The CDC recommends that those of reproductive age who may become pregnant, including pregnant people, take 400 micrograms of supplemental folic acid each day in addition to consuming folate-rich foods to prevent neural birth defects in a developing baby. While there is no standard formula for a prenatal multivitamin, they typically contain key nutrients including iron, vitamin D, vitamins A and C, iodine, choline, omega-3 DHA, and B vitamins, including folic acid. Aside from multivitamins, additional supplements may be recommended—your need for these will depend on the nutrients your multivitamin is lacking as well as your individual needs. When shopping for your prenatal vitamins, it’s important to choose supplements that are made by a trusted brand and, preferably, are third-party tested. Purity and quality are of utmost concern when it comes to taking supplements during pregnancy. To make our recommendations, our prenatal dietitian used her experience working with hundreds of pregnant people, insight from the latest research, and consulted other experts in the field. Each pregnant person has unique nutritional needs, so be sure to speak with a healthcare professional before selecting a prenatal vitamin. This prenatal goes above and beyond to deliver you the methylated forms of vitamin B12 and folate, which are the forms that all bodies can use. It contains 4,000 IU vitamin D, which can help to reverse deficiency and avoid complications such as gestational diabetes. This vitamin is also one of the few prenatals to contain not just a drop of choline but a whopping 300 mg. As a bonus, this supplement contains inositol, which can be a useful nutrient for blood sugar balance. Of note, by design this prenatal does not contain iron or omega 3s, as iron needs vary by individual during pregnancy, and omega 3s may be best when taken separately from a multivitamin. While it’s important to work with a healthcare provider to determine if an iron supplement is beneficial, and if so, how much to take, we do recommend an omega 3 supplement for all pregnant people. Try Nordic Naturals Prenatal DHA. FullWell’s creator, Ayla Barmmer MS, RD, LDN, knows that quality is important and spared no expense when it came to creating her product. Every lot is third-party tested. Additionally, the facility is certified to comply with Good Manufacturing Practices (GMP) and is UL-certified (a global safety certification). Due to the quantity of nutrients and their formulations, the serving size for FullWell is a somewhat daunting eight pills daily. However, these soft capsules are easy to swallow, and you can even break them open into your smoothie or oatmeal. Price at time of publication: $50 ($1.67 per day) It is recommended that pregnant people consume at least 300 mg of DHA for pregnancy, and this supplement contains 200 mg on its own. If you can add to that one serving of fatty fish per week, you will be meeting your needs and helping your baby’s brain and eye health. While it contains DHA, this prenatal lacks a few nutrients such as adequate levels of vitamins A, C, and D. It contains calcium and iron together, which is not ideal for absorption. You will not find choline here either. So, you may end up wanting to supplement with these other items if you are deficient or have a tough time meeting your needs through diet. Price at time of publication: $15 ($0.14 per day) It’s worth noting that monk fruit is a high-intensity sweetener and with that brings its own flavor. For people who like the flavor or don’t mind it, this is not a con. Still, this could be an issue for those who do not care for the taste of monk fruit. Even as a powder, this prenatal manages to include vitamin A, ample vitamin D, methylated B vitamins, choline, calcium, and many other critical nutrients. It also contains a unique antioxidant blend. Needed manufacturers are all third-party tested. The product is careful to include sustainably sourced forms of their nutrients and keeps unnecessary fillers and additives out. The biggest downside or barrier is cost. However, this could be an option during the nausea stage before switching to a more budget-friendly option. Price at time of publication: $70 ($2.33 per day) Sourcing plant-based ingredients has its pros and cons when it comes to a prenatal. First, it contains a unique stomach soothing blend with ingredients like ginger, peppermint, and lemon to help with nausea. Secondly, this supplement uses the food form of folate, which is very well absorbed and effective. However, it also uses iron from plant sources, which is not as effective at raising iron levels in the case of anemia during pregnancy. The Mykind Organics prenatal does not contain