What Are Prenatal Vitamins & Do You Really Need To Take Them?

Quick Health Scoop

• Prenatal multivitamins support the nutrient needs of both mom and baby throughout the entire pregnancy^†
• Most prenatal multivitamins provide essential vitamins and minerals for baby’s healthy growth and development, including folic acid, Vitamin A, Vitamin B12, Vitamin D, calcium, and iron^†
• What are prenatal vitamins good for? Because baby develops in different ways during the nine-month gestation period, it’s important to take a prenatal multivitamin daily throughout pregnancy, and for those trying to conceive, it’s best to start taking one even before conception

Unless your healthcare professional advises otherwise, it is a resounding, “YES” that you should be taking a prenatal supplement. Growing a little human takes a lot of work! That’s why it’s critically important for women who are pregnant (or even thinking about becoming pregnant) to eat a balanced, healthy diet—and take a prenatal multivitamin every day. In fact, prenatal multivitamins support the nutritional needs of both the developing baby and the expecting mother.^†

But what are the most important prenatal vitamins and minerals needed during pregnancy? What do prenatal vitamins and minerals do during pregnancy? And what trimester are prenatal vitamins and minerals most important?

Dig in to learn more about the importance of all the vitamins and minerals needed from when you are trying to conceive to all the trimesters of pregnancy.

Are Prenatal Multivitamins Really Necessary and Why are They so Important?

Even if you think you’re eating super healthy, you should still supplement your diet with a prenatal multivitamin every day—ideally, you should start taking prenatals before you even conceive and continue through the entire pregnancy. But do you need prenatal vitamins? YES! Taking a prenatal multivitamin every day is so crucial to help support a baby’s healthy growth and development that most physicians recommend them to pregnant women. Why? Because they help fill in any nutritional gaps that may be missing from your diet, especially because some vitamins and minerals have higher intake recommendations during pregnancy. Considering that approximately 50% of pregnancies are unplanned, according to the United Nations Populations Fund, it is important to be prepared. Taking a prenatal multivitamin supports the health of both mom and baby.^†

When Should I Start Taking a Prenatal Multivitamin?

If you are trying to conceive, the best time to start taking a prenatal multivitamin is right away. Why? Because you want to make sure your body has enough of the key nutrients in a prenatal multivitamin to support the growth and development of your baby even before you know you are pregnant.^†

Over nine months, the baby grows at a rapid pace while mom changes along with baby’s development. Pregnancy places higher nutrient demands on the body, since mom must meet the nutritional needs of a growing baby without sacrificing her own nutrient requirements. But what are the most important nutrients needed during pregnancy? What vitamins and minerals are in prenatal multivitamins? Certain nutrients are vital both before and during pregnancy, including the following:

• Folic Acid: Also known as vitamin B9, folate is the natural food form found particularly in leafy-green vegetables and legumes. Folic acid is the synthetic form used in fortified foods and in supplements. Folic acid is needed in adequate amounts at the very beginning of pregnancy – before the 28th day of gestation – which is when the neural tube is formed, which becomes baby’s central nervous system.¹ Healthful diets with adequate folate/folic acid may reduce a woman’s risk of having a child with a brain or spinal cord defect. In fact, the US Public Health Service recommends that every woman capable of becoming pregnant take 400 mcg per day to prevent neural tube defects.² Once you are pregnant, the daily recommendation is 600 mcg/day.³ However, it’s hard to get this amount from foods alone, and a prenatal multivitamin will cover the recommended amount. 
• Calcium and Vitamin D: Calcium and Vitamin D are both essential nutrients for fetal skeletal development, helping the baby build healthy, strong bones. Calcium requirements during pregnancy and lactation are 1,000 mg/day for women ages 19+ years and 1,300 mg/day for adolescent women ages 14–18 years.⁴ Without enough daily calcium intake, it is sacrificed from the mother’s bones to support the rapid growth of the baby. Vitamin D helps improve calcium absorption and also independently provides bone mineral support functions. The vitamin D requirement during pregnancy and lactation is 15 mcg (600 IU)/day for bone health, but is likely higher according to Vitamin D experts and the Endocrine Society and more like 37.5 – 50 mcg / 1,500–2,000 IU daily to maintain serum vitamin D levels in the healthy range.^{5, 6} If you don’t consume at least 3 servings of dairy per day (from yogurt, milk and cheese), you may need to take an additional calcium supplement as well as a prenatal multivitamin.^†
• Iron: An essential mineral, iron is utilized by red blood cells to help carry oxygen to organs, tissues and baby. Women’s iron needs during pregnancy substantially increase to support their increased blood volume and red blood cell formation, as well as the healthy growth of their baby.† The recommended iron intake during pregnancy is 27 mg/day.⁷ Low maternal iron status during pregnancy has been associated with increased risk of low birth weight, preterm delivery and other adverse outcomes.⁸
• Iodine: Iodine is an essential mineral, important for normal thyroid function.^7† Iodine is found in the diet mostly from iodized salt, seafood and dairy, however, increased consumption of processed foods, along with trends of non-iodized salt (like sea salt), has led to a decrease in dietary iodine intake and status in American women of childbearing age.⁹ The recommended daily intake for iodine is 220 mcg/day during pregnancy.⁷ The American Academy of Pediatrics recommends a prenatal supplement with 150 micrograms of iodine daily, along with using iodized table salt to cook during pregnancy.
• DHA: Docosahexaenoic acid (DHA) is a polyunsaturated omega-3 fatty acid mainly supplied to the diet from marine-based sources such as salmon, tuna, and sardines. Research demonstrates that DHA helps support the healthy growth and development of the baby’s brain, eyes and nervous system.^{10, 11} Professional organizations, such as the Perinatal Lipid Intake Working Group, European Food Safety Authority, and International Society for the Study of Fatty Acids and Lipids recommend pregnant and breastfeeding women consume at least 200 mg of DHA daily. Fatty fish are excellent dietary sources of omega-3 fatty acids. Women of child-bearing age, pregnant women and breastfeeding mothers are advised to consume 8–12 ounces (2–3 servings) of lower-mercury fish every week, according to the latest dietary guidelines for Americans.¹² If you don’t meet these recommendations from food alone, a prenatal multivitamin with DHA can help bridge nutrient gaps.^†
• Choline: While pregnant women can make choline in small amounts in their body, dietary intake is required to support health.¹³ Choline is important for fetal brain development.¹⁴ Pregnant women transfer large amounts of choline to their baby via the placenta, placing an increased demand on maternal choline stores during pregnancy.¹⁴ Good sources of choline include eggs, meat, and seafood.^†

What You Should Know About Taking Prenatal Vitamins

Pregnant women often ask common questions about taking prenatal multivitamins. Here are a few:

Q: What happens if you miss a day of prenatal vitamins? 

A: While skipping one day of taking a prenatal multivitamin is not a need for concern; however, missing several days could lead to decreases in key nutrients. Take the prenatal multivitamin at your next meal, but no need to take more than one serving per day. 

Q: Should you take prenatals in the morning or night?

A:  It’s best to take your prenatal multivitamin with a meal, because most vitamins and minerals absorb best with food, especially those containing some fat. Whether you choose to take your prenatal with breakfast, lunch or dinner, it is up to you! To make it easier to remember, take your supplements at the same time every day to establish this healthy habit. If breakfast works best, great! If not, take your prenatal at lunch or dinner. 

Learn More: When is the Best Time to Take Vitamins?

Q: Can you take other multivitamins and prenatal multivitamins together?

A: Prenatal multivitamins are multivitamins, but they’re specially formulated to meet the nutrition needs of pregnant women. Talk with your doctor before taking any other supplements. You do not want to go over the upper limit of certain vitamins or minerals.

Q: Can I just take folic acid instead of prenatal vitamins?

A: No. As mentioned above, once you become pregnant, both you and your growing baby need many essential vitamins and minerals, as well as DHA and choline, for healthy growth and development throughout pregnancy. 

Q: Are gummy prenatal vitamins effective? 

A: Many women like taking gummy vitamins because they’re easy to use and taste good. Just keep in mind that many gummy multivitamins, including prenatal gummies, may not contain many of the minerals needed during pregnancy, like calcium and iron. You may need to take an additional supplement with those minerals. 

Q: Can you get too many nutrients when you’re pregnant?

