Reducing Racial Disparities in Anemia in Pregnancy

There are many reasons someone might have low iron, including: Heavy periods; Uterine fibroids; Not getting enough iron in food; Living in neighborhoods with limited healthy food or healthcare; and Systemic barriers in medical care that affect different communities differently.

To address this problem, our research team wanted to understand how anemia affects severe health complications during and after pregnancy, and how these risks differ among racial and ethnic groups.

Our research team wanted to know two things:

1. How often does anemia happen during pregnancy?
2. How much does it contribute to those severe “near-miss” complications – and does this vary across racial and ethnic groups?

To study this, we looked at medical records for nearly 4 million births in California between 2011 and 2020. We used standard medical definitions to identify who had anemia during pregnancy and who experienced a severe maternal health complication. For this study, we did not include people with inherited blood disorders so we could focus on iron-deficiency anemia.

Here’s what we found:

Rates of anemia were highest among Black mothers.

In 2020: 21.5% of Black pregnant mothers had anemia; 18.2% of Native Hawaiian or Pacific Islander mothers; 12.6% of Hispanic mothers; 10.6% of Asian mothers; and 9.6% of White mothers.

Anemia rates increased for all groups from 2011 to 2020. For Black pregnant people, the rate more than doubled over these ten years.

Anemia plays a major role in severe health complications. We found that anemia contributed to: About 1 in 5 cases of severe maternal complications among Black and Hispanic mothers; 14.7% among White mothers; and 11.3% among Asian mothers.

Not only did anemia increase the risk for everyone, but the gap between Black and White patients got wider over time. This shows that Black patients continue to face unequal care – especially in screening and treating anemia.

What this means:

Our study highlights a clear message: anemia during pregnancy deserves much more attention. It’s common, it’s increasing, and it puts mothers and babies at risk. Addressing anemia – especially in communities facing systemic barriers – could prevent many emergency situations and save lives.

Why is this important?

Because anemia is something we can screen for. We can treat and for it might even be preventable.

If you’re pregnant, planning a pregnancy, or supporting someone who is: ask about anemia. Get checked. Get treated early.

And if we do that – especially in communities that face barriers in access to care – we could reduce thousands of life-threatening complications for new mothers.