Your doctor or midwife may take a blood sample to obtain a full blood count. This will show any abnormalities in red or white blood cells and whether there is an active allergic response. At the same time your blood can be tested for other factors, such as: thyroid and liver function; rubella, toxoplasmosis, cytomegalovirus and genito-urinary infections; iron stores; and the Rh factor.

Rubella

If the full blood count shows that you have no immunity to rubella, you may prefer to strengthen your immune system with herbal reme­dies and nutritional supplements rather than expose your developing baby to rubella immunisation.

Genito-urinary infections

As well as those GUIs tested through vaginal swab if may be necessary to do blood tests for HIV, Hepatitis B and C and Syphilis, if your clinical history indicates any risk factors.

Iron stores (serum ferritin)

Several studies have shown an association between iron levels during pregnancy and an increased risk of prematurity, low birth weight and erinatal mortality. The preferred test is serum ferritin (iron stores), arid these levels should be monitored at the end of each trimester, although levels fall during the last two trimesters due to expansion of plasma volume. The dosages of supplement that you may need will depend on the levels. If your iron stores are low it’s important that you take only organic iron (such as iron chelate) because inorganic iron (such as ferrous sulphate) will compete with zinc for uptake and absorption, destroy vitamin E and may cause constipation. Inorganic iron (the type which should be avoided) is found in many commonly used iron supplements.

It’s also very important that you don’t take iron supplements unnec­essarily. It’s common for pregnant women to be given routine iron supplementation and we deplore this practice. Apart from the adverse effects of inorganic iron on zinc and vitamin E, your body has no mech­anism for excreting excess iron (apart from menstrual losses, and of course you won’t be experiencing any of these for a while).

Rhesus factor

Determining the rhesus (Rh) factor of both parents’ blood is important. Problems only arise if the father is Rh positive and the mother Rh negative, and the baby inherits the father’s rhesus factor. In this case, some of the baby’s blood may enter the mother’s circulation via the placenta and her body will start to make antibodies to the ‘foreign’ blood. This doesn’t usually affect the first child, but subsequent chil­dren can be harmed unless they can be given a complete blood exchange soon after birth. If you fall into this category, ensuring that your nutritional status is adequate can also ensure optimal capillary strength with less likelihood of any blood leakage occurring.

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