by dr kotb and his team
If you’re pregnant or trying to become pregnant, you should first talk to your doctor about your dietary needs. But if your doctor recommends prenatal vitamins, we have some suggestions. We surveyed the ingredients labels of 67 over-the-counter brands, and then talked to a panel of doctors to find out what to look for in the best prenatal vitamin. The answer: a safe and effective amount of folate, a few key nutrients, plus a third-party to vet it — so you actually know what you’re taking.
How We Chose the Best Prenatal Vitamins
All the good stuff
We talked to three doctors to determine what nutrients were most essential in a prenatal vitamin. All our top picks include:
- Folate or folic acid to prevent neural tube defects in the developing fetus
- Vitamin A (in the form of beta-carotene) to help the baby’s organs and bones develop, and to aid in the repair of the mother’s tissue post delivery
- Iron to boost production of maternal blood volume
- Calcium for bone health in both baby and mother
- Iodine to aid in the brain development of the fetus
- Vitamin D to aid in fetal development and help prevent preeclampsia
- Vitamins B12 and B6 for a healthy fetal nervous system
Ingredients in safe amounts
Talk to your doctorWhen planning your folate intake, keep in mind that you probably get some folate from your diet, especially leafy greens, beans, fruits, and grains. Your doctor can help you determine how much additional folate you need.
We required baseline levels of folate, an ingredient with particularly strong evidence to support its importance during pregnancy. However, recent research has changed the conversation about folate intake. The short version: Research shows that folic acid is absorbed about 70 percent better than folate. We did the math to convert folic acid amounts to their folate equivalents, and only included vitamins with a minimum of 400 micrograms of folate, as recommended by the CDC. We also capped acceptable folic acid levels at CDC’s tolerable upper limit for pregnant women: about 1,000 micrograms. For more information on folate intake, the National Institutes of Health have a detailed (if a little jargon-heavy) folate information page.
None of the bad stuff
Some ingredients have no place in a prenatal vitamin. We made sure our picks didn’t have:
- Vitamin A retinoids, because too much vitamin A from retinoids (found in meat, dairy, and eggs) can put a fetus at risk for birth defects. Vitamin A deficiencies are rare, since the food we eat is jam-packed full of this important nutrient; this is one area where you can afford to be choosy.
- Junk ingredients like artificial coloring or ingredients that are potentially toxic, including titanium dioxide, carmine, butylated hydroxytoluene, benzoic acid, PEG 3350, talc, and magnesium silicate.
Prenatal vitamins are classified as a supplement and aren’t subject to approval by the FDA (though, the agency does provide manufacturing standards). Just like with other vitamins and supplements, there is very little oversight for manufacturers — and no guarantee that you’re actually getting what the label promises.
We only included products with third-party certification from an organization like LabDoor or NSF — independent testing companies that check to see whether the ingredients in a supplement match what’s on the label.
Easy to swallow
Pregnancy isn’t the time for experimenting with your gag reflex. We examined these vitamins ourselves to make sure they didn’t smell bad or require swallowing a huge pill.
All our picks are available over-the-counter from most major retailers, like Amazon, GNC, and Whole Foods.
The 3 Best Prenatal Vitamins
- The Honest Company Prenatal Multivitamin –Best Comprehensive Prenatal
- Deva Vegan Prenatal Multivitamin –Best Prenatal for Low-Folate Diets
- Garden of Life myKind Organics Prenatal Multi –Best Food-Based Prenatal
Why we chose it
Every essential ingredient
This capsule contains 650 mcg of folate, which is a high dose without going near the daily recommended maximum. And if you need a little more iron, calcium, or iodine in your system, The Honest Co. has 27 mg of iron, 200 mg of calcium, and 200 mcg of iodine — more than our other top picks.
If vitamin D is a concern for you, The Honest Company Prenatal Multivitamin has plenty: 1,400 IU, verified through Labdoor’s third-party testing. Our bodies produce vitamin D naturally when exposed to sunlight, but a 2009 study published in Scientific American shows at least three-fourths of American teens and adults are still vitamin D-deficient. One study suggests women take a whopping 1,000-2,000 I.U. of vitamin D a day, but most prenatals don’t have those high levels.
+1 extra credit nutrient
Like Deva, this prenatal vitamin also contains a bit of choline (30 mg to Deva’s 50). Again, that’s not enough to truly be effective, but it’s more than Garden of Life’s zero. Overall, the Honest Company’s prenatal really loads up on all the essentials.
The Honest Co. adds natural vanilla to its prenatal vitamins for flavor. The immediate aftertaste is surprisingly pleasant as a result. Amazon reviewers were split on whether this is a pro, though: Some found the vanilla flavor not to be very gentle for those suffering morning sickness. For others, the vanilla hint was the only way they could get it down. Either way, don’t let it sit on your tongue; the coating does come off and reveals a salt-water fishy taste.
Points to consider
This pill’s the largest of our picks at a bit wider than a quarter. If you know swallowing pills is tough for you, consider Deva’s littler tablets instead.
A bottle of 30 supplements costs $20 — that’s $0.66 per tablet, or six times the price of each Deva vitamin.
Why we chose it
Every necessary nutrient
Deva’s Vegan Prenatal Multivitamin had every nutrient we were looking for, plus it was third-party tested, had no artificial sweeteners, and contained safe and effective levels of folic acid. That last part is rarer than it might sound: The research around folic acid being absorbed at higher concentrations than folate pushes many supplements over the upper tolerance level of 1,000 mcg DFE. However, Deva’s conversion managed to maintain that safe-but-effective balance at 935 mcg. Among the products that met our requirements, this was easily the most folate equivalent without going over the maximum recommended amount, making it great for women who get very little folate in their diets.
