Prenatal vitamins: When should you start and how to choose

One of the things most people who are planning a pregnancy or just got pregnant often wonder is: when should I start taking prenatal vitamins, and do I even need to take them? While there is a lot of conflicting information about supplements, it’s widely accepted that taking certain vitamins and minerals (such as in prenatal supplements, like Perelel's Conception Support Pack and 1st Trimester Prenatal Pack) can help support a healthy pregnancy [1].

When should you start taking prenatal vitamins?

You want to consider starting to take prenatal supplements:

When you decide to try for a pregnancy

Everyone’s fertility journey is different, and how long it takes to get pregnant varies from person to person, so you want to focus on supplements, as well as other preconception care, as soon as possible [1]. Guidance on taking prenatal supplements prior to pregnancy varies, but many doctors recommend taking supplements well in advance of conception. 

"Anyone considering pregnancy in the 12 months before trying to conceive should add a prenatal vitamin—or a targeted Concept Support vitamin routine—in their day-to-day," says Board-Certified Obstetrician-Gynecologist (MD),Fellow of the American College of Obstetricians and Gynecologists (FACOG), and Perelel Panelist Dr. Andy Huang. 

You might be wondering why you should bother taking supplements so early. Well, it's no secret that while pregnancy can be one of the most beautiful things you can experience, it's very demanding on our bodies. Growing a fetus into a baby requires a lot of resources, aka vitamins, nutrients, and minerals. "Your body may take time to ramp up in its readiness for pregnancy, depending on your general pre-conception wellbeing and overall health," adds Dr. Huang. By building resource reservoirs of nutrients and minerals, you'll help your body prepare to share those resources with the fetus when the time comes.

When you find out you're pregnant

If you visit a doctor and take a pregnancy test and you find out that you're pregnant, now is also a great time to start taking prenatal vitamins. While taking essential prenatal supplements is important in the early stages of pregnancy, try not to worry if you find out that you’re pregnant, but haven’t been taking your vitamins yet. Speak with your doctor as soon as possible to discuss the best options for you. 

Why are prenatal vitamins important?

"Prenatal vitamins contain minerals and co-enzymes formulated to meet the increased nutritional demands of pregnancy, supporting both the baby’s development and the mother’s needs," says Dr. Huang. They can help prevent pregnancy complications that come with micronutrient deficiencies, such as gestational diabetes and anemia, and infant health problems, such as neural tube defects [2].

Each nutrient found in a prenatal vitamin has its role. "Folate, DHA, and iodine support the baby’s brain, spine, and organ development. While iron, calcium, and B vitamins help the mother handle the increase in blood volume, bone demands, and energy needs," explains Dr. Huang.

There is also some evidence that adequate supplementation might increase fertility in women, but more conclusive research is needed to determine the effects of various mineral deficiencies on our bodies [3].

What are the most important nutrients in prenatal vitamins, especially for the first month of pregnancy?

There are tens of thousands of different supplements available on the market, which can make choosing the right supplement for you a challenging task. We're here to help.

"Not all prenatal vitamins are created equal," says Dr. Huang. "Traditional options followed a one-size-fits-all approach, but today we know that targeted formulas—tailored to each unique trimester—offer the best support for you and your growing baby." With that in mind, Perelel developed their prenatal vitamins.

When looking for which prenatal vitamins to choose, there are two things you want to pay attention to: the ingredients and the dosage. "It is important that you’re choosing a prenatal with bioavailable ingredients, meaning they are in the most absorbable format for your body to use," adds Dr. Huang.

Here are some of the key nutrients to look for in prenatal vitamins:

Folic Acid

Folic acid is a synthetic, lab-made form of folate (Vitamin B) that can be found in citrus fruits and vegetables. It helps our bodies make new cells. Folic acid is essential for the early stages of pregnancy for neural tube development. All people who can get pregnant should take 400 mcg of folic acid every day [4].

