Midwife

ncampese · October 2014

Hi ladies,

So I've been mulling this over for a few days, and wouldn't mind your opinions. We just recently moved; I switched from an OB to a midwife and up until now was 110% happy with the change.

Before getting pregnant, I knew my iron was borderline low (veg). I mentioned this at my last mw visit and she said we will test at 32 weeks since this is when most women see it drop. (I am 27 now). However, I stressed that I can tell it is low by how I feel (dizzy after eating, low energy, weak, etc). Again, she said we will test at 32. Would you ladies wait it out or be more aggressive?

One other thing that was mentioned that made me flinch was that doing a kick count isn't necessary. As long as I feel one or two movements a day then everything should be okay. I haven't come across any book or website/source that has repeated this info.

Am I overthinking this? :-/

Edited: word oops

Aillise · October 2014

I too have low iron, both before and during pregnancy. I am also b 12 deficient. I mentioned to my OB that my prenatal vitamins do not contain iron or added calcium. Which both of those (iron pills and calcium chews) I had in addition to my prescribed prenatal vitiman when pregnant with DS. I brought this up to my OB and she said don't worry about it. I just switched to the same OB I had when I had my son, I have an appt Friday with her. And I plan to mention it to her.
If is something you are worried about, and you feel the affects from the lack of I would definitely keep pushing the issue. Just stress how important it is to you that baby and yourself are healthy. If she comes back with the same response ask her (nicely to educate/explain to you) why in her midwife experience (or medical experience) she doesn't find it necessary until 32 weeks. (Basically back up her reasoning/theroy. So you can make the choice).

As for the kick count, I personally do a kick count about twice a day. You don't have to follow the one to 2 movements a day advice she gave you since it's not harmful to note more movements. It's more about what you feel comfortable doing.

ETA: accidently posted to soon, and wording.

MusicFanatic · October 2014

I'd be more aggressive on the iron. I would never discount how you feel, your gut and symptoms. If you're feeling weak, dizzy, lack of energy.. I tend to think she should be taking what you say a bit more seriously. I also have low iron and have fainted from it. I'm on a pill now and 100% fine, but I have no idea why she wants to wait weeks when you think you know the cause and it's an easy fix!

thompnia · October 2014

My OB never told me to do kick counts with my first pregnancy. This time, whenever they ask about movement, I just say that I feel her move every day. I think counts would stress me out. What if I tried to do an count while she was sleeping and didn't get any? My OB said as long as I feel her every day we are good.

EmilyA724 · October 2014

Maybe I'm wrong but I thought iron was something they tested for after the glucose test. Is that wrong? Either way if you are questioning and don't feel completely comfortable, I'd look in to switching.

letsgox · October 2014

@EmilyA724‌ I had my iron tested with my GTT as well.

OP Could you take a prenatal with iron now since you're feeling that you are symptomatically anemic at this point? Take it with some vitamin C for increased absorption. If you don't feel comfortable taking an iron supplement prior to blood work, then yes, I'd be more insistent. Although your MW may not find anemia prior to 32 weeks to be something that needs treatment so they may not change anything at this point.

[Deleted User] · October 2014

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Trek3 · October 2014

I just discussed the iron issue with my MW as I am feeling REALLY tired lately. I learned something new!!!

Iron levels dip between 27-30 weeks of pregnancy, and start coming up again after that, they "should" be normal again by 32 weeks. Most do a blood test to check iron levels around 24-26 weeks, and if you have symptoms will test again AFTER this dip (so around 32 weeks, like yours said).

They wait to test because most women's levels will naturally return to normal. If your levels were low at the first test you may need supplements regardless.

If you can wait it out, eat iron-rich foods with vitamin C to help absorption, and complain at 32 weeks if you still have symptoms. Avoid caffeine for an hour before/after eating iron as it can interfere with absorption.

As for the kick count, that definitely bothers me - you should be feeling a defined number within 1-2 hours (I have heard anywhere from 6 to 10 movements in this amount of time). Basically, if you have not felt movement any given day, eat or drink something sweet, and lie down or put your feet up and wait for movement. If you don't feel much then you should get checked out.

Trek3 · October 2014

saiven said:

My guess is that it's just a low intervention style of medicine and you may need to be more insistent than you're used to. I would call and speak to the midwife or one of the midwives about having the iron test because you are feeling symptoms of anemia. Also, talk to them about starting an iron supplement without the testing and if there's a particular one they would prescribe or recommend.