+1 extra credit nutrient
Deva Vegan Prenatal Multivitamin had the most choline of the supplements that passed our criteria. Choline has only recently gained traction as an important nutrient during pregnancy, and most supplements don’t include it yet. Though Deva’s 50 mg of choline isn’t quite enough to make a significant impact, any at all is a bonus.
Deva offers those nutrients at a cheaper price than either of our other picks. A bottle of Deva’s supplement is only $10 for 90 servings ($0.11 per serving), which means $50 will get you about 15 months worth of Deva Vegan vitamins (perfect for continuing supplements during lactation.)
The tablets are the smallest of our top picks — smaller than a quarter — and you only have to take one pill per day.
Points to consider
High folate levels
The amount of daily folate equivalent in Deva (935 mg) is near the tolerable upper limit recommended by the CDC (1,000 mg). So, if you eat a lot of folate-rich foods (leafy greens, beans, fruits, and grains), Deva might put you over that threshold. If you have a folate-heavy diet, we recommend The Honest Company’s prenatal vitamin, which contains less folate (650 mg) and is less likely to put you over the recommended limit.
Insufficient vitamin D
Third-party testing company Labdoor found Deva’s prenatal to carry 85% less vitamin D than the label claims — only 60 IU, instead of 400. But we feel that Deva’s overall nutritional benefits — particularly when it comes to folate and choline — were still worth recommending. If you live in a sunnier area or already take a vitamin D supplement, Deva is the best prenatal multivitamin. For those who want to prioritize vitamin D, The Honest Company Prenatal Multivitamin passed Labdoor’s vitamin D label claim testing with 1,000 IU.
Tastes like medicine
You’ll want to swallow these tablets quick: As their coating wears off, a bile-heavy after-taste seeps in. Still, we’d take a small, bad-tasting tablet over a big horse pill any day. And remember, you only need one per day.
Why we chose it
Every essential ingredient
As our only fully food-based recommendation, Garden of Life is great for people who prioritize organics and food-sourced nutrients. You’ll get all the recommended nutrients while maintaining your dedication to all things natural. Keep in mind, though, that natural nutrients doesn’t mean more nutrients: Compared to our other top picks, Garden of Life has less folate (800 mcg), calcium (15 mg), and iron (18 mg).
Garden of Life uses only food-based ingredients, with the source of each listed on the label: Its folate is derived from organic broccoli, and its vitamin C comes from organic lemon. The vitamin is also organic, vegan, and gluten free. Food-based vitamins are often claimed to be easier on your stomach and healthier because they’re derived from natural sources; however, there isn’t conclusive evidence proving they’re superior to vitamins with nutrients created in a lab. If these kinds of supplements give you peace of mind, though, Garden of Life is your best bet for food-based prenatal vitamins.
Points to consider
Garden of Life is our only pick that requires you take three tablets daily. Especially since they’re quarter-sized, we could see the routine of downing one of these grassy-tasting tablets with every meal
getting old pretty quickly.
A bottle of 180 tablets for $80 means that each tablet costs $0.44 (less than The Honest Co.’s supplements), however, you’ll be taking three per day. So your ultimate daily cost will be much higher than either of our other recommendations (about $1.33/day).
How to Find the Right Prenatal Vitamin for You
Always consult with your doctor
Every woman has unique nutritional needs. Some need more iron than others, while others need more calcium. If you live in a cloudy area or really slather on the sunscreen, you might need a higher dosage of vitamin D. The best way to know what’s best for you is to talk to your doctor.
Don’t rely on a vitamin alone for nutrition during pregnancy
Our expert panel emphasized the fact that prenatal vitamins can’t completely compensate for a poor diet during pregnancy. Good supplements supplement healthy eating habits and conscientious nutrition.
Dr. Scott Sullivan, an associate professor at the Medical University of South Carolina told us, “Some people need even more supplementation; other people need to pay attention their diet as well.”
Prenatal Vitamin FAQ
Do I really need to take a prenatal vitamin?
Every doctor we talked to unanimously agreed: Taking a prenatal vitamin regularly before and during pregnancy is a smart idea. It can only help reduce the risk of birth defects and improve your own health during pregnancy.
But what about the study that said they’re unnecessary?
A 2016 study published in the journal Drug and Therapeutics Bulletin concluded that only folic acid and vitamin D are necessary in supplement form for growing fetuses; our experts questioned the research.
“While I think it was a nice review, it wasn’t really a study,” Dr. Sullivan told us. “There wasn’t any new data … it was an opinion piece.”
Why is folate so important?
Inadequate folate levels early in pregnancy can lead to neural tube defects, which sometimes result in infants being born with paralyzed legs or improperly formed skulls, among other problems. Doctors and researchers widely agree that pregnant women and women trying to conceive should take folate (or its synthetic alter ego, folic acid) in supplement form.
How can I work more folate into my diet?
Folate exists naturally in leafy green vegetables (brussels sprouts have some of the highest folate levels of any food) as well as fruit, grains, beans, and some dairy products. Folic acid is also added to most breads, grains, pasta, and cereals manufactured in the US, following a 1998 government mandate aimed at improving general public health.
When should I start taking prenatal vitamins?
Neural tube defects happen during the first month of pregnancy, when a fetus is in the earliest stages of development. Since it’s critical to have sufficient levels of folic acid during those first weeks of pregnancy, doctors recommend women start taking a daily prenatal vitamin one or two months before trying to conceive (this includes undergoing in vitro fertilization).