5 Things to Help You Choose a Prenatal Vitamin

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I’ve always adhered to the food first philosophy when it came to vitamins and supplements; however, there is no denying that prenatal vitamins can help us fill the nutritional gaps in our diet.


The question isn’t should we take prenatal supplements, it’s which prenatal vitamins and supplements should we take?


If you find yourself standing in the supplement aisle at your local pharmacy, this simple question can be difficult to answer because of the abundance of options. I’ve been that girl, in the aisle, scanning the vitamin labels looking like a lost puppy.


The thing is…


We all have different needs, which makes it nearly impossible to suggest that one brand of prenatal supplements would be best for every woman, so…I’m not going to do that. 


Instead, I’m going to share some information to help you make your own decision. 


Disclaimer: I am not a medical professional and I always recommend that you talk with a qualified and trusted health care provider, before taking any medications or supplements – especially if you are pregnant.


1. Folic Acid isn’t the same as Folate

Folate is the natural form of the B9 vitamin that is found in foods like spinach, greens, lentils, beans, broccoli, and avocado (1). It’s essential for helping the body make red blood cells and plays a significant role in DNA formation.


This vitamin is recommended to us during pregnancy because research suggests that a lack of this micronutrient can lead to neural tube defects and other serious complications like anemia, and cardiovascular disease (2).


Although folate is the naturally occurring form of B9, many prenatal vitamins contain folic acid, a synthetic form of the vitamin. 


Here are some things to note about choosing a vitamin with folic acid instead of folate:

  • 40%-60% of the population have a genetic variant that prevents the conversion of folic acid to a form that our bodies can use called L-Methyfolate also known as 5-MTHF (3). 
  • The inability to convert folic acid to its active form can result in a dangerous build-up of unmetabolized folic acid in the blood (4).


If you know you have this gene variant or want to err on the side of caution, consider choosing a prenatal vitamin with the bioactive forms of folate.


How to identify if your prenatal vitamin has folate?

 Check the label for:

  • “L-5- MTHF”, “5-MTHF”,  “L-methylfolate”


If the MTHFR gene isn’t a concern for you, there are several prenatal vitamins that have folic acid. Again just have a discussion with your doctor if you need assistance choosing. 



Many countries including the USA require that manufacturers of grains like bread, cereals, flours, cornmeal, pasta, and rice are enriched with folic acid to reduce the risk of neural tube defects (5). 


To my knowledge Methylation Testing (MTHFR) is not part of standard pregnancy testings in the USA.









2. You May Need to Take Multiple Vitamins a Day 

There are prenatal vitamins that require you to take more than one pill a day. This isn’t a negative thing because our bodies have a limit to the nutrients that can be absorbed in single sittings; however, be mindful of the serving size and decide what is realistic for you. 


Serving Size: 4 Tablets



Serving Size: 6 gummies



You can find out how many pills, gels, or gummies you need to take by referring to the top left side of the label.



3. Most Gummy Vitamins Don’t Have Iron

Gummy vitamins are colorful, easy to swallow, and may even taste better than some of the horse-sized vitamins on the market; however, they often do not have iron.


This matters because iron plays an essential role in healthy red blood cell production and is needed to make hemoglobin, a protein that transports oxygen through the blood and lungs to our tissues. 




During pregnancy when our blood volume increases by up to 50 percent, we need double the iron that we did pre-pregnancy and this is why pregnant women are at increased risk of iron deficiency anemia (6). 




Before you jump for joy because you think that a prenatal vitamin without iron means no constipation, this is a friendly reminder that iron is important for you and your developing baby. Have a chat with your doctor, midwife, or nurse to find out exactly what you need. 


Some women benefit from taking an iron supplement separate from a prenatal because calcium and iron compete for absorption.



    • Vitamin C helps your body absorb iron.
    • Cooking in iron pots can add iron to your meals. 


Here you can find a list of foods high in iron.









4. There Are some Pills That Are Easier to Take on an Empty Stomach

Morning sickness (sometimes, all day sickness) can be a real challenge for some women. If this is the case for you, a prenatal supplement that can be taken on an empty stomach may be helpful. 


Also, there are vitamins that have ginger and/or B6 to help ease your discomfort.








Honestly, trial and error may be how you find out which prenatal vitamin works best but if you know you’re having difficulty keeping anything down you can try a soft-gel or a gummy vitamin (taking into consideration the missing iron). Talk it over with your medical provider.



5. Other  vitamins and minerals you’ll want to have in your prenatal vitamin:

  • Folate (see #1)
  • Iron (see #3)
  • Iodine 
  • Magnesium 
  • Vitamin C
  • Zinc
  • Vitamin A
  • Vitamin D3
  • Calcium
  • Vitamin E
  • DHA
  • Vitamin B12 (methylcobalamin
  • Selenium


See my post about healthy foods to eat when pregnant to learn where you can get many of these nutrients in your diet. 



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  1. Link, R. (2018). 15 Healthy foods that are high in folate (folic acid). Healthline. https://www.healthline.com/nutrition/foods-high-in-folate-folic-acid#section16
  2. Panzavolta G., Scaglione, F. (2014). Folate, folic acid and 5-methyltetrahydrofolate are not the same thing. Xenobiotica. https://www.ncbi.nlm.nih.gov/pubmed/24494987
  3. Bell, S.J., Greenberg, J.A. (2011). Multivitamin supplementation during pregnancy: Emphasis on folic acid and l-methylfolate. Obstet Gynecol. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3250974/
  4. Leech, J. (2018). L-Methylfolate (5-MTHF): Your Must-Read Beginner’s Guide. https://www.dietvsdisease.org/l-methylfolate-5-mthf/
  5. National Institutes of Health. Folate. https://ods.od.nih.gov/factsheets/Folate-HealthProfessional/#en24
  6. The Mayo Clinic. Iron deficiency anemia during pregnancy: Prevention tips. https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/anemia-during-pregnancy/art-20114455