Vitamin D

Vitamin D is an essential nutrient that enables our bodies to absorb calcium, one of the main building blocks for our bones. It's also essential for good immune function. Those who are pregnant and breastfeeding need 15 mcg (600 IU) of Vitamin D daily [5].

Iron

Iron is an essential nutrient that helps transport oxygen through the blood to all parts of the body. Iron deficiency anemia affects one in six pregnant women. Supplementing during pregnancy with iron is essential because iron is important for aiding the development of the fetus during pregnancy and decreasing the risk of premature birth. Pregnant women require 27 mg of iron daily [6].

Some research indicates that >25% of people who are pregnant consume too much folic acid and iron, which can have adverse health effects [8]. Before you start taking an iron supplement during pregnancy, it’s a good idea to consult your doctor to check on your iron levels. 

Calcium

It's recommended that pregnant women who don't consume products high in calcium (such as dairy, tofu, leafy green vegetables [7]) often take calcium supplements (1.5 – 2.0g oral elemental calcium) daily to prevent pre-eclampsia, a complication of pregnancy [8]. For better calcium absorption and to prevent risks like cell damage or hardened arteries, Vitamin D should be taken with calcium [2].

Can you switch prenatal vitamins during pregnancy?

You absolutely can, and some doctors even advise this approach. "Because your nutritional needs change from preconception, throughout each trimester of pregnancy, and into postpartum, a targeted vitamin routine will give you the exact nutrients you need, when you need them," says Dr. Huang.

When it comes to switching supplements, it’s best to do this in consultation with your doctor. They can help you find the right fit for your specific pregnancy journey and can carry out blood work to understand what nutrients you may be lacking. 

So, you may end uptaking one type of prenatal in the early stages of the pregnancy, and then switch to a different formulation later in pregnancy to better support your body's needs as the fetus grows. For example, Dr. Huang recommends:

• For preconception: Focus on folate (400–800 mcg), iron, B12, and choline to prep the body and prevent early defects.
• For first trimester: Maintain high folate, but shift towards B6 and iron for nausea.
• For the second trimester: Add more iron, calcium, and vitamin D for bone growth.
• For the third trimester: Increase DHA and choline for rapid brain growth, along with more magnesium for cramps.
• For postpartum: Add extra iron if blood loss, high B vitamins for energy, DHA/choline for breastfeeding, calcium, and vitamin D for bone recovery.

Not all prenatal supplements are created equally, so if you notice some uncomfortable side effects or you believe the dosage isn't right for you anymore, speak to your doctor to find a better option for you.

How do you choose a daily prenatal?

Sadly, choosing the right daily prenatal vitamin is harder than it should be, and recent research indicates that up to 90% of pregnant women in the US may be at risk of inadequate intake of certain essential micronutrients from their diet, though this percentage varies depending on the specific nutrient and age groups. However, researchers found that over 99% of supplements available on the market don't contain the appropriate dosages of key micronutrients pregnant women need [9].

The authors of the study mentioned above suggest that the large US dietary supplement market might not meet the nutrient needs of pregnant women. The researchers reviewed over 20,000 different supplements available in the U.S. market (prenatal and non-prenatal), and they only found one supplement (not prenatal) that has all the key nutrients pregnant women need at the correct dosages [9].

Natural Cycles and Perel 

We have partnered with Perelel, the first OBGYN-founded vitamin company, to bring you in-depth, accurate, and tailored information about prenatal supplements. As pioneers in the female health space, we recognize the importance of debunking myths and providing reliable guidance on women's health. Natural Cycles users can use the code ‘NaturalCycles’ to access 20% off Perelel's doctor-designed conception support pack.* These supplements are formulated by top fertility doctors, are clinically proven to have the right ingredients at the right dosages, and even have a no-nausea formula for those who have a hard time taking supplements due to morning sickness.

What to avoid when choosing a prenatal supplement

When choosing prenatal supplements, you want to be cautious of the ingredient list. There are several additives and ingredients that are not needed and should be avoided. "Excess vitamin A (over 3,000 IU as retinol), artificial dyes, sweeteners, preservatives, non-approved proprietary blends, and gummies without iron or DHA in prenatal supplements," explains Dr. Huang.

