Why You Need To Start Taking Prenatal Vitamins Way Before You're Pregnant

·13 min read
Photo credit: Jewelyn Butron
Photo credit: Jewelyn Butron

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Getting all the vitamins and minerals you need through eating nutrient-dense foods alone can be difficult—especially if you’re pregnant. ICYMI, pregnant people deal with symptoms like morning sickness and a hypersensitive nose, which can make it difficult to consume filling, well-rounded meals. Whether you’re currently pregnant or trying to conceive, odds are you’re very invested in supporting your and your baby’s health. Enter: the best prenatal vitamins that are gynecologist-approved.

Prenatal vitamins are supplements designed to fill any gaps in your diet and ensure all the nutrients your baby needs to grow are present in your system—especially ones like magnesium, zinc, calcium, vitamins B and C, and folate, says G. Thomas Ruiz, MD, an ob-gyn at MemorialCare Orange Coast Medical Center in Fountain Valley, California.

It’s very common that your diet alone is not enough to provide you with all the vitamins needed for your baby's growth and development, says Tiffany Woodus, MD, an ob-gyn at Woodus Obstetrics & Gynecology in Texas. "Most women simply do not consume enough of the key nutrients that have been shown to give babies the best possible start in life." (This is totally normal!)

Here is everything you need to know about prenatal vitamins, such as the benefits of taking them, when to take them, and what to look for when finding the right one for you, according to experts.

What are prenatal vitamins, exactly, and why do they matter?

Prenatal vitamins are a multivitamin specifically formulated for someone who is pregnant or trying to have a baby, explains Katharine O'Connell White, MD, an associate professor in the department of obstetrics and gynecology at Boston University and the author of Your Guide to Miscarriage and Pregnancy Loss. They have specific amounts of nutrients and minerals that are safe for pregnant people. For example, certain ones need to be taken in lower doses while you're carrying your baby (such as vitamin A) because consuming too much can harm the developing fetus, Dr. White explains.

On the other hand, sometimes prenatals will have more of certain nutrients, such as folic acid, which prevents some birth defects, or iron, which prevents anemia, a common symptom during pregnancy.

What are the benefits of taking prenatal vitamins?

Aside from aiding in your baby's growth, particular supplements can lower the risk of certain conditions for both you and your baby. "Prenatal vitamins can help decrease your risk of nausea, birth defects, and preterm birth. These benefits are optimized when prenatal vitamins are started prior to conception," says Dr. Woodus.

Supplemental folate (or folic acid), in particular, is very important. It's been shown to reduce neural tube defects, which affect the baby's brain and spine, according to the CDC. Folic acid can also reduce the risk of autism spectrum disorders, research shows. When prenatal vitamins are taken three months before conception or during the first month of pregnancy, the risk of having a child with autism decreases even in genetically susceptible mothers and children, a study in the Journal of Epidemiology found.

When do I need to start taking prenatal vitamins—and for how long?

Ideally, you should start as soon as you begin trying to conceive, Dr. Ruiz says. (FYI, it's a myth that they will increase your fertility, though.) Your baby will need those extra nutrients from the moment of conception, she explains.

It's best to make sure your system is well stocked for several months before you conceive, Dr. White adds. That ideal number is three months before the pregnancy occurs, according to Mary Jane Minkin, MD, an ob-gyn at Yale University.

Specifically, iron can be pretty important prior to conception since "most women are anemic and will become more anemic during pregnancy," Dr. Minkin explains. Iron will also help keep fatigue at bay during pregnancy, which is common.

Folic acid can be important before conception too. "We know that babies conceived while their mom is taking folic acid have a much lower incidence of a neural tube defect," Dr. Minkin says.

However, if you conceived unexpectedly and were not taking these prenatal vitamins beforehand, don’t stress—three months prior is simply the best case scenario.

As soon as you know you’re pregnant, though, gynecologists recommend getting started on a prenatal immediately, says Danielle Jones, MD, an ob-gyn and pregnancy educator based in Austin, Texas. And yep, continue to take them throughout your pregnancy and afterward, for as long as you are breastfeeding, Dr. Ruiz advises.

What do I really need in a prenatal vitamin?

Going through drugstore shelves or Amazon can be intimidating. And don't worry, it's not just you—all those options don't just start to sound alike, they really are very similar, says Wendy Goodall McDonald, MD, a Chicago-based ob-gyn.