As for the kick counts, I don't know what my MW is going to do (my 28 week appointment is Friday) but I'm actually probably not going to do official kick counts unless they press the issue. All babies go through periods of rest and periods of movement and trying to keep track of whether this baby has kicked me 10 times in a two hour period is going to make me super anxious. So, I'll just make sure he's moving everyday consistently and call if there's a sharp decrease in movements.

@saiven You aren't expected to do "official" kick counts every day. It is recommended if you are not feeling normal movement one day or you think something is off, then you eat, sit down, and actually count. If baby is awake and OK, usually you'll get the required number much faster than 1-2 hours.

My second barely made the number in 2 hours, I went in to get monitored. Almost as soon as I got hooked up, she started moving a lot more - but it can be a sign of distress and always better to get checked. My water broke that night!!!

butchmum · October 2014

My midwife has me taking Floridix for iron (it's a liquid, plantbased supplement which she says has the fewest side effects. It's expensive, and tastes disgusting, but my energy levels are good). She said that if I wanted to take it/could afford it, I might as well, as everyone's iron typically drops around this period anyway (as a previous poster mentions; reason being that our blood volume increases dramatically at the start of the third tri and the white blood cells are made first, then the red blood cells catch up a few weeks later).

She also told me that at this point there wasn't much benefit from doing kick counts. She said that months 6 and 7 are typically the most active for baby and that as long as I'm noticing movement each day, not to worry. She said that in the last couple of months she would want me to do them, as that is the point that baby runs out of room and normally gets less active as a consequence anyway, and so the count becomes an important measure rather than just another thing to fit into the day.

Hope that helps!

honeybeee3 · October 2014

When I saw my MW last week, I also brought up concerns about my iron and energy level. She wrote lab orders that day in addition to the glucose screening order that she had already written. She also gave me a list of iron rich foods and suggested I started incorporating them into my diet.

As for kick counts, I've been told you with both of my pregnancies that they are only necessary if you feel a are concerned or feel decrease in movement.

These are just my experiences. I'd say if you have any concerns you should definitely talk to your MW again or it's early enough still to switch to someone else.

ncampese · October 2014

@muskiefan07‌ @Britt1406‌
I currently am taking a prenatal with iron but I do think I will need additional supplementation. Thx ladies.

ncampese · October 2014

Thank you everyone!!! I will further press the issue when I see my mw next week. I go for my GTT in a couple days but there was no mention of testing my iron. In the mean time, I'll continue with my prenatal. Thx again! :-)

SpaceGirlSpiff · October 2014

Just throwing something out there -- My OB recently advised me to start taking an iron supplement since my levels came back low, but she wants me to take it opposite of my prenatal vitamin, rather than with it (my prenatal has iron in it too). So for example, if you take your prenatal in the morning with breakfast, take the iron supplement at night with dinner

Also I think it's calcium that can get in the way of absorption (?), so you'd make sure to avoid eating too much calcium or taking any vitamin/supplement with calcium at the same time as the iron tablet as well

I'm taking the Slo Fe supplement which is a slow release iron tablet that's supposed to work throughout the day, so just one pill per day.

SpaceGirlSpiff · October 2014

Just throwing something out there -- My OB recently advised me to start taking an iron supplement since my levels came back low, but she wants me to take it opposite of my prenatal vitamin, rather than with it (my prenatal has iron in it too). So for example, if you take your prenatal in the morning with breakfast, take the iron supplement at night with dinner

Also I think it's calcium that can get in the way of absorption (?), so you'd make sure to avoid eating too much calcium or taking any vitamin/supplement with calcium at the same time as the iron tablet as well

I'm taking the Slo Fe supplement which is a slow release iron tablet that's supposed to work throughout the day, so just one pill per day.

ncampese · October 2014

@SpaceGirlSpiff‌ Good to know. Thanks!

ncampese · October 2014

@ICarriedAWatermelon‌ Yes, that was explained to me through my mw. Saying iron is a whole lot easier. ;-)

Bigboneded · October 2014

@ICarriedAWatermelon‌, you can have iron checked. H&H is an indicator for anemia, but I am pretty sure you can get serum levels, no? And can check more than H&H like TIBC.... at any rate @ncampese, I would be more assertive, because you are symptomatic. It is not okay to just decline testing and not address a treatment plan. If you are faint, that's a problem! If you think its iron deficiency, why not just test it? Alternatively, go ahead and supplement- if you feel better, then you were likely correct :-)

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