My heart was racing.
I felt breathless with the tiniest amount of exertion.
I felt intense anxiety for, what I felt like, no good reason.
I felt like I was having panic attacks – ALL the time.
Walking into the kitchen to get a glass of juice was an ENORMOUS feat.
Even texting was exhausting.
I’d try to reply to my parents’ texts from overseas, but holding up the phone took so much energy that after a few written words I’d have to lower my arms to rest and recover before I could write another sentence.
Sending one text message took, not only, a phenomenal amount of time but a phenomenal amount of effort.
I was actually relieved when I went to the dietician and found out how depleted I was – both in micronutrients (vitamins etc.) and macronutrients (protein etc.) – because at least there was something I could about it; at least I had an answer as to why I was feeling so horrendous.
I was shocked, though, at how quickly my iron levels plummeted; from the 40’s to 10 in just 4 weeks (as mentioned in The Dietician, the normal range of iron/ferritin is around 20-250ng/ml but in order to feel “normal” your iron levels need to be at least above 30ng/ml).
As a midwife I have always been extremely passionate about ensuring that my patients have adequate iron levels. This was not something that I was taught in my university course, for some odd reason, but was from personal experience and extensive research.
Having suffered from chronic low iron due to heavy bleeding (from severe endometriosis), I have always been ACUTELY aware of how significantly iron affects your energy levels, your overall functioning and your mental health.
In the public system, here in Australia, we will check your iron levels ONLY if you meet specific criteria: low MCV on a full blood count (FBC/CBC), if you are very symptomatic, or have a history of anemia or iron deficiency.
The problem with this is that I have seen many women with a normal MCV level who have had very low iron/ferritin levels (I have also experienced this myself – multiple times).
To make matters worse, these poor women have depleted iron stores BEFORE entering into their 3rd trimester, not realising that the baby will deplete them EVEN MORE in the final trimester.
See, what happens is this: the baby says “Wait a minute, I need to store extra iron in my liver NOW because breastmilk doesn’t have much iron in it and I need these stores to last me until 6 months when I start eating solid food!”
So the baby does what the baby does best – it takes what it needs, leaving the mother depleted beyond belief.
The repercussions of these low iron stores start a snowball effect (which I will try to keep brief).
Low Iron = Low energy
Low energy = Increased fatigue during labour and lower tolerance for the high physical demands of labour.
Increased fatigue and exhaustion = lower pain tolerance (in other words – MORE PAIN).
Lower pain tolerance = earlier epidural use etc.
Epidural use = increased risk for interventions (such as vacuum, forceps or c-section).
And then, of course, there is the bleeding after birth – where you lose more iron – causing you to enter into the most exhausting, sleep-deprived time of your life in UTTER DEPLETION (increasing your risk for postnatal depression and anxiety).
This depletion can take MONTHS or even YEARS to recover from.
The consequence and cascade of events that can occur from low iron can be life altering.
(As a disclaimer I’d like to say that I have nothing against the use of epidurals or interventions. There are many times when these things are absolutely necessary and medically indicated and ensure the safe arrival of a LIVE baby – which, I can tell you – IS the ultimate goal.)
So to simplify: the main point of all this jibber jabber is – GET YOUR IRON LEVELS CHECKED.
I am very grateful that my obstetrician immediately admitted me for an iron infusion.
In the public system I would have been advised to “just take oral iron tablets” (that is, if they checked my iron levels in the first place). Our usual recommendation is Ferro-Grad C; which is, not only, poorly absorbed and poorly tolerated (due to nausea and constipation) but can take MONTHS to get your iron levels up (this also depends on if you take it properly: in the evening, with no caffeine or minerals – like magnesium or calcium – that affect the absorption of iron by competing for similar binding sites).
At the end of the day heme/animal iron from red meat is absorbed the best: an unfortunate fact for a mostly-vegetarian like myself who cannot tolerate red meat; another reason why I am insanely grateful for iron infusions.
The day I went to the hospital for my iron infusion I took the train.
I don’t know why.
Pure martyrdom, I guess.
My husband could have driven me.
Or my friend, Rachel, had offered to take me.
Instead, I stepped off the train dizzy, breathless, and tachycardic (racing heart) and started to cry when I realised that I couldn’t climb the small “hill” to the hospital.
I called my husband in tears.
In exasperation (of my stubbornness) he told me to catch an Uber up the hill – which was a great idea. I waited nine minutes for a two minute ride. The Uber driver dropped me off right at the entrance and a hospital volunteer assisted me into a wheelchair and took me inside.
I had taken along my iPad, naively thinking that I would try to blog during the infusion. Instead, I fell asleep as soon as I laid down on the hospital bed. I barely remember them putting the IV in, or taking my obs/vital signs – which showed a fast heart rate, fast respiratory rate and low blood pressure.
I slept through almost the entire infusion.
When they woke me up I was already breathing better and my heart rate felt slower. They informed me that the effects would not be immediate, but I already could feel the difference.
It did take 3 weeks for the iron infusion to take it’s full effect – and for me to be able to notice a difference in my energy levels – but the difference in my breathing, heart rate and feelings of anxiety was IMMEDIATE.
I could hardly believe it.
I left the hospital with a glimmer of hope that perhaps, in three weeks time, I could return to work.
Little did I know that by 23 weeks I would hardly be able to walk – not from fatigue, but from the sheer discomfort of the pelvic pain and pubis symphysis separation.
______________________________________________________________________
I will blog more about this later, but for a fantastic resource on the depletion caused by pregnancy I would highly recommend that all women, and healthcare professionals, read “The Postnatal Depletion Cure”.
https://www.thehealthlodge.com.au/postnatal-depletion-dr-oscar-serrallach
The Bebé Report 