Marcie Hadley - Precious Arrows Doula

05/30/2026

05/29/2026

First fruits picked. Who else loves playing in the dirt?

05/26/2026

Most providers think of iron as a linear equation....

Eat more iron (mostly animal-based), and the baby gets more iron...but pregnancy physiology is far more complicated, and elegant, than this.

👉🏼Outside of pregnancy, non-heme iron absorption is roughly 5-15%, but in pregnancy it skyrockets to nearly 70% in the third trimester (a 10-fold increase)
👉🏼Outside of pregnancy, heme iron absorption is roughly 35-40%, and in pregnancy, this doesn't change.

Here's where it really gets interesting...and where most prenatal nutrition stops...

Per the Handbook of Nutrition in Pregnancy (Humana Press), studies suggest that heme iron is taken up by enterocytes whole, intact, and transported directly to the placenta, where heme-specific transport proteins (highly expressed in the syncytiotrophoblast) take it up preferentially over non-heme iron. So the fetus preferentially receives intact heme iron.

While Mom's body prefers to use non-heme iron for maternal functions (thyroid, RBC/Hemoglobin, enzymes, etc.), storing the excess as ferritin.

The placental cells, as well, seem to rely more on non-heme (transferrin-bound Fe3) to fuel their function, sending excess to the baby. (The placenta is selfish and will prioritize its own iron needs over the baby and mom.)

When the baby is "full," meaning they have accumulated the ~350mg of iron they need before delivery, heme transport proteins in the placenta begin to downregulate, allowing more heme iron to accumulate in mom and going back to her storage needs...usually right around GA 36, causing her ferritin to rise again.

How does this change treatment?

If we are focusing solely on heme iron to fix iron deficiency, we may be helping baby...but not mom (at least not until baby is "full")

Remember... the same placental machinery that protects the fetus and regulates iron also poses a risk on the other side. Excess iron can accumulate in the placenta and cause damage, particularly heme iron (more on this later)

05/26/2026

Did you know the placenta regulates iron?

This is one of my favorite papers (oldie but a goodie) to share with providers because it helps to reframe how we think about iron in pregnancy.

For decades, the dominant model was that the FETUS controlled how much iron it received. This review challenged that by providing evidence that maternal iron status and placental iron signaling play a more active role in regulating transfer.

Iron transport across the placenta is transcellular and unidirectional, meaning it goes one way...from mom to baby...through the syncytiotrophoblast cells.

Specific transporters, such as TFR1 (transferrin receptor I), bind maternal transferrin-bound iron in circulation...not unlike other cells in the maternal physiology...it can be stored as ferritin in the placenta, used for placental cell functions, or transferred to the baby.

When maternal iron is low, the placenta expresses more TFR1 to increase placental uptake of iron.

The placenta is selfish. When iron levels are low, it prioritizes iron for its own function, shifting less to the fetus by downregulating Ferroportin at the basement membrane and in fetal capillaries.

Other transporters, such as LPR1, PCFT, and FLVCR2, take up Fe2+/heme iron directly. This form of iron is transferred directly to the fetus. FLVCR1 directly transports heme iron to the fetal capillary regardless of placental iron status.

Why is this important clinically?

Iron form matters depending on who we are trying to support. Ideally, we are working on mom... if mom is healthy, baby is healthy... however, in cases of severe iron deficiency, we need to prioritize the baby.

Non-heme iron supports maternal/placental function, while heme iron is better for the baby.

We need both!

When working on iron deficiencies, we won't see ferritin levels begin to rise until all the buckets are full. Baby, placenta, and mom.

05/25/2026

05/25/2026

What makes the Foundations of Lactation Education Course unique? We share creative ways to teach complex concepts. Education that is fun is memorable. | 11 comments on LinkedIn

05/21/2026

The first step in protecting breastfeeding is delaying the newborn exam and honoring your baby's Golden Hour.
I've noticed more baby nurses stepping in to do the newborn exam using langauge that misleads parents. Dad, you may need to watch and protect that first hour of skin-to-skin or your doula will speak up to remind you.

05/20/2026

05/19/2026

VBACs are very possible, but almost always require preparation and true support.
Reach out if you would like to discuss support for your VBAC journey.

05/17/2026

I hope to have spinach, kale, and romaine to harvest this week! I am so happy with the blueberry bushes this year! Hoping for an elderberry harvest, too.
No fancy plants around the house just yet, but an expanding food forrest, I hope.
I was going to plant raspberries by the blackberries, but Kaleb told me they don't get along! I had already dug a bed, so it may a watermelon bed instead.
I have liked the idea of visiting my berry patch for many years,so I was briefly sad that they couldn't all live together.
I've grieved and am ready to move the raspberries to another spot.
I also have realized my garden needs a shade tree.