By: Carol Harrison, Registered Dietitian
When women become pregnant, their iron needs jump by 50%—from 18 mg a day to 27 mg a day1—and for a good reason: iron is vital for a healthy pregnancy and a healthy baby. Yet more than 50% of pregnancies are affected by low iron, and 25% are complicated by severe iron deficiency, according to a study of more than 44,000 pregnancies in Ontario.2 If you’re pregnant or planning to be, getting enough iron needs to be a key focus.

What happens if you don’t get enough iron while you’re pregnant?
Signs and symptoms of low iron3:
- Exhaustion or fatigue
- Dizziness
- Irritability or depression
- Trouble focusing
- Heart palpitations
- Shortness of breath
Low iron increases the risk of:
- Giving birth prematurely 1,4
- Low birth weight 1,4
- Maternal and infant mortality1,5
- Impaired immune function for mom and baby
- Baby born with low iron stores1
- Postpartum depression6
Starting out with a deficit makes it harder to replenish the body’s iron stores and meet the increased demand for this essential mineral. Plus, replenishing low iron can take months, even with iron supplements.7 It’s much better to avoid becoming iron-deficient in the first place.
Good to know: Because pregnant women aren’t routinely checked for low iron, consider asking your doctor to check your iron level, especially if you’re vegetarian, if you eat little red meat, or if you have symptoms of iron deficiency. Low iron should be taken very seriously, especially given that it can cause irreversible developmental delays in babies and ongoing problems in childhood.
Recent Canadian research shows that eating beef is the strongest dietary predictor associated with better iron status in women.8

When planning meals, the type and amount of dietary iron matters
Paying attention to the top food sources—and whether they provide heme iron or non-heme iron—matters. Heme iron is easily absorbed by our bodies—it is found in meat, fish and poultry. Non-heme iron is not absorbed as well by our bodies—it is found in eggs and plant foods like spinach, lentils, tofu and enriched pasta, cereal and breads.

Chicken 596, Turkey 711, Pork 6945, Salmon 3183, Trout 3187, Pasta 4464, Pumpkin seeds 2516, Spinach 2213, Eggs 130, Baked beans 3248, Tofu 4911.
Serving sizes based on Health Canada’s Table of Reference Amounts for Food: https://www.canada.ca/en/health-canada/services/technical-
documents-labelling-requirements/table-reference-amounts-food.html
% DVs calculated based on Health Canada’s 2016 Nutrition Labelling – Table of Daily Values: https://www.canada.ca/en/health-canada/services/technical-documents-labelling-requirements/table-daily-values.html
What about iron supplements?
Health Canada recommends pregnant women take a daily multivitamin that contains 16 to 20 mg of iron – in addition to planning meals based on Canada’s Food Guide.9 Talk to your physician to find out how much iron is right for you.
5 ways to get more iron
- Eat iron-rich animal and plant foods daily.
- Prioritize foods with heme iron (red meat, poultry, seafood).
- Increase absorption of non-heme iron from plant foods and eggs by eating them with meat, poultry, seafood and/or foods rich in vitamin C.10
- Wait an hour or two after eating before you drink tea or coffee or take calcium supplements, which can reduce iron absorption.10
- Use cast-iron cookware. It adds a small amount of non-heme iron to foods, especially if they’re moist, acidic and cooked slowly (e.g., stew, tomato sauce).11
References:
- Institute of Medicine (US) Panel on Micronutrients. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington (DC): National Academies Press (US); 2001. 9, Iron. ↩︎
- Teichman J, Nisenbaum R, Lausman A, Sholzberg M. Suboptimal iron deficiency screening in pregnancy and the impact of socioeconomic status in a high-resource setting. Blood Adv. 2021 Nov 23;5(22):4666-4673. doi: 10.1182/bloodadvances.2021004352. PMID: 34459878; PMCID: PMC8759118 ↩︎
- BCGuidelines.ca. Iron Deficiency – Diagnosis and Management. April 2019. Accessed Feb. 11, 2024. ↩︎
- Georgieff MK. Iron deficiency in pregnancy. Am J Obstet Gynecol. 2020 Oct;223(4):516-524. doi: 10.1016/j.ajog.2020.03.006. Epub 2020 Mar 14. PMID: 32184147; PMCID: PMC7492370. ↩︎
- Smith C, Teng F, Branch E, Chu S, Joseph KS. Maternal and Perinatal Morbidity and Mortality Associated With Anemia in Pregnancy. Obstet Gynecol. 2019 Dec;134(6):1234-1244. PMID: 31764734; PMCID: PMC6882541. ↩︎
- Azami M, Badfar G, Khalighi Z et al. The association between anemia and postpartum depression: A systematic review and meta-analysis. Caspian J Intern Med. 2019 Spring;10(2):115–24. doi: 10.22088/cjim.10.2.115. PMID: 31363389; PMCID: PMC6619471. ↩︎
- Cooper M, Bertinato J, Ennis JK et al. Population Iron Status in Canada: Results from the Canadian Health Measures Survey 2012–2019. J Nutr. 2023;153(5):1534–43. doi:10.1016/j.tjnut.2023.03.012. ↩︎
- Chang VC, Cotterchio M, Kotsopoulos J et al. Iron Status and Associated Factors among Canadian Women: Results from the Canadian Health Measures Survey. J Nutr. 2023;153(3):781–97. doi:10.1016/j.tjnut.2022.10.011. ↩︎
- Health Canada. Prenatal Nutrition Guidelines for Health Professionals: Iron. 2009. Accessed Feb. 11, 2024. ↩︎
- HealthLinkBC. Iron and Your Health. November 2020. Accessed on Feb. 11, 2024. ↩︎
- Sharma S, Khandelwal R, Yadav K et al. Effect of cooking food in iron-containing cookware on increase in blood hemoglobin level and iron content of the food: A systematic review. Nepal J Epidemiol. 2021 Jun 30;11(2):994-1005. ↩︎