anaemia is a medical condition in which there is not enough healthy red blood cells to carry oxygen to the tissues in the body. Iron deficiency anaemia is a common anaemia caused by insufficient dietary intake and absorption of iron and loss from bleeding which can originate from a range of sources such as the intestinal, uterine or urinary track.

The normal physiological change of an increase in plasma volume causes haemodilution in a pregnant woman. Although the red cell mass increases, plasma volume increases disproportionately, resulting in a lowering of the haemoglobin. Pregnancy tends to interfere with maternal erythropoiesis by competing for the available raw materials such as folic acid, vitamin b12, protein apart from iron.

According to ayurveda

As per ayurveda classics anaemia is condition similar to “Pandu”.

In Ayurvedic classics, the description of Pandu is available in three forms i.e. Pandu as a disease, Pandu as a complication, Pandu as a sign.

Pandu is a clinical condition characterized by whitish yellow discoloration of skin, eyes, nails etc. The person with this disease suffers from decreased blood amount, strength and complexion. He becomes Nihsara (loss of natural integrity, tone and strength of Dhatus)


Asia has the highest rates of anaemia in the world. About half of the world's anaemic women live in the Indian subcontinent, and 88% of them develop anaemia during pregnancy. The situation in Asia has not improved in recent years.

Anaemia is the world’s second leading cause of disability and thus one of the most serious global public health problems. Predictably, the prevalence of anaemia in developing countries is three to four times higher than in industrialized countries.

In India, Anaemia affects an estimated 50% of the population. In India, anaemia is considerably high for rural women (54%) than for urban women (46%). Surveys in different parts of the country reveal that 87% of pregnant women suffer from anaemia and about 10% have severe anaemia (H < 80 g/l). Variations in the prevalence rates of anaemia are seen within the country with the lowest prevalence of 33% being reported from Andhra Pradesh to the highest of 98% in Rajasthan. The statistics shows clear picture that Rajasthan is a dry state (jangaladesha). So there is more possibility for rasa kshaya and it leads to pandu(anaemia).

  • Poor intake of iron in diet;
  • Folic acid deficiency;
  • Even if iron and folic acid intake are sufficient, a pregnant woman may become anaemic because pregnancy alters the digestive process. Also the unborn child consumes some of the iron or folic acid normally available to the mother's body.
  • Increased iron demand during pregnancy:
Fetus and placenta 300mg
Maternal Hb mass expansion 500mg
Loss in urine/sweat/gut 200mg
Loss during delivery 150-200mg
Lactation 150-200mg
Ayurvedic View

During pregnancy baby is totally dependable on mother for nutrition as well as emotions or etc. Both are connected each other with placental cord till out coming of baby to the outer world. So, this way baby contribute in each and every nutrition which is consumed by mother.This phenomena demands higher intake of all the elements including iron intake. That results in iron deficiency anaemia during pregnancy.

  • Excessive intake of alkaline, sour, saline, hot, Virudhaaahara and AsatmyaBhojana
  • Sleeping during day time
  • Exercise or sexual intercourse before complete digestion of food
  • Improper administration of PanchaKarma therapies
  • Transgression of prescribed seasonal regimens and suppression of natural urges.

Symptoms of iron deficiency anaemia are not unique to iron deficiency (i.e. not pathognomonic). Iron is needed for many enzymes to function normally, so a wide range of symptoms may eventually emerge, either as the secondary result of the anaemia, or as other primary results of iron deficiency. Symptoms of iron deficiency include:

  • general fatigue
  • weakness
  • pale skin
  • shortness of breath
  • dizziness
  • strange cravings for non-food items, such as dirt, ice, and clay
  • tingling or a crawling feeling in the legs
  • swelling or soreness in the tongue
  • cold hands and feet
  • fast or irregular heartbeat
  • brittle nails
  • headaches
What Ayurveda says

General symptoms of PanduRoga as described by Aacharya Charaka are, the patient suffers from tinnitus, suppression of the power of digestion, weakness, prostration, repugnance against food, fatigue, giddiness, pain in the body, fever, dyspnoea, heaviness and anorexia. Patient feels as if all the limbs of his body are being kneaded, squeezed and churned. Patient suffers from swelling of the orbital region. Patient’s complexion becomes green, small hair of his body fall out, loses his bodily lusture, becomes irritable, dislikes cold things, feels sleepy, spits in excess, avoids speaking, suffers from cramps in the calf region and while making efforts for climbing, suffers from pain and weakness in the lumber region, thighs and feet.