Some ingredients in prenatal supplements can be unsafe due to their high dosage. "Avoid taking excess iodine, herbal supplements, fish oil brands that may contain mercury, or any other high dose of vitamins unless approved," says Dr. Huang.

Prenatal vitamin vs. multivitamins

The key differences between a prenatal vitamin and a multivitamin are the ingredients and dosages. Prenatal vitamins are designed with pregnant people in mind and contain key nutrients essential for a healthy pregnancy, such as folate, vitamin D, and iron. These supplements will most likely have a higher dosage of those nutrients, too. Multivitamins are designed for adults and kids and can have a very wide range of nutrients and varying dosages.

Tips for taking prenatal vitamins

If you're ready to start taking prenatal vitamins, here are some of our tips to help you make the experience better:

• Consult your doctor: Before you start taking a prenatal vitamin, always consult with your doctor about which type of supplement to take and the dosage. Having the reassurance and support from your doctor will help alleviate the stress and help you find the right supplement for you.
• Focus on nutrition: Eating a nutritionally balanced diet full of unprocessed whole foods, even if you take prenatal supplements, is key to supporting your health before, during, and after pregnancy.
• Strive for consistency: For supplements to work and for you to experience the full benefit of taking prenatal vitamins, ensure you're taking them consistently. The time of the day doesn't matter as much, but it's important to take them every day for the prescribed period.
• Listen to your body: Some prenatal vitamins might make you feel nauseous or cause other physical discomfort. Don't ignore the signs from your body — listen to these signals. Consider adjusting the dose after speaking to your doctor or finding a different type of supplement that makes you feel better. If you feel nauseous after taking a supplement, consider taking it with food or fruit juice.
• Increase your fiber intake: Taking prenatal supplements that contain iron might cause constipation [10]. If you experience constipation while taking a prenatal, one thing that can help alleviate it is increasing your fiber intake and making sure you're properly hydrating and drinking water. The recommended daily fiber intake for pregnant women is 25-35 mg. Try not to go overboard with fiber, because excess fiber might have side effects like nutrient loss and diarrhea [10]. 
• Experiment with timing: If you have severe morning sickness that makes it hard for you to take supplements, play around to see what works. "Try taking some or all of it at night instead, taking it with food, switching to a smaller supplement, or taking a prescription prenatal with added B6 to help with nausea," says Dr. Huang.

Other ways to support your pregnancy journey

While prenatal supplements can be essential to support a healthy pregnancy, vitamins alone can't produce magical results. If you're planning a pregnancy or have just found out that you're pregnant, you may want to focus on making other shifts, too. Such as positive lifestyle changes to help support a healthy pregnancy.

"Eat a balanced diet high in antioxidants, stay hydrated, exercise regularly, sleep, manage stress, limit caffeine, and avoid alcohol and tobacco," says Dr. Huang. He also highlights the importance of listening to your body when it comes to rest and movement, and attending your regular check-ups with your OBGYN.

Are there any side effects of taking prenatal vitamins while not pregnant?

The short answer is — it depends. "There is a risk of excess iron, folic acid, and vitamin A if taken daily, which can throw off your nutrient balance," explains Dr. Huang. Prenatal vitamins often have folic acid and iron, which are essential nutrients for people who are pregnant or are trying to get pregnant. However, over 25% of pregnant women exceed the maximum intake of iron and folic acid, which can cause adverse health effects [11].

Before you take any sort of supplement, you want to speak with your doctor. They can run the tests to figure out what nutrient deficiencies you have, and find the right type of supplement that fits your individual health and lifestyle needs. 

Plan your pregnancy with Natural Cycles and Perelel

Thanks for reading up on prenatal vitamins. We hope you found this article helpful. Whatever stage you’re at in your journey to planning pregnancy, Natural Cycles and Perelel are here to support you. Use code 'NaturalCycles' to access a 20% discount for Perelel’s Conception