Hello and welcome, A fall in hemoglobin level is expected suring pregnancy as the demand is more and the blood is also dilute than normal. However a level below 10 is not acceptable and we call it anemia. There are different reasons for this with diet deficiency and worms being the commonest causes. Other reasons may be disorders of hemoglobin like sickle cell and thalassaemia, infections and malaria. Anemia below 8 is called moderate anemia. The problem is that women with anemia may develop excessive bleeding and go in shock, also there may be increased pressure on the heart due to low hemoglobin and it may fail. So care needs to be taken while managing them. As of now I suggest that you consult your doctor and start her on oral iron and vitamin B complex as both are needed to raise the hemoglobin. Investigations like perepheral smear, PCV and hemoglobin electrophoresis, serum iron, TIBC are needed to determine the cause and exetnt of the issue. If possible she may have a blood transfusion now to increase the hemoglobin. Other option is Intarvenous iron infusion but all these take time to raise the hemoglobin. Drugs that kill worms like albendazole are given to every women with anemia and ask your doctor for these. A diet rich is iron containing vegetables like spinach, fenugreek, carrots, beetroots, apples and all red fruits is important. Also meat and eggs [ if non vegetarian ] help build the globin part of hemoglobin and correct anemia. Keep blood ready as it can be used if there is a need for emergency blood transfusion. With these measure she should be alright. All my good wishes are with you for a safe delivery. Hope this satisfies your query. Thanks for using HCM. Feel free to ask any more questions that you may have. Dr Madhuri Bagde Consultant Obstetrician and Gynecologist