Here are some other types of anemia that are less common.

HOOK WORM INFECTION

Hook worm infection is found in women who go barefoot in tropical areas. The hookworm enters their body through their bare feet and finds its way to the intestines. Wearing shoes would prevent this problem. Treatment includes an anti-parasitic as well as an oral iron source taken for 5 months.

FOLIC ACID DEFICIENCY

Approximately 26% of pregnancies are complicated by a lack of folic acid. Folic acid is needed in order for the body to make normal red blood cells in bone marrow. Adequate amounts of folic acid can be obtained by eating a diet that contains liver and other organ meats as well as green vegetables or supplementation may be from 0.5 mg to 5 mg daily.

Recent research has concluded that a deficiency in folic acid can cause neural tube defects in babies. The Centers for Disease Control recommend that all women who have previously given birth to a baby with spina bifida take 4 mg of folate daily before and during pregnancy. That is an extremely high dose, available only with prescription. The U.S. Public Health Service recommends that all women of childbearing age increase their folate level to 0.4 mg per day.

MEGALOBLASTIC ANEMIA

This is a severe form of folic acid deficiency which may occur when the hemoglobin falls below 7 g/dl. Usually these women will fail to respond to iron supplementation prior to being diagnosed with this problem. A positive response is usually seen shortly after treatment with 5 mg of folic acid 5 times per day until 6 weeks postpartum. Midwives Daphne Singingtree and Althea Seaver suggest 4 mg folic acid and 0.5 mcg vit. B12.

PERNICIOUS ANEMIA

A severe form of anemia caused by a deficiency of vitamin B12. The number of red blood cells decreases with this disease due to a failure of the bone marrow to produce them. It is thought that it is inherited and comes about due to an inability of the stomach to secrete a substance that is necessary for the absorption of vitamin B12. It is most often found in people over the age of 30. Symptoms might include weakness and gastrointentestinal problems, a yellow hue to the skin, sore tongue and tingling in the extremities, nerve deterioration, diarrhea and loss of appetite may occur. It can be fatal.

SICKLE CELL DISEASE

Sickle cell disease is most commonly found among people from tropical Africa or the West Indies. It is an inherited trait. The red blood cells take on a sickle shape and clump together to prevent adequate circulation. During the last trimester of pregnancy the woman may experience severe iron deficiency and have jaundice, hematuria, bone pain and possibly a pulmonary thromboembolism. Treatment may include high doses of folic acid and a blood transfusion if her Hgb is below 7. Wounds may not heal well and the fetus is at risk of hypoxia during labor.

THALASSEMIA MAJOR OR MINOR

Women from the Mediterranean areea and South East Asia are the most likely candidates for this problem which is inherited. It occurs despite adequate iron in the blood. Treatment includes supplementation with folic acid and possibly blood transfusions. The baby may suffer from hemolytic anemia and hydrops. If the mother has Thalassemia major she will be more likely to develop pre-eclampsia, have a low birth weight baby, fetal distress and fetal wastage. Thalassemia minor does not respond to iron therapy but causes no systemic problems. It needs to be differentiated from iron deficiency anemia as excess iron intake can occur that is harmful.

Treatment includes injections of Vitamin B12 and a very nutritious diet along with desiccated liver and supplementation with a B complex vitamin. Because folic acid can mask the effects of pernicious anemia, supplementation of this nutrient needs to be kept very small.