Anaemia is one of the top complications for pregnant women in India. It is a condition with no boundaries: it can affect rich and poor, men and women, adults and children. For women, it often starts well before pregnancy, becoming especially problematic during those nine months.

What is Anaemia?

Anaemia occurs when a person lacks hemoglobin, the part of the blood that carries oxygen to the body’s organs. For most people, this is caused by a diet that contains too little iron, the nutrient your body requires to make hemoglobin. So is the solution simply to eat a lot of foods high in iron? Not necessarily. The best source of iron by far is meat – a problem in India, where much of the population is strictly vegetarian.

But assuming you are eating enough meat or other iron-rich foods – are you immune? Again, not necessarily, because preventing anaemia isn’t only about ingesting enough iron; it’s also about making sure that iron is absorbed by your body. And for that to happen, you need two more nutrients: protein and vitamin C.

Anaemia and pregnancy

Anaemia isn’t a treat for anyone, but it’s especially worrisome for pregnant women, whose blood needs to do double duty: supply oxygen to their own organs as well as to the developing fetus. In India, where 52% of reproductive-aged women are anaemic already (according to a 2000 world nutrition study by the UN and International Food Policy Research Institute), hemoglobin can easily drop to dangerous levels during pregnancy. At that point, the only way to curb the anaemia during pregnancy is through a series of expensive injections.

Untreated, anaemia can have serious health risks for both you and your baby. It increases the danger from blood loss during delivery and is associated with post-partum depression. Iron deficiency is also related to a higher risk of premature delivery and low birth weight.

A healthy, anti-anaemia diet

Food increases iron levels very slowly, so it’s important from the start that your pregnancy diet includes enough of three critical nutrients: protein and iron, which form the hemoglobin, and Vitamin C, which promotes iron absorption.

For vegetarians, this can be tricky, as meat is the best source of protein and iron. To compensate, your pregnancy diet should contain a pulse, a cereal, and a green leafy vegetable in every meal; don’t eat one without the others! This will give you the triple hit you need: protein and iron from the pulse and cereal and Vitamin C from the leaves (which give you bonus Vitamin A and B-Carotene as well).

For pulses, consider:

• Whole sprouts, which increase protein digestibility and contain Vitamins C and B
• Split dals, such as mung dal, channa, or dal
• A pulse-based atta (flour)

For cereals, consider:

• Rice and rice products, such as poha or kumura
• Broken wheat, such as dalia, fada, or lapsi
• Jowar
• Bajra
• Ragi

For, green leafy vegetables (either raw or cooked), consider:

• Curry leaves
• Coriander leaves
• Mint leaves
• Spinach
• Cabbage
• Spring onion greens
• Radish leaves
• Colocacia leaves
• Drumstick leaves

Non-veg eaters have it a little easier. A pregnancy diet that includes fish, chicken, eggs, or another meat four to seven days a week will provide enough iron and protein. Drinking milk is also a good idea; while it’s not the best source of iron, it does contain some iron, as well as lots of protein. For Vitamin C, also eat lots of raw, leafy vegetables, as described above.

But it’s not only about what foods you’re eating – it’s also about how they’re cooked:

• Eat leafy vegetables raw.  At the very least, only lightly cook them in their own moisture.  Their vitamin C content diminishes the longer they are cooked.
• Use jaggery as a sweetener.  In your chai, or in veg or fruit dishes, pick jaggery over sugar or honey.  Jaggery is made in iron pots which imbue it with a high iron content.
• Avoid sodium bicarbonate (“baking soda” or “bicarbonate of soda”).  Above all, make sure that whoever is cooking does not use sodium bicarbonate. It may make the veggies look good, but it leaches away all nutrients.

Supplementation

If you’re worried your diet still isn’t providing you with enough iron, protein and/or vitamin C, supplements for one or all of the above may be the way to go. Be sure to discuss with your doctor how much and how often to take them.