Fifteen to thirty percent of pregnant women are diagnosed with anemia (hemoglobin [Hb] less than 11.0 g/dL) and are at increased risk for preterm delivery, low birthweight, and other neurological complications. In order to determine if anemic pregnant women were more likely to receive postpartum RBC transfusions, the association between hemoglobin levels and transfusions was analyzed in 8039 pregnant women from a tertiary care maternity hospital. Of the 8039 women, 1562 (19.4%) were anemic, and 106 (1.3%) received a postpartum RBC transfusion. Among the anemic women, 3.6% received a blood transfusion compared to 0.76% of the non-anemic women (odds ratio, 4.97; 95% CI, 3.38-7.31; p=0.0001). Furthermore, anemia during pregnancy increased the risk of postpartum RBC transfusions for both vaginal and cesarean section births. Diagnosing and treating antenatal anemia before delivery may reduce the rates of postnatal RBC transfusions.