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Choosing a Prenatal Vitamin

Choosing a Prenatal Vitamin; Prenatal vitamins are important. Happy cute expectant female holding medicine and glass of water while relaxing in bed and looking at camera

We all need to have a healthy level of vitamins and other nutrients in our system to be at our best. However, pregnancy increases the need for some of these nutrients, both for the development of the fetus and the health of the mother.

The best way to get the essential vitamins, minerals and nutrients that your body needs is through diet. However, it is not always possible to get all that is necessary from diet alone. Even if you maintain a perfect diet, you may not be able to maintain some of the higher levels of these nutrients during pregnancy. That’s where a good prenatal vitamin comes in.

With multiple options lining drugstores and supermarket shelves, choosing a prenatal vitamin can seem like a guessing game. Here is some information to help:  

What to Look For

For starters, it is important you discuss a recommended diet with your care provider at the beginning of the pregnancy. Your midwife or another care provider may give you a prescription for prenatal vitamins, or have a list of over the counter varieties that they recommend based on your individual needs.  When choosing a prenatal vitamin, look for the following:

  • Folic Acid: (at least 400 micrograms): Folic acid is a crucial nutrient for women. According to the Centers for Disease Control and Prevention (CDC), folic acid is recommended for all women of reproductive age, even if they are not pregnant. But in the case of prenatal use,  folic acid will help prevent neural tube defects. 
  • Calcium (250 mg): Calcium is important for bone health of both you and your baby. For you, it will help prevent the development of osteoporosis. For your baby, calcium is instrumental in developing bones. All women, including pregnant women, need about 1,000 mg of calcium per day. Most of this should be obtained through diet, but the prenatal vitamin gives pregnant women a boost.
  • DHA (200 mg, but consult your healthcare provider): Traditionally, regular prenatal vitamins do not contain DHA (docosahexaenoic acid). However, most care providers recommend this nutrient. Speak with yours about what is right for you. This supplement in a vitamin may be more necessary for women who are unable to get their recommended amount of omega-3 fatty acids through diet. When your prenatal vitamin has DHA you should avoid additional vitamin A supplements as an excess of vitamin A is potentially dangerous. 
  • Iron (27 mg): Iron will help your baby’s blood development and ability to transport oxygen. Your iron level will be tested as part of your prenatal blood work. If you are found to be anemic (low iron), a separate iron supplement in addition to your prenatal vitamin may be recommended. 
  • Vitamin B6 (2 mg): B6 can help with the nausea commonly referred to as morning sickness. Many prescription drugs used to treat morning sickness are a combination of a type of Vitamin B6 called pyridoxine and the antihistamine doxylamine.
  • Vitamin C (50 – 80 mg): Vitamin C, which is used to facilitate iron absorption and fortifies the immune system is one of the easiest vitamins to get through diet. You will be able to get plenty through healthy eating. Lots of fruits and vegetables you should already be eating contain vitamin C. Keep in mind that too much vitamin C (over 2,000 mg) can be dangerous to the baby so look for this level of the nutrient in the prenatal vitamin.
  • Vitamin D (400 IUs): In combination with calcium, vitamin D is necessary for the development of the baby’s bones. It will also help protect your bones from osteoporosis. You’ll find most prenatal vitamins have 400 IUs (international units) but the American College of Obstetricians and Gynecologists recommends 600. If you are unable to get the rest through diet (fortified milk, egg yolks, salmon, etc.), then you might be put on an additional supplement.
  • Zinc (15 mg): Zinc supports your immune health and promotes healthy cell division.
  • Copper (2 mg): This trace element is used in the formation of blood cells. It is also needed to maintain nerve, immune system, and bone health.
  •  Iodine (150 mcg): Iodine is important in the development of your baby’s thyroid and brain. Not all prenatal vitamins contain iodine, so discuss this with your care provider to see if you might need a separate supplement.

Other nutrients you might see include vitamins E & B12, niacin, riboflavin, magnesium, biotin, choline, phosphorus, pantothenic acid, and ginger (for queasiness).

When researching vitamins, you might see terms like Recommended Dietary Allowance (RDA) and Tolerable Upper Intake Levels (UL). RDA is the amount of the nutrient the average person needs for good health, whereas UL refers to the highest amount of a nutrient someone can ingest without experiencing negative effects.

When Should You Start Taking Prenatal Vitamins?

Ideally, you should start taking prenatal vitamins before you get pregnant when you begin trying to conceive. In fact, it is often suggested that women in their reproductive years include a prenatal vitamin in their regular routine. This is because of how early the baby can benefit from the additional nutrients. You may be pregnant for a month or two before you actually know you are (especially if you are not actively trying to get pregnant and it is unexpected), so getting a head start is never a bad idea.

Your midwife, doctor, or another care provider might advise you to continue to take prenatal vitamins even after you deliver. They can help promote postpartum healing and be helpful if you plan to breastfeed. 

Other Things to Know About Prenatal Vitamins

 Prenatal vitamins might have some mild but unpleasant side effects. However, this should not dissuade you from taking them as they can be offset or prevented with some easy routine changes.

One of the most common concerns is nausea or queasiness after taking the vitamin. Many people have a bit of an upset stomach after taking vitamins and depending on what stage of pregnancy you are in and your specific experience, nausea may already be a problem. To combat queasiness, it is recommended to take your prenatal vitamin with some food in your stomach. So, having a snack can help. Also, it might be easier to take the prenatal vitamin at night before you go to bed.

The other common side effect of prenatal vitamins is constipation. This is due to the iron in the vitamins, which as noted before, is a crucial nutrient during pregnancy. To prevent constipation, you can add more fiber to your diet, drink plenty of fluids, and partake in exercise that has been approved by your care provider. If these things don’t work, consult with your care provider about the safety of using stool softeners.

If you find you are still having difficulty tolerating your prenatal vitamin, speak with your care provider. They may have recommendations for different types of prenatal vitamins. Or they could suggest other regimens to get the needed supplements outside of a traditional prenatal vitamin. This may include finding a combination of the individual supplements you need. It might seem counterintuitive to take more pills, but this method could be more tolerable for some.

At City of Oaks Midwifery, our certified nurse-midwives (CNMs) are dedicated to a relational approach to pregnancy care. From the beginning, we will be there to support you and answer your questions, including making sure you are well educated on prenatal vitamins. To make an appointment at one of our three offices in Raleigh, Clayton, and Cary, call 919-351-8253.


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