choline, magnesium, or calcium and skips DHA and EPA, even though those could be plant-sourced as well. However, the supplement is three easy pills and is widely available at a more moderate price point. Price at time of publication: $61 ($1.02 per day) You will notice that NusaPure lists 650 mg of choline bitartrate, which translates into 267 mg of elemental choline. The recommended amount for pregnancy is 450 mg, so this is one of the few supplements that gets you pretty close. Please note that NusaPure only contains choline and is not a full prenatal supplement, so you will have to choose another prenatal in addition to this. Price at time of publication: $20 ($0.20 per day) Perelel’s products are non-GMO and dairy- and gluten-free. Still, these vitamins are not vegan as they source the omega-3 from high-quality fish oil. Each packet contains five pills, so if you have a tough time taking many pills, this one may not be the one for you. Since it prides itself on high-quality ingredients and customization, it has a higher price point than other prenatals. Price at time of publication: $58 ($1.93 per day) This omega-3 supplement contains 480 mg of DHA, which is above the 300 mg recommended amount. So even if you are not consuming a serving of fatty fish, you can rest assured your needs are being met. Alongside DHA is the complementary fatty acid, EPA, as well as a small amount of vitamin D. Nordic Naturals sources easily absorbable forms of omega-3s from anchovies and sardines, so this supplement would not be suitable for vegetarians. However, if the environmental impact of fishing is important to you, Nordic prides itself on being non-GMO and Friends of the Sea certified. Please note that this is not a full multivitamin prenatal supplement, as it only contains DHA and Vitamin D. Price at time of publication: $42 ($0.47 per day) The capsules have a pleasantly smooth outside, and they place a citrus-infused tab into the bottle to help reduce nausea. The capsules are vegan, gluten-free and major allergen-free, non-GMO, and free of artificial colorants and fillers. Plus, they can be conveniently delivered to your door each month. Nutrient-wise, Ritual prioritizes some crucial vitamins and minerals for parent and baby. They use the methylated form of folate for best absorption, include a small amount of choline and abundant DHA for eye and brain development, and include more vitamin D than most other two-pill prenatals. You will notice that calcium is left out, and only a modest amount of iron is included. If you do not consume dairy or other calcium-rich foods regularly, you will likely want to take an additional calcium supplement. If you are prone to iron deficiency, you might also need to supplement with additional iron. Ritual also does not include vitamin A or C, a few B vitamins, and other trace minerals, such as zinc. Of note, Ritual offers a subscription service for their products. This can be beneficial to get the vitamins (or any of their other products) at a slightly lower price point and automatically renewed. However, they are also available for one time purchase if you don’t want a subscription. Price at time of publication: $43 ($1.43 per day) for one time purchase Of note, Smarty Pants’ prenatal does include all of the fat-soluble vitamins (A, D, E, and K), folate as L-methylfolate, and a small amount of choline and omega-3 fatty acids. Because some nutrients are more bulky, and manufacturers can’t squeeze them into a few gummies, they are left out. So, keep in mind, you might need additional calcium, iron, or magnesium if you choose this product. A perk of gummy vitamins is that they taste great. However, this great flavor comes from added sugars. This product uses cane sugar for sweetness, so be mindful of your overall added sugar consumption if this prenatal is also part of your daily routine. Price at time of publication: $30 ($1 per day) Those that are pregnant: Pregnancy is a time of increased nutrient needs. According to USDA data, many pregnant and lactating people are not meeting recommendations for certain food groups and specific nutrients, so it is generally recommended for these populations to take a daily prenatal vitamin. Both the CDC and American College of Obstretricians and Gynecologists recommend taking a daily prenatal vitamin with 400 micrograms of folic acid during pregnancy. Those that are breastfeeding: It may be beneficial to continue a prenatal vitamin postpartum while breastfeeding; however the RDAs for lactating women differ slightly from the needs of pregnant women. For example, prenatal vitamins may exceed postpartum needs for both iron and folic acid, and may be too low in iodine and choline.