These are the recommended daily amounts of essential nutrients you should be getting when you're pregnant and what a basic prenatal should have, per guidelines by the American College of Obstetricians and Gynecologists (ACOG):

  • Folic acid: 600 micrograms (to support the development of the baby's brain and spine)

  • Vitamin D: 600 international units (to facilitate proper growth and reduce the risk of preterm delivery)

  • Calcium: 1,000 milligrams (to aid in the formation of the baby's bones and teeth)

  • Iron: 27 milligrams (to help with the increase in blood volume needed to support both mom and baby)

  • Omega-3 fatty acids: 200 milligrams (to make sure the baby's brain and eyes are healthy)

  • Iodine: 220 micrograms (to help the baby's brain development)

  • Choline: 45o milligrams (for development of the baby's brain and spinal cord)

  • Vitamin A: 770 micrograms (for the baby's development of healthy skin, eyes, and bones)

  • Vitamin C: 85 milligrams(to help the growth of gums, teeth, and bones)

  • Vitamin D: 6oo international units (for the baby's bones and teeth)

  • Vitamin B6: About two milligrams (to help form red blood cells to aid mom and baby in actually absorbing the nutrients they need)

  • Vitamin B12: About three milligrams (to keep red blood cell production and the nervous system running smoothly)

One note: Getting enough vitamin D is especially important for BIPOC women, as they're more prone to having a deficiency, says Lucky Sekhon, MD, an ob-gyn, infertility specialist, and reproductive endocrinologist at Reproductive Medicine Associates of New York.

Vitamin D is important for strong bones and a healthy pregnancy, and having too little has been linked to conditions like preeclampsia, which is high blood pressure and associated organ damage during pregnancy, and preterm delivery. "Vitamin D is derived from sun exposure and skin absorption, which is limited in melanin-pigmented skin," says Dr. Sekhon. "The average prenatal vitamin contains 400 IU of vitamin D. A woman whose levels are known to be deficient will require more than this daily amount to replenish it."

These are the 13 best prenatal vitamins, as recommended by doctors.

While it's a little different for everyone (for example, some people might have tummy troubles with one versus another), here are the top prenatal vitamins on the market, including the best-selling ones on Amazon to add to your cart. (Plus insights from the pros as to why you should take them.)

1. One A Day Women's Prenatal 1 Multivitamin

This is the most popular brand of prenatal vitamins on the market, and it's a solid choice, says Hillary Wright, MEd, RD, the director of nutrition counseling at Boston IVF and an expert in prenatal nutrition.

It's not necessarily fancy, but it gets the job done for a reasonable price and, best of all, it's been verified by an independent lab so its contents are as advertised, she adds. (This isn't always the case with supplements since they're not monitored by the FDA.)

2. Nature Made Prenatal + DHA 200 mg Multivitamin

The best thing about this prenatal vitamin: a huge dose of DHA, a fatty acid crucial to fetal brain development, Wright says.

"A lot of prenatals advertise they have this, but they have a minuscule amount—you want a minimum of 200 mg of DHA per serving," she says. You can also get DHA by taking a separate fish oil supplement.

3. Ritual Prenatal Vitamins

One thing to know about iron and calcium in vitamins: "They compete with each other for absorption," says Alyssa Dweck, MD, an ob-gyn in Westchester County, New York, and co-author of V Is for Vagina. "I recommend getting iron from a vitamin and calcium from your diet," she says, since it's much easier to get calcium from foods (think: dairy, greens) than iron. This vitamin doesn't contain calcium, which may help you better absorb the iron in it (which could be especially important if you're anemic).

These vitamins’ minty flavor is a nice bonus for women experiencing morning sickness, as mint is known to control nausea, Dr. Dweck adds.

4. TheraNatal One Prenatal Vitamin & Mineral Supplement

This prenatal contains iodine, a mineral vital to hormone regulation, fetal growth, and brain development, Wright says. Ideally, you want to take in about 150 micrograms of iodine every day, according to Wright, who also notes that this product in particular is independently tested and has a high standard of quality.

There is just one major downside: They don't come cheap. These are by far one of the most expensive OTC options on the list, although you may be able to get them at a lower price through your doctor's prescription.

5. Thorne Basic Prenatal

This one's another great choice, according to Felice Gersh, MD, a board-certified ob-gyn and the director of Integrative Medical Group of Irvine in Irvine, California, because it also contains the methylated forms of folate and B12. Plus, it has even more folate (a full milligram more, in fact) than most vitamins out there, which makes it ideal for women who don’t get enough green leafy vegetables in their diet.

Another good thing about this? "This vitamin is also high in vitamin D and provides a healthy blend of calcium citrate and malate, though it does take three capsules daily to get these amounts,” she says, which differs from the usual one and done regiment for most prenatal vitamins.

6. Garden of Life Vitamin Code Raw Prenatal

In addition to being a good source of vitamin D, it also offers a blend of vitamin A, which is known for being beneficial for your (and your fetus’) eyes per the WHO, and contains ginger to soothe nausea, probiotics that support your immune system, and an organic vegetable blend.

