What ingredients to look for in a prenatal vitamin

There's no shortage of prenatal vitamins available online or on shelves, so picking any option is likely to help you get your body what it needs to support a healthy pregnancy, right? Not exactly.

You see, the dietary supplement category (which prenatal supplements are a part of) has minimal government oversight — meaning there isn't a ton of regulation around what over-the-counter supplements get the "prenatal" label. But if you choose a prenatal vitamin and it has a good assortment of the nutrients recommended for pregnancy, it can help you bridge the gap between low intake from food and higher nutrient demands before and during pregnancy and lactation (whether or not you're breastfeeding).

The American College of Obstetricians and Gynecologists (ACOG) recommends these 11 nutrients during pregnancy: folate, iron, choline, omega-3 fatty acids, vitamin C, vitamin A, vitamin B6, vitamin B12, calcium, and vitamin D — many of which are available in prenatal vitamins. Below, we're breaking down why prenatals and their ingredients matter.

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Like we mentioned above, ACOG, the leading body of OB-GYNs, says these are the most important nutrients your body needs before and during pregnancy:

• 600 micrograms (mcg) of folate (aka folic acid or methylfolate) to support fetal neural tube development — 400 of which should come from prenatal vitamins.*

• 27 milligrams (mg) of iron to form red blood cells and hemoglobin — the protein in your blood that transports oxygen from your lungs throughout the body.*

• 450 mg of choline to support fetal neurodevelopment.*

• 85 mg of vitamin C to promote the growth of all connective tissue (skin, joints, etc.) and a healthy immune system.*

• 770 mcg of vitamin A to support fetal eye development and good vision, as well as a healthy immune system.*

• 1.9 mg of vitamin B6 to boost your energy while you're pregnant.*

• 2.6 mcg of vitamin B12 to help keep the central nervous system on track.*

• 220 mcg of iodine to help with developing a healthy fetal brain and maintaining thyroid health.*

• 1,000 mg of calcium to strengthen fetal teeth and bones.

• 600 international units (IU) of vitamin D3 to promote bone health and improve immune function for you and the fetus.*

• Omega-3 fatty acids DHA and EPA (ACOG doesn't recommend an exact amount) to help with retina and fetal brain development.*

On top of the above list, vegetarians need to keep track of their intake of iron, zinc, omega-3 fatty acids, vitamin D, choline, and vitamin B12 because they're often not getting enough from food alone — and vegans are sometimes deficient in calcium as well.

The best prenatal vitamin for you includes the nutrients you're not getting from what you eat in the right quantities to prep your body for the healthiest pregnancy possible.

(P.S. You might notice that magnesium is missing from the list. While many prenatal options include it, magnesium isn't recommended by ACOG for pregnancy. If you think you need to up your body's levels of magnesium, talk to your healthcare provider about whether or not you should take a supplement that includes it.)

In an ideal world, it would be easy to get all the nutrients you need to prepare your body to support fetal development just from what you eat — especially since food also brings with it antioxidants, fibers, and other important components for optimal health.*

But many essential nutrients aren't readily available from food (like vitamin D, choline, and the omega-3 fatty acid DHA), the quantities they're needed in for pregnancy are higher than the average way of eating can supply, and many of us have food restrictions (like vegetarian eating) that make it even more difficult to get certain nutrients from what we eat. Whatever the reason for it, people with ovaries in the US are routinely not getting enough folate, choline, and iron from food.

That's why prenatal vitamins are key. They help you fill in any nutritional gaps in what you're getting from food so you can build up the nutrient levels recommended before, during, and after pregnancy. As Anna Bohnengel, MS, RD, LD explains it, taking prenatal vitamins "can relieve some of the stress of trying to do it all perfectly, giving you what we like to think of as a nutritional insurance policy."

Let's return to ACOG's guidelines to answer this question:

• ACOG recommends that you get 600 micrograms (mcg) of folic acid (aka folate) each day.

• But because it’s hard to get that much folate from food alone, they recommend taking a daily prenatal vitamin with at least 400 mcg of dietary folate equivalent (DFE) starting at least one month before pregnancy (not just during your first trimester).

That said, the CDC sees value in all people with ovaries taking a prenatal with folate throughout their "reproductive years" to support fetal neural tube (brain, spine, and spinal cord) development in the event of pregnancy.*

But the truth is that it's challenging to know exactly when you're going to get pregnant. (In fact, it's estimated that almost half of pregnancies are unplanned.) Taking a prenatal months (or even years, depending on the formulation) before conception helps you prepare your body for pregnancy, nutritionally speaking, no matter when that ends up happening.*

While many prenatal vitamin options do have a good number of the nutrients recommended for pregnancy, what sets them apart is exactly what nutrients are inside, what forms the nutrients are in, how high the nutrient levels are, and even the form the prenatal itself comes in.

Here's why some prenatal options out there don't pass the sniff test:

• They may have nutrient levels that are well over the recommended daily intake (which can make you feel sick).

• They may contain not-so-digestible forms of each nutrient.

• They may have a bunch of filler nutrients you don't really need (often meaning more capsules).

• They may come in gummy form — and as delicious as gummy vitamins can be, they're more likely than other vitamin forms (e.g., capsules, tablets, soft gels) to not have an accurate representation of what's inside on the label.

• While virtually all prenatals will have some form of folate, many don't include choline. (One 2016 study found that out of the top 25 prenatal vitamins available, only around one-third did.) Much like folate, choline is an essential ingredient for the development of the spinal column (aka the neural tube).

*This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

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Current version

May 24, 2021

Written by

Sarah duRivage-Jacobs

Fact checked by

Health Guide Team

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