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The Best Prenatal Vitamins for a Healthy Pregnancy, According to Doctors
Medically Reviewed by Jennifer Wu, M.D., F.A.C.O.G.
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Updated: August 20, 2021
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One of the most important steps you can take during pregnancy to ensure you have a healthy baby is also one of the simplest: take a prenatal vitamin every day. Virtually nobody follows a nutritionally perfect diet, especially early in pregnancy when round-the-clock morning sickness suppresses your appetite, or when the food you do manage to get down doesn't stay down. Though a daily prenatal supplement can't take the place of a good prenatal diet, it can serve as dietary insurance, guaranteeing that your baby won't be cheated if you don't always hit the nutritional mark you're aiming for.
Here's how prenatal vitamins benefit you, along with how to choose the best prenatal vitamin.
What are the benefits of prenatal vitamins?
Prenatal vitamins offer benefits for both mom and baby, including:
- Reduce risk of birth defects. Perhaps the most important (and best publicized) reason to take a prenatal vitamin is for the folic acid (vitamin B9, or folate when it's in food form) it contains. Studies show that getting enough folic acid and B12 before sperm meets egg and in the early stages of pregnancy can dramatically reduce the risk of neural tube defects (like spina bifida) along with congenital heart defects in your developing baby.
- Cut back on nausea. Vitamin B6 helps to reduce nausea — and research has shown that women who take a daily multivitamin containing at least 10 mcg of B6 before conception and/or during the first few weeks of pregnancy experience less nausea during the first trimester.
- May reduce the risk of autism. Several studies have shown that babies of moms who regularly took prenatal vitamins before and during pregnancy may be less likely to have autism spectrum disorder.
- Help prevent preterm birth. Taking a prenatal vitamin throughout pregnancy has been linked to lower risk of preterm birth. That's perhaps especially due to the vitamin B12 they contain, since B12 deficiency is associated with lower birth weight and preterm birth.
When should you start taking prenatal vitamins?
Ideally, you'll start taking a prenatal vitamin as soon as you decide to start trying to conceive. Women who take supplemental folic acid before they get pregnant — before the sperm meets the egg — can substantially reduce the risk of neural tube defects like spina bifida and anencephaly, which are conditions that occur very early after conception.
If you weren't taking a prenatal before you conceived, don't panic. Just start taking one now, and continue popping one daily after you give birth until you stop breastfeeding.
What should be in your prenatal vitamin ?
Take a look at the label of any prenatal vitamin you're considering for a few key vitamins:
- Folic acid (vitamin B9): 400-600 mcg. Since baby's neural tube forms in the first month of pregnancy — before most women know that they're pregnant — it's ideal to start taking your prenatal vitamin before you start trying to conceive. In addition to eating plenty of folate-rich foods, opt for a vitamin with at least 400 mcg of folic acid (aka vitamin B9) and ideally get 600 mcg from all sources throughout your pregnancy. For women whose family history shows a high risk of neural tube defects (or for a woman who's already had a baby with a neural tube defect), guidelines recommend aiming for 10 times that amount (or 4 mg) from folic acid supplements — but always talk to your doctor before taking any additional supplements.
- Iron: 27 mg . This mineral is the building block for baby's cells — and your body needs more than ever during pregnancy. If, like many women, you become anemic during pregnancy, your doctor may recommend that you take more.
- Iodine: 220 mcg . Iodine aids your baby-to-be's thyroid and brain development — and studies have shown that many American women aren't getting enough of this essential mineral. That's why the American Academy of Pediatrics (AAP) recommends that pregnant women take a daily supplement containing 220 mcg of iodine. Not all prenatals contain iodine or this amount of it, so if the supplement you're considering doesn't, talk to your doctor about taking a separate iodine supplement.
- Vitamin B6: 1.9 mg. This B vitamin helps decrease the potential for morning sickness — in fact, prescription morning sickness drugs are a combination of pyridoxine (vitamin B6) and doxylamine (an antihistamine).
