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How Anemia Impacted My Twin Pregnancy

How Anemia Impacted My Twin Pregnancy


Last updated on August 18th, 2023 at 11:47 am

Growing up, I gave blood quite a bit. It’s not like I knew the Red Cross volunteers on a first name basis, but I would always donate blood when the mobile truck came to my community. One day, during my senior year of high school, that standard procedure where they tested my hemoglobin came back low. Hemoglobin is a protein in your blood that contains iron, and it’s usually collected through a quick ear or finger prick. That day, the volunteers told me I couldn’t give blood because my Hemoglobin was too low. I had iron-deficiency anemia and I was shocked. I was young and I thought I was invincible.

As I grew older, I donated blood less and less. To be honest, it was no longer a simple process. Having been denied giving blood about a half dozen times, that feeling of mortality slowly sunk in. In order to donate blood in the future, I would need to prepare myself in advance by taking some vitamins. And honestly, that just didn’t happen. I could try to come up with some legit reasons why I didn’t do it, but the truth is, I simply didn’t plan in advance. I pretty much stopped donating blood.


It wasn’t until I was in my early thirties that I even thought about my iron levels again. I was 32 and pregnant with my first child. I had just visited with my OB/GYN and successfully heard my baby’s heartbeat. I was elated. Then, came all the blood work. Wow! It felt like I was giving blood again. The phlebotomist must have filled 8-10 vials of blood to test for various disorders. Thankfully, I passed with flying colors- probably a result of good prenatal vitamins. And the same thing happened during the pregnancy with my second child. Amazing! Could I have “grown out” of my anemia somehow?

And then I became pregnant with twins.

During my first appointment, my OB/GYN missed the second baby, so I didn’t know I was pregnant with twins until I was 11 weeks. The sonographer was complaining about the front desk not scheduling me as a “twin” appointment. I had no idea what she was talking about until I saw two little people bouncing around on the monitor and nearly passed out. That light-headed feeling is basically how I felt until a couple weeks later, when I first met with my Perinatologist.. She monitored me every two weeks because I was pregnant with monochorionic diamniotic twins, which means my girls were sharing the same placenta. I think we were both surprised when we saw my low iron levels.

Hello anemia, remember me? Great, I guess you’re back for the next six months or so. Why did this happen? To understand this, we have to get a bit technical. Iron-deficiency anemia is actually common in any pregnancy. It means mom has a low red blood count, which makes it more difficult to carry oxygen to your tissues and to your baby. Makes sense considering you’re in the process of creating another human life, right? Multiply that times two or three babies, and you start to see the problem.

Dr. Wade Schwendemann, a Perinatologist at the San Diego Perinatal Center, says a woman’s blood volume increases by about 50% while she’s pregnant, but the red cell and blood cell mass only increases by about 33% percent. Your body is purposely making itself more anemic as a way to protect itself from excess blood loss during delivery. Pretty cool, right? Unless you’re already a mom who needs every ounce of energy to keep up with her two young toddlers at home- while she’s cooking a couple more buns in the oven!


Thankfully, I just experienced feelings of fatigue and weakness as a result of my anemia. But, other common symptoms are pale skin, lips and nails, shortness of breath, rapid heartbeat and trouble concentrating. If you notice any of these symptoms, you should contact your health care provider for a simple blood test. If iron-deficiency anemia during pregnancy goes undiagnosed or untreated, it can result in a preterm or low-birth-weight baby, postpartum depression or your baby could be born with anemia or have developmental delays.

There are two main ways to combat iron deficiency anemia during pregnancy. If you’re like me, and your iron levels are super low, you may want to try both. First, do as your mama told you and get more leafy, dark green vegetables in your diet. The best recipes typically involve spinach, broccoli and kale. Lean read meat, beans and eggs are also great iron-rich foods. Next, take a vitamin with plenty of b12. Check the side-label because your prenatal vitamin may not be enough. When I was pregnant with my twins, I took two b12 vitamins each day. See, I told you my iron-levels were low!  And if you’re taking b12, be sure to take it on an empty stomach and wash it down with a glass of orange juice. Our bodies have a tough time processing iron, and Vitamin C helps to absorb it. If your body can’t absorb the iron, you may become constipated, and that’s not fun when you’re already bursting at the seams because you’re pregnant with multiples.


What about after you deliver your babies? Will you still be iron-deficient? Will you ever be able to donate blood again? According to Dr. Schwendemann, your body has an incredible ability to re-build its own blood store, but you should plan on treating your iron-deficiency anemia for at least 12 weeks postpartum. It will help give you the strength and endurance you need to care for your brand-new babies.

With that said, pass the steak, mama!

All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.

Sunny Gault

Sunny Gault has been obsessed with twins since childhood. Despite having no family history, she told her mom she was going to have twins, and 25 years later she gave birth to identical girls. She is also a wife and proud mama of two older singleton boys. Sunny’s fascination with her own twins lead her to create the podcast Twin Talks, produced by her company, New Mommy Media.

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