Risk Factors for Anaemia in Pregnancy

All pregnant women are at risk for becoming anemic. That's because they need more iron and folic acid than usual. But the risk is higher if you:

  • Are pregnant with multiples (more than one child)
  • Have had two pregnancies close together
  • Vomit a lot because of morning sickness
  • Are a pregnant teenager
  • Don't eat enough foods that are rich in iron
  • Had anaemia before you became pregnant
How it Affects mother’s health
  • During pregnancy
    • Malnutrition
    • Recurrent infection
    • Heart failure (rarely)
  • During labour
    • Post partum haemorrhage
    • Shock
    • Cardiac failure (rarely)
  • After child birth
    • Failing of lactation
    • Sepsis ( infection)
    • Pulmonary embolism
    • Venous thrombosis
How it affects baby

Amount of iron transferred to the baby is unaffected even if the mother suffers from iron deficiency anaemia. So the neonate does not suffer from anaemia at birth. But there is increased incidence of low birth weight babies with it. There may be intrauterine death due to severe maternal anoxaemia(lack of oxygen level to tissue)

Ayurvedic Management

As per Ayurveda anaemia (pandu) is a disease of rasavahasrotasa. It is condition which occurs due to rasakshaya. During pregnancy the elements which consumed by mother is contributed by fetus which leads to rasakshaya. So as per Ayurveda we have to work on rasavahasrotasa.

Ayurvedic Drugs
  • Navayaslauha
  • Vidangadiloha
  • AamalakiRasayana
  • Gaumutraharitaki
  • Lohasava
  • Punarnavasava
  • Yogarajaguggalu
  • Lohasava
  • Punarnavadimandoora
  • Dadimadhyaghrurta (ghee)
  • Pathyadighruta (ghee)
  • Shilajitavati
  • Dhatrirasayana etc.
Home remedies
  • Apple :
    “An apple a day keeps doctor away.” The famous health quotes proves its popularity exactly. Apple is a rich iron source including other essential elements. However, not one but 2-3 apples in a day can fulfil a person’s need for a day.
  • Honey : Honey is an excellent source for anaemia. It is rich in iron, copper and manganese.
  • Black currant :
    Soak 8-10 black currants for overnight in water. In the morning remove the seeds and drink it at least for one month.
  • Winter melon :
    It is a good source for iron as well as multivitamins to correct your deficiency.
  • Wheatgerm :
    It is a powerhouse if nutrients, mainly iron and zinc. It is a portion which is removed while processing refined flour. This is particularly beneficial for vegetarians who cannot get some first rated nutrients sourced from animals.
  • Bananas :
    Consume a ripe banana with 2 tbs honey, daily.
  • Almonds :
    Soak about 6-7 almonds in water for a night and eat in the next morning after removing its skin.
  • Amla :
    Mix 50 ml of fresh amla juice with 20 ml of honey and drink it every morning.
  • Milk :
    Milk is almost complete diet, so how can we forget it for iron source. Add about 5-7 black pepper balls in 200 ml of milk and boil it well in an iron vessel. This concept is similar to pippalirasayana described by Acharya Charak in rasayanachikitsa.
  • Spinach :
    Spinach, as a vegetable, is an excellent remedy to overcome iron deficiency.
  • Dandelion and burdock root :
    These herbs increase the body’s ability to absorb iron from the food that is consumed.
  • Massage :
    Getting a whole body massage with oils like mustard, olive or coconut can help in increasing the blood circulation of the body. You can also use Ayurvedic medicated oil for massage like MAHAMASH TAILA, ASHWAGANDHA TAILA, LAKSHADI TAILA etc.
  • Cold bath :
    It is also excellent thing to treat iron deficiency anaemia.
  • Tomato juice
  • Other :
    Beans, eggs, brown rice, raisins, seafood, beets, poultry, sunflower seeds, dried fruits, vitamin C rich diet like citrus fruits, green pepper, whole grains and chives. Folic acid rich foods like fresh leafy vegetables, mushrooms, lima beans, black eyed peas.

    Daily laxatives are also beneficial as per Ayurveda sidhhanta.
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