PIP: Anemia is a major cause of maternal mortality in India. In 1990, 19% of the maternal deaths were related to anemia. It is also a contributory factor to maternal deaths caused by hemorrhage, septicemia, and eclampsia. Anemia caused by lack of iron is the commonest nutritional deficiency in the world. According to recent reports, a significant number of children and women in the western world are also iron deficient. An adult man needs a daily amount of 1.1 mg of iron, compared with twice as much by a woman even when she is not pregnant. The total iron needed during pregnancy is about 1000 mg. The daily requirements for iron, as well as folate, are 6 times greater for a woman in the last trimester of pregnancy than for a nonpregnant woman. In healthy, well-nourished women with adequate iron stores, about half the total requirement of iron during pregnancy may come from maternal reserves. If the diet is not supplemented with extra iron, a woman will become progressively depleted of iron during pregnancy, and anemia will result. Lack of iron directly affects the immune system; it diminishes the number of T-cells and the production of antibodies. The World Health Organization (WHO) defined 3 stages of iron-deficiency: decreased storage of iron without any other detectable abnormalities; iron stores are exhausted, but anemia has not occurred yet; and overt iron deficiency when there is a decrease in the concentration of circulating hemoglobin. The end result of iron deficiency is nutritional anemia. Most Indian women are anemic with a hemoglobin level of 7-10.5 gm% (the norm is 11.5-14.0 gm%). Iron supplementation, calcium supplements, and a high-protein diet should be given these women during pregnancy. They should also be made aware about proper birth spacing, especially in rural areas, under existing government education programs.