Who May Not Benefit from a Prenatal Vitamin
Men: Getting pregnant is a two-person job. The man’s overall health, as well as sperm health, are important to consider, specifically while trying to get pregnant. Research has seen positive effects on sperm count, motility, and morphology, as well as conception, from supplemental intakes of selenium, vitamin C, vitamin E, alpha-lipoic acid, folic acid, and zinc. While most prenatal supplements are specifically designed for those with female reproductive organs, we encourage men to work with a healthcare provider if they would like to choose a supplement to improve their fertility. If you do not plan to become pregnant: If you do not plan to become pregnant soon, you may be better off sticking with a standard multivitamin. Prenatal vitamins contain higher levels of certain nutrients due to the increased needs of mom and baby, but this is not necessary for a non-pregnant state unless you have documented deficiencies. Prenatal vitamins can be taken without being pregnant. However, it is advised to take them leading up to pregnancy and even during the postpartum period. Keep in mind that prenatals are designed for the state of pregnancy, where the need for some nutrients is greater than the non-pregnant state, so you will want to be careful not to over-consume supplements.
How We Select Supplements
Our team works hard to be transparent about why we recommend certain supplements in our dietary supplement methodology. We support supplements that are evidence-based and rooted in science. We value certain product attributes that we find to be associated with the highest quality products. And we prioritize products that are third-party tested and certified by one of three independent, third-party certifiers: USP, NSF, or ConsumerLabs. It’s important to note that the FDA does not review dietary supplements for safety and effectiveness before they go to market. Our team of experts has created a detailed, science-backed methodology to choose the supplements we recommend.
Key Nutrients in a Prenatal Vitamin
Prenatal vitamins contain a wide range of nutrients, targeting the specific vitamin and mineral needs to support a healthy pregnancy. “I look for the active form of the B vitamins folate [B9] and methylcobalamin [B12]. I also look for iodine, choline, and adequate amounts of vitamin D,” says Kristin Brown BSc, RD, who owns Grounded Health Nutrition and Wellness. These are some of the top nutrients to look for in a prenatal vitamin and their different forms:
Folate
Folate is a B vitamin found naturally in dark leafy greens, citrus, nuts, and liver. Folic acid is the form of folate that has been recommended as a supplement for years. However, it is the inactive form of the vitamin and must be converted to the active form for your body to use it. We now know that roughly half of the population has a genetic mutation (MTHFR gene variant) that can impact this conversion process. Because of this, in recent years, there have been more prenatal supplements that include the active form, L-5-methyltetrahydrofolate, rather than folic acid. It is important to note that the CDC still recommends supplemental folate in the form of folic acid, regardless of MTHFR genotype. Folic acid or L-5-methyltetrahydrofolate is arguably the most important nutrient to begin taking once you learn you are pregnant, and ideally a few months prior to becoming pregnant. It is responsible for the formation of the neural tube (what will become the brain and spinal cord). The Institute of Medicine and U.S. National Institutes of Health still recommend all pregnant people supplement with 600 mcg of folic acid to prevent neural tube defects.
Vitamin D
Vitamin D is actually a hormone and plays a role in bone growth, regulating cell growth, immune function, and glucose metabolism. There are not many good food sources of vitamin D, so a supplement is usually warranted in pregnancy to maintain adequate levels. Studies have shown that mothers who were deficient in vitamin D had higher rates of gestational diabetes, preeclampsia, preterm birth, and were more likely to give birth to small babies. Their children also had weaker, less dense bones at their peak. Vitamin D as cholecalciferol is the more potent form, compared to the plant-based form, ergocalciferol. If you want to effectively boost your vitamin D status, then vitamin D3 (cholecalciferol) is the way to go.
Vitamin A
Vitamin A-rich foods, such as liver, sweet potato, spinach, pumpkin, and carrots are excellent dietary sources to consume regularly and safely. Vitamin A is essential for cell differentiation and replication. It plays an important role in the development of the eyes, ears, spine, and heart. Vitamin A is one of the few vitamins that should be carefully monitored for not exceeding toxic levels. Doses exceeding 10,000 IU/day of the retinol form of vitamin A have been linked to severe birth defects. While many pregnant people do not need to supplement with vitamin A, those who choose to supplement with this nutrient may want to consider options with the beta-carotene form, which is not dangerous in high doses.