- DHA: Talk to your doctor. Regular prenatal vitamins may not contain DHA — an omega-3 fatty acid found in many types of fish. DHA has been shown to aid in baby's brain development, both before and after birth. If you're unable to get the recommended two to three servings (8 to 12 ounces) of pregnancy-safe fatty fish per week, ask your doctor if you should take an omega-3 fatty acid supplement. Generally, you'll need 200-300 mg of DHA a day.
A few other nutrients to be aware of:
- Calcium. Another crucial nutrient for women, calcium is especially important when you're growing another set of bones (your baby's). All women ages 19 to 50, including pregnant women, need 1,000 mg per day. In addition to getting plenty of calcium in your diet from milk, yogurt or other calcium-rich foods, you can get a boost from your prenatal vitamin. Don't take more than 250 mg of calcium at the same time as supplementary iron, because calcium interferes with iron absorption. If your doctor is concerned you're not getting enough, he may recommend you take an additional supplement.
- Vitamin A: 750-3,000 mcg . Amounts over 3,000 mcg can be toxic. Many manufacturers have reduced the amount of vitamin A in their vitamin supplements or replaced it with beta-carotene, a much safer source of vitamin A.
- Vitamin D: 15 mcg (600 IU). Your body needs vitamin D, in combination with calcium, to grow your baby's bones and keep yours strong. Most prenatal vitamins contain at least 10 mcg (400 IU) of vitamin D, but the American College of Obstetricians and Gynecologists (ACOG) recommends getting 15 mcg (600 IU). You can make up the difference through foods such as vitamin D-fortified milk, salmon and egg yolks. If your doctor suspects you may not be getting enough vitamin D (a relatively common issue among women), he or she may screen your levels at your first prenatal checkup. If you're deficient, he'll likely recommend that you take an additional supplement.
- Zinc: 11- 40 mg. This mineral supports your immune system and healthy cell division.
- Copper: 1.3 mg . Your body uses this trace element to form blood cells, as well as maintain nerve, bone and immune system health.
- Vitamin C: 50-85 mg. You can get plenty of this vitamin, which helps your body to absorb iron and supports your immune system, in your prenatal diet. More than 2,000 mg can be dangerous for your baby — so as always, don't take a supplement in addition to your prenatal vitamin unless recommended by your doctor.
- Other: Other vitamins and minerals to keep an eye out for are the dietary reference intake (DRI) for vitamin E (15 mg), thiamin (1.4 mg), riboflavin (1.4 mg), niacin (18 mg) and vitamin B12 (2.6 mcg). Most prenatal supplements contain two to three times the DRI of these, and there are no known harmful effects from such doses. Some preparations also contain magnesium, selenium, biotin, choline, pantothenic acid, extra B6 (to combat queasiness) and/or ginger (ditto).
If you're a vegetarian or vegan during pregnancy, be sure to tell your doctor to ensure you're getting the right nutrients in your supplements.
Tips for choosing the best prenatal vitamin
There are plenty of prenatal vitamin supplements on the market — so how do you pick the best one? Your individual needs may differ, so it's best to work directly with your doctor when deciding on the right prenatal vitamin for you.
In the meantime, here are a few tips to help you choose the best prenatal vitamin:
Look for an independent seal of approval
Several groups independently verify dietary supplements (including prenatal vitamins) using rigorous criteria. If you'd like extra reassurance that your supplement meets high standards, look for seals from the following organizations:
- U.S. Pharmacopeia (USP)
- NSF International
- Consumer Lab
However, keep in mind that getting approval from one of these groups is a voluntary, not required, step for manufacturers. So if your prenatal vitamin isn't marked with one of these seals, it doesn't necessarily mean it's not good. Bottom line: If you're at all concerned about the quality of the supplement you're taking, talk to your doctor.
Figure out if you can stomach it
Once you choose your prenatal vitamin, you might find you have a tough time stomaching it. The most common reasons (and solutions):
- If you have trouble swallowing it, look for a pill with a slicker coating. You may want to consider a pill sans calcium, since they tend to be smaller (calcium takes up a lot of space). If you do, be sure to talk to your practitioner to be sure you get enough of this essential mineral in other ways. You might also want to try a chewable or liquid prenatal vitamin (though you may have to try a few to find one with a taste that works for you).