A: Taking too much of a certain vitamin or mineral can be harmful, especially if you’re pregnant. For instance, extremely high levels of Vitamin A (retinol) can cause birth defects in early pregnancy.¹⁵ A prenatal multivitamin provides key nutrients a pregnant woman needs throughout pregnancy in safe amounts.

Taking Prenatal Multivitamins In Every Trimester

Baby develops and grows differently in each trimester—and mom’s body changes to accommodate the pregnancy. Because your nutrient needs increase during pregnancy, you’ll need extra calories (from nutritious food) along the way. Here’s a quick overview of what happens to mom and baby over nine months:

• First trimester: This is the most crucial time of baby's development when the body structure and organ systems develop. 
• Second trimester: Baby’s muscles and bones begin to develop, and all essential organs have formed.¹⁶ Mom usually needs about 340 extra calories a day during this time.
• Third trimester: Baby will grow and gain weight, as bones harden, and skin becomes thicker. DHA has been accumulating in the baby’s brain and eyes during the third trimester.¹⁷ Mom might need about 450 extra calories a day. 

The Bottom Line

What are prenatal vitamins and minerals and what are they good for? They’re your nutritional support when you’re pregnant. Do you have to take prenatal vitamins the whole nine months? Yes! They ensure that, as you face increased nutritional demands, both you and your baby get all the essential vitamins and minerals, as well as DHA, you need at every stage. Prenatal vitamins contain a special formulation for pregnant women, including folic acid, calcium and, Vitamin D, iron, iodine, DHA and choline. Once baby is born, consider taking postnatal multivitamins—especially if you’re breastfeeding.

Continue to check back on the Nature Made blog for the latest science-backed articles to help you take ownership of your health.

Learn More About Vitamins for Women:

• What Vitamins Should Women Take Daily?
• Vitamins for Women Over 50
• Taking Vitamin C During Pregnancy

† These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.

References 

1. Scholl TO, Johnson WG. Folic acid: influence on the outcome of pregnancy. Am J Clin Nutr. 2000;71(5 Suppl):1295S–1303S. 
2. Folic acid for the prevention of neural tube defects: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2009;150(9):626-631
3. Food and Nutrition Board, Institute of Medicine. Folate. Dietary Reference Intakes: Thiamin, Riboflavin, Niacin, Vitamin B6, Folate, Vitamin B12, Pantothenic Acid, Biotin, and Choline. Washington, D.C.: National Academy Press; 1998:196-305.
4. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. National Academy Press. Washington, D.C. 2010. 
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8. Iron status during pregnancy: setting the stage for mother and infant. Am J Clin Nutr. 2005;81:1218–1222.
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10. Cetin I, Koletzko B. Long-chain omega-3 fatty acid supply in pregnancy and lactation. Curr Opin Clin Nutr Metab Care. 2008;11:297– 302. 
11. Koletzko B, Lien E, Agostoni C, et al. The roles of long-chain polyunsaturated fatty acids in pregnancy, lactation and infancy: review of current knowledge and consensus recommendations. J Perinat Med. 2008;36(1):5–14.
12. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at DietaryGuidelines.gov.Mun JG, Legette LL, Ikonte CJ, Mitmesser SH. Choline and DHA in Maternal and Infant Nutrition: Synergistic Implications in Brain and Eye Health. Nutrients. 2019;11(5):1125.
13. Mun JG, Legette LL, Ikonte CJ, Mitmesser SH. Choline and DHA in Maternal and Infant Nutrition: Synergistic Implications in Brain and Eye Health. Nutrients. 2019;11(5):1125.
14. Zeisel SH. Nutrition in pregnancy: the argument for including a source of choline. Int J Women’s Health. 2013;5:193-199.
15. Food and Nutrition Board, Institute of Medicine. Vitamin A. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, D.C.: National Academy Press; 2001:65-126
16. Beth Israel Lahey Health Winchester Hospital. “Fetal Development by Trimester.” 2021. Accessed on: April 30, 2021. https://www.winchesterhospital.org/health-library/article?id=101070
17. Penn Medicine Lancaster General Health. “Everything You Need to Know About Prenatal Vitamins.” 2021. Accessed on: April 30, 2021. https://www.lancastergeneralhealth.org/health-hub-home/motherhood/getting-pregnant/everything-you-need-to-know-about-prenatal-vitamins