Iron
There is little question about the need for having adequate intake, and while iron can be easily found in beef, oysters, beans, spinach, and more, deficiency is not uncommon. During pregnancy, the number of red blood cells increases to help carry oxygen to the baby. Every cell for both the pregnant parent and baby requires iron, and as a result, iron needs will double for people during pregnancy. Poor iron status is linked to iron deficiency anemia (IDA) for the mother, and the possibility of preterm birth, low birth weight, low fetal iron stores, and impaired cognitive and behavioral development. The American College of Obstetricians and Gynecologists encourages screening for and treatment of IDA with supplemental iron or prenatal vitamins. Iron can be found in many forms in prenatal vitamins. Ferrous iron is more bioavailable than ferric, and prenatals may contain ferrous fumarate, ferrous sulfate, or ferrous gluconate. In high doses, iron in these forms may cause constipation, so the bisglycinate form or polysaccharide-iron complex might be better tolerated.
Choline
Choline still feels like the “new kid on the block” when it comes to prenatal nutrition, but luckily, it is getting more of the attention it deserves. Consumption of two eggs per day can meet half of your choline needs. However, the majority of pregnant people are not meeting recommended intakes. It can also be found in red meat, liver, salmon, chicken breast, and beans. Choline is an essential nutrient that is needed to build cell membranes and neurotransmitters. It is also important for gene expression, lipid transport, and brain development. Consuming choline while pregnant helps with the health and function of the placenta, improves the neural development of the offspring, and plays a role in epigenetic programming, which could influence the baby’s future cognitive development and chronic disease risk. Choline comes in various forms as well, each with differing amounts of actual choline per gram. Choline bitartrate and alpha-GCP have more choline, whereas the more commonly found forms of phosphatidyl-choline and citicoline have less choline. This doesn’t mean that one source is necessarily “better” than another, but you may need a higher dose of the forms that contain less choline.
DHA
Brain health and development get a lot of attention during pregnancy, and so you have likely heard of the omega-3 fatty acid DHA. This compound, which is primarily found in fatty fish, is critical for brain, eye, and nervous system development. It has even been studied to show longer gestation periods (potentially lower risk of premature birth), higher birth weight, better mental and psychomotor skills in the offspring, and improved cardiovascular health later in life. As there is so much confusion regarding seafood intake during pregnancy (hint: low mercury fish are safe and encouraged), many people are not consuming enough DHA, so supplementation is helpful.
What to Look for in a Prenatal Vitamin
Third-Party Testing
Supplements that are third-party tested are sent to a lab and tested to ensure they contain what they say they contain and are not contaminated with specific high-risk, common contaminants. However, it’s important to note:
Third-party testing does not test to see if a product is effective or safe for everyone, and it does not ensure the supplement will not interact with other supplements or medications.Not all third-party testing is created equal. It is not uncommon for supplement companies to pay labs for certificates after conducting minimal to no testing.The third-party certifications you can trust are ConsumerLabs, NSF, and USP. However, these certifications are difficult to obtain and expensive, so many companies choose not to get their products tested by one of these three organizations.Sometimes products tested by these three companies are more expensive to try to offset the cost they pay for certification.Even though a supplement is not tested by one of these three companies, that does not mean it’s a bad product. We recommend doing some research on the reputability of the manufacturer and calling the manufacturer and their testing lab to determine their protocols and decide if you feel comfortable consuming the supplement.
Ingredients, Potential Interactions, and Contraindications
It is essential to carefully read the ingredient list and nutrition facts panel of a supplement to know which ingredients and how much of each ingredient is included relative to the recommended daily value of that ingredient. Bring the supplement label to your healthcare provider to review the different ingredients contained in the supplement and any potential interactions between these ingredients and other supplements and medications you are taking. Inositol, sometimes referred to as vitamin B8, acts as an insulin sensitizer which means it helps regulate blood sugar levels. With the rising rates of prediabetes, type 2 diabetes, and gestational diabetes, as well as people with PCOS, inositol is being looked at as a valid therapeutic approach to blood sugar management in pregnancy. It may be included in some prenatal supplements and is generally recognized as safe. Red raspberry leaf is used during pregnancy and labor to tone and strengthen the uterus. While this is a popular supplement among midwives and the complementary medicine field, there aren’t enough studies on its safety or efficacy. Since it is known to induce contractions, much of the research has focused on its use only after 32 weeks gestation, so the safety of taking this supplement in the first and second trimesters and its connection with preterm labor is unclear.
