Why hemoglobin levels go down during pregnancy

A common question I get is why does hemoglobin go down during pregnancy and how to help prevent this in order to have a homebirth.

I had my hemoglobin tested all 3 trimesters and didn’t experience a significant dip until the third trimester.
-first trimester: 13.8
-second trimester: 13.5
-third trimester 12.3

Most providers will require a hemoglobin no lower than 10.5 (some are even higher) because of the association between a risk of bleeding during birth.

Morley Robbins from The Root Cause Protocol has a great article that breaks down research that shows a lower hemoglobin can actually be beneficial the second half of pregnancy. Learn more here: https://therootcauseprotocol.com/iron-toxicity-post-81/

Aside from that, I think it’s important to understand WHY hemoglobin naturally decreases during pregnancy so that we aren’t scared of it.

1. Blood volume is increasing significantly during the third trimester, but since hemoglobin production stays the same, overall hemoglobin levels look lower.

2. Estrogen continually rises and peaks in the third trimester, which can naturally cause lower hemoglobin because it increases our blood volume amongst many other important functions.

3. During the third trimester, mom is giving baby a large number of nutrients, including iron and copper. This increases the need for iron and copper during this time as well as vitamin A (vitamin A helps us use copper).

Want to hear more about my pregnancy journeys? Check out the podcast episodes below from the are you menstrual? podcast.


3 Ways to Work With Us

Mineral Healing Journey: A 6-Month, High-Touch Program for Women Ready to Rebalance Their Hormones at the Root

If you’re dealing with irregular cycles, PCOS, stubborn weight gain, low energy, thyroid issues, or hormone chaos, and you’re still in your cycling years, this is our most comprehensive hormone recalibration program. We’ll coach you through strategic nourishment, mineral repletion, and strength training to rebuild your metabolism and restore balance.

[Learn More About Mineral Healing Journey]

Nurture Your Fertility

Our 12-Month Advanced Fertility Program for Women Who’ve Tried Everything

If you’ve been trying to conceive for years, have experienced loss, failed cycles, or unexplained infertility, or feel like you’re “doing everything right” but still not getting pregnant, this is for you.

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[Learn More About Nurture Your Fertility]

Master Your Minerals

Self-Paced Education for Women Who Want to Understand Their Body

If you’re not ready for our group coaching but know your symptoms aren’t random, this is where to start. Master Your Minerals is our comprehensive, self-paced course that teaches you how minerals impact your hormones, metabolism, energy, and fertility.

You’ll get symptom trackers, practical tools, and structured guidance so you can start connecting the dots on your own. This is best for women who are proactive, want education first, and prefer to implement at their own pace.

[Learn More About Master Your Minerals]

Amanda Montalvo

Amanda Montalvo is a women's health dietitian who helps women find the root cause of hormone imbalances and regain healthy menstrual cycles.

Master Your Minerals

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