- If your prenatal vitamin makes you feel nauseous , try taking your vitamin with a meal or snack or right before you go to bed. Still having trouble? Ask your doctor to recommend a different brand that you may be able to stomach better or one with more B6, which can curb nausea and morning sickness.
- If you've got constipation, diarrhea or gas, it could be the extra iron in your pill. Be sure to drink plenty of fluids, eat fiber-rich foods and include regular physical activity in your daily routine. If this doesn't relieve your stomach woes, talk to your doctor about alternatives (i.e., a supplement without iron, or a separate iron preparation that dissolves in the intestines rather than in the more sensitive stomach, or one that is slow-release).
Is it okay to take gummy prenatal vitamins?
Yes, especially if you have trouble swallowing pills — or you can't stomach a horse-sized capsule without triggering another bout of morning sickness.
But there are some drawbacks to prenatal gummies (not to mention the added sugar). In general, gummies contain fewer nutrients than the prenatals that come in pill form, says Hillary Wright, R.D., director of nutrition at the Domar Center for Mind/Body Health at Boston IVF; oftentimes, they're also lacking iron.
Is it necessary to take a prescription prenatal vitamin?
Prescription prenatals typically contain more folic acid than the over-the-counter varieties, says Wright. But not all moms need the extra dose. One caveat: If you've already given birth to a baby with neural tube defects, your doctor will likely start you on a prescription supplement of folic acid, says Mary Jane Minkin, M.D., a clinical professor in the department of OB/GYN at the Yale School of Medicine.
In general, over-the-counter prenatals are more than able to cover your nutritional bases — just talk to your doctor about which formula is right for you.
One other note here: If cost is a concern to you and you have a good drug plan with your insurance company, you may actually want to ask your doctor about prescription prenatals — they may actually be cheaper than OTC options.
How we chose the best prenatal vitamins
We started with the ingredients outlined above and found prenatal supplements that contain most (if not all) of the nutrients you need. From there, we checked which of these options were also tested and recommended by members of our What to Expect community, OB/GYNs or editors.
Here are our top picks.
Best Overall Prenatal Vitamin
One a Day Prenatal Multivitamin
Buying Options:
Target
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Amazon
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Pros: Widely recommended by OB/GYNs, wide variety of nutrients (including DHA)
Cons: Some people say the large size can be hard to swallow
Why We Love It
You can't go wrong with One a Day's prenatal vitamins, a What to Expect Award winner. The brand contains all the essential nutrients (iron, vitamin D, folic acid), plus a few important extras, like DHA and B6.
Size: 60 softgels per bottle
Best Value Prenatal Vitamin
Nature Made Prenatal Multi + DHA
Buying Options:
Target
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Amazon
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Pros: Contains a wide variety of pregnancy nutrients in high amounts
Cons: A larger supplement (a little longer than the size of penny)
Why We Love It
A 2020 What to Expect Mom Must-Have award winner, these prenatal vitamins from Nature Made are packed with all the nutrients you need, and in impressive amounts. They're especially rich in folate, vitamin D, iron and DHA. The affordable price tag doesn't hurt either, especially when you consider how many vitamins you'll need over the course of your pregnancy. You'll receive one bottle with a 90-day supply, so you'll want to order three to be covered until baby's arrival.
Size: 90 tablets per bottle
Best Prenatal Gummy Vitamin
Vitafusion Prenatal Gummy Vitamins
Buying Options:
Amazon
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Target
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Pros: Easy to take, high in vitamin D
Cons: Doesn't contain iron
Why We Love It
Can't stomach a horse-sized supplement? Or having trouble remembering to take your vitamin? A gummy might help. Vitafusion PreNatal gummies pack many of the essential nutrients you need (including DHA) into a lemon- and raspberry-flavored chew that rivals your favorite candy. Plus, they also contain 800 IU of vitamin D — "more than most prenatals," says Wright.
