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Whatever your hemoglobin level a normal vaginal delivery means you lose far less blood than an operative delivery so there is no minimum.

If you are talking about delivery at home with a midwife, she/he would probably want back-up if your hemoglobin was below 10 g/dl.

A lot depends on your previous obstetric history and the person doing the delivery.

We put women on vitamins with Iron to prevent anemia, and sometimes must give extra Iron in order for her to produce enough red blood cells. The above answer states that there is less blood loss with a vaginal delivery than with a C-Section. This is not always true, in medicine you can never say never, and never say always. I have seen many women who lost almost no blood during a C-Section and have seen many who lost signiicant blood with a normal vaginal delivery. This is one of the risks of a home delivery, if you do have serious bleeding Pitocin can be given (in the muscle, in the vein, or directly into the uterus) to control the bleeding, but this is only available in the hospital setting. If you are anemic and have a significant blood loss, it is obviously more risky than someone with a normal hemoglobin. Many women have a normal, uneventful delivery at home or in the hospital, but for that 1% that have complications, the time it takes to get to the hospital for the proper treatment can be an eternity.

Hemoglobin lower than 10.5 in early pregnancy is of more concern than in the third trimester. Low hemoglobin and hematocrit results in early pregnancy reflect true anemia and can indicate increased risk of preterm birth and other complications. Lower than prepregnant H/H counts in the third trimester can be an indicator of the normal hemodolution of pregnancy. In fact, if this hemodilution doesn't occur, there is an increased risk of of low birth weight babies and preterm birth. A hematocrit of 33-34% is normal at term and is the "just right" point between the two extremes. (See Obstetric and Gynelogic Emergencies edited by Pearlman, Tintinalli & Dyne.)

As for the safety of home birth, your midwife should help you figure out which type of anemia, if any, is affecting you. Iron-deficiency anemia is the most common, followed by folic acid deficiency anemia. She may counsel you to try nutritional fixes including more iron-rich foods with vitamin C-rich foods, iron-rich herbal infusions and tinctures and folic acid supplementation and alternative forms of iron supplementation such as Floradix, especially if you have mild anemia.

Your homebirth midwife should have tools and tricks of the trade ready in case of hemorrhage. In California, for example, midwives may use Pitocin, methergine, shepherd's purse and other herbal remedies. Please discuss your concerns with your midwife and don't let fear of rare complications rule your birth.

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Q: What are the normal hemoglobin levels at 6 weeks of pregnancy?
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