Prenatal Vitamin Dosage
The dosage of the various vitamins and minerals you may find in a prenatal vitamin will vary greatly. While there are RDA (Recommended Dietary Allowance) and UL (Tolerable Upper Intake Levels) established, there is no definition or standard of what nutrients a prenatal vitamin must contain and at what levels. Every pregnant person’s body has different needs, baseline nutrient levels, absorption capabilities, and pregnancy-related complications that may arise. So, it’s important to discuss with your healthcare provider which nutrients are a top priority for you, obtain bloodwork to confirm any suspected deficiencies that could warrant more aggressive supplementation, and consider what your diet contributes during this critical time as well. Some prenatal vitamin companies may add more or less than the established RDA for a nutrient, or they may use different forms of a vitamin or mineral. Therefore, it is encouraged to research the reputability of the company and its scientific process for developing its product.
Excess Prenatal Vitamin Toxicity
Vitamin A: According to the Institute of Medicine, the tolerable upper intake level during pregnancy for preformed Vitamin A is 3,000 mcg. Excessive vitamin A from the retinol form can cause birth defects and weaken bones. If you and a healthcare provider determine that you would like to include prenatal that contains vitamin A, we recommend choosing one with the beta-carotene form of vitamin A instead, as the only side effect of taking excessive beta-carotene is a yellowing of the skin. Folate: The tolerable upper intake level for folate is listed as 1,000 mcg for pregnancy. One study showed that intakes over 1,000 mcg in the period immediately before and after getting pregnant resulted in poor cognitive development in 4-year-olds. It has also been shown that high levels of unmetabolized folic acid, which can result from the body’s inability to convert folic acid to the acid methyl form (or for those with the MTHFR gene variant), could weaken the immune response and even increase the risk of neonatal jaundice, and infant asthma. It can also lead to developmental delays like autism. Vitamin D: Intakes over 4,000 IU are considered to exceed the tolerable upper intake level, and excessive vitamin D can result in dangerously high calcium levels. However, this amount often does not take into consideration whether a person is deficient going into pregnancy. If a pregnant person is deficient, they may benefit from slightly higher therapeutic doses for the health of themself and the baby. Iron: The tolerable upper intake level of iron is 45 mg during pregnancy. While it is rare to overload on iron from foods, excessive supplemental intakes can cause gastric upset, constipation, nausea, abdominal pain, vomiting, and faintness, especially if taken on an empty stomach. Choline: During pregnancy, it is not recommended to exceed 3,500 mg of choline. Excessive intake can lead to fishy body odor or hypotension, low blood pressure, caused by increased production of TMAO, a substance correlated with cardiovascular disease.
Why Trust Verywell Family
Casey Seiden is a registered dietitian nutritionist and certified diabetes care and education specialist based in New York City. Casey works at Maternal Fetal Medicine Associates, the premier maternal-fetal medicine practice in Manhattan, where she provides nutrition therapy and counseling to women with high-risk pregnancies. She is also the founder of Casey Seiden Nutrition, a virtual private practice specializing in a non-diet approach to diabetes care and women’s health. Taking a prenatal vitamin as much as three months before getting pregnant could help improve egg quality, as well as ensure you are starting pregnancy with a solid foundation. Plus, making sure you are not lacking in any nutrients is helpful if first-trimester nausea rears its head and getting adequate nutrient intake is difficult. A prenatal or postpartum supplement after birth is also beneficial since a birthing parent’s body is depleted, and some nutrients are lost through nursing, making needs as high, if not higher, in some cases. The form of the supplement is also a factor. Our most expensive option is Needed’s powdered prenatal which may be helpful during periods of pregnancy where nausea makes it too difficult to swallow a pill. Our top pick is FullWell’s Prenatal Multivitamin which comes out to about $1.67 per day—it contains optimal levels of almost all nutrients. But we do recommend taking an omega 3 supplement in addition, and, depending on your individual body and diet, you may also need an iron supplement. Our budget pick, Nature Made’s Prenatal + DHA, is third party verified, affordable, only one pill a day, and contains some key nutrients, but it is also not nutritionally ideal. You may still save money by choosing this option and adding some individual nutrient supplements each day.