Size: 90 gummies per bottle
Best Vegetarian Prenatal Vitamin
Garden of Life Vitamin Code Raw
Buying Options:
Amazon
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Pros: Made with organic ingredients, contains probiotics
Cons: Doesn't contain DHA
Why We Love It
Garden of Life prenatals are made entirely from whole foods and boast an impressive list of nutrients (800 mcg of folate and 1,400 IUs of vitamin D, for example). We also love that they contain vitamin B6 and some ginger, which can help ease morning sickness.
Size: 180 vegetarian capsules per bottle
Best Preconception Prenatal Vitamin
Theralogix Theranatal Core
Buying Options:
Amazon
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Pros: Vegetarian, specifically formulated for TTC
Cons: Doesn't contain DHA
Why We Love It
Designed to help your body prepare for pregnancy, Theralogix's prenatal vitamins contain 1,000 mcg of folic acid and 2,000 IU of vitamin D, plus other nutrients that are beneficial when you're trying to conceive. "They're fairly priced, given the additional nutrients present in their supplements," says Wright.
Size:90 tablets per bottle
Best Kosher Prenatal Vitamin
New Chapter Prenatal Vitamins
Buying Options:
Amazon
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Pros: Made with organic ingredients
Cons: Doesn't contain DHA
Why We Love It
New Chapter's kosher prenatals are made from organic ingredients; they're also vegetarian and sugar-free. We also like how they contain 27 mg of iron, but are gentle enough to take on an empty stomach.
Size:96 vegetarian tablets per bottle
Best Dedicated Prenatal DHA
Nordic Naturals Strawberry-Flavored Prenatal DHA
Buying Options:
Amazon
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Pros: Strawberry flavor to combat fishy taste
Cons: Doesn't contain other necessary nutrients, so you'll need to take it alongside another vitamin
Why We Love It
If your prenatal vitamin doesn't contain DHA, ask your doctor if you should take an additional omega-3 supplement like Nordic Naturals. Their prenatal softgels contain an impressive 830 mg of DHA and 400 IU of vitamin D.
Best of all? While many fish oil supplements taste, well, a little fishy (which probably won't sit well with your morning sickness), these softgels are available in a strawberry flavor.
Size: 120 softgels per bottle
What to Expect When You're Expecting, 5th edition, Heidi Murkoff.
American College of Obstetricians and Gynecologists, Nutrition During Pregnancy, March 2021.
American College of Obstetricians and Gynecologists, Morning Sickness: Nausea and Vomiting of Pregnancy, May 2020.
Centers for Disease Control and Prevention, Folic Acid, February 2018.
Centers for Disease Control and Prevention, Iodine, December 2019.
National Institutes of Health, National Library of Medicine, Association of Maternal Prenatal Vitamin Use with Risk for Autism Spectrum Disorder Recurrence in Young Siblings, April 2019.
National Institutes of Health, National Library of Medicine, Folate Supplementation for Prevention of Congenital Heart Defects and Low Birth Weight: An Update, October 2019.
National Institutes of Health, Office of Dietary Supplements, Copper, March 2021.
National Institutes of Health, Office of Dietary Supplements, Iodine, March 2021.
National Institutes of Health, Office of Dietary Supplements, Iron, March 2021.
National Institutes of Health, Office of Dietary Supplements, Omega-3 Fatty Acids, March 2021.
National Institutes of Health, Office of Dietary Supplements, Vitamin A, March 2021.
National Institutes of Health, Office of Dietary Supplements, Vitamin B6, March 2021.
National Institutes of Health, Office of Dietary Supplements, Vitamin B12, April 2021.
National Institutes of Health, Office of Dietary Supplements, Vitamin C, March 2021.
National Institutes of Health, Office of Dietary Supplements, Zinc, March 2021.
U.S. Food & Drug Administration, FDA Provides Guidance for Industry to Convert Units of Measure for Certain Nutrients on Nutrition and Supplement Facts Labels, August 2019.
WhatToExpect.com, How Much Iron Do You Need During Pregnancy?, May 2020.
Source: https://www.whattoexpect.com/baby-products/pregnancy/best-prenatal-vitamins-buy-over-counter/
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