“This is a great option for women looking for a very affordable option without any unhealthy binders and fillers,” Dr. Gersh adds.

7. Mama Bird Prenatal Vitamin

These vitamins contain methylated folate. Folate is one of the most important vitamins in prenatal pills, but some women have a genetic condition that makes it hard for their bodies to convert the folic acid in most prenatals to the active form the body can use, Wright explains.

But there's a catch: You won't know if you have the condition unless you have genetic testing done. So, if you want to be super safe and cover all your bases, then a methylated version of folate might be worth the money. Still, she emphasizes that for the majority of women, the regular (and more affordable) variety is just fine.

8. Vitapearl

Unlike the others on the list thus far, this small, easy-to-tolerate (read: lower risk of GI distress) pill is only available through an Rx from your doc. So now you're probably wondering: Is prescription better than OTC? Not necessarily, according to Dr. McDonald, who says she doesn't having a preference for one over the other.

What draws people to a prescription rather than the OTC versions is that your health insurance might cover the cost if the specific prenatal fits your plan, Dr. Dweck explains. If that sounds like something you'd be interested in, consult your insurance plan to see what, if any prenatal vitamins, are covered and then chat about it further with your provider.

9. OB Complete One (+ Petite)

This prescription option recommended by Dr. McDonald stands outs for being loaded with iron—40 mg to be exact—which is great because, per ACOG, during pregnancy your body needs extra iron to help make more blood to carry all that oxygen to the fetus. Just be sure to avoid eating or drinking dairy within 30 minutes of taking this vitamin, as the calcium can interfere with iron absorption, she explains.

10. Prenate Mini

If even the word "vitamin" freaks you out (hi, huge horse pills), Dr. McDonald recommends Prenate Mini, the micro-sized alternative that still gives you the essential nutrients needed for a healthy pregnancy. Of particular note is its large amount of DHA—350 mg—which should free you from potentially having to take an added DHA supplement.

Quick reminder: DHA is a type of omega-3 fatty acid (you know, the brain-boosting fat that you can frequently find in fish). Omega-3 fatty acids are believed to play an important role in the fetus' brain development before and after birth, according to ACOG, which is why extra DHA is super important.

11. Smarty Pants Prenatal Formula

Gummy vitamins aren't just for kids. They're for pregnant women too, especially when they're packed with 18 essential vitamins that all have a part in promoting fetal growth. These gummies in particular pack 290 mcg of iodine, which Dr. Woodus says is essential for healthy brain development.

Since the recommended intake of it is 220 mcg, these chewy vitamins can help you meet your daily requirement. The CDC recommends taking iodine while breastfeeding, as iodine deficiencies may put infants at risk of cognitive and psychomotor impairments.

12. MegaFood Baby & Me 2

Infants of moms who consumed greater amounts of choline during their final trimesters were able to process information at faster rates than infants of mothers who had less, per a 2018 study published in the Journal of the Federation of American Societies for Experimental Biology.

"Choline is important for the development of the baby's brain and spinal cord," says Dr. Woodus. These prenatals from MegaFood include 300 mg of choline. The recommended daily amount is 450 mg, but Dr. Woodus says the nutrient can also be found in foods like milk, eggs, peanuts, and soy products.

13. Centrum Prenatal + DHA

If you find you're vitamin D deficient, you may want to seek vitamins that include a little extra (most pack 400 IU) or make sure you're getting enough from other sources like fatty fishes. These Centrum prenatal vitamins fit the bill and include 600 IU of vitamin D.

14. Vitafusion Prenatal Gummy Vitamins

This prenatal formula includes essential vitamins and minerals and provides an excellent source of folic acid and 50 mg of omega-3 DHA, says Dr. Minkin. Plus, the included fish oil has been tested for mercury and PCBs, which can be toxic and cause neurobehavioral issues, she adds.

The DHA can help support your baby's brain development, while the folic acid reduces the risk of birth defects and multivitamins with vitamin D support bone development, all in an easy-to-take gummy form, Dr. Minkins notes.

15. Vitafol Prenatals

Vitafol is a go-to prescription for Sandy Dorcelus, DO, a gynecologist at NYU Langone Hospital. Specifically, Dr. Dorcelus likes that Vitafol are small and easy to swallow. Plus, they are enteric-coated, making them easy on the stomach. “About one-third of my pregnant patients complain about nausea due to prenatal vitamins,” she adds.

That said, if you’re anemic, on anti-seizure medications, or have had a previous birth with neural tube defects, Dr. Dorcelus recommends taking an additional iron supplement with this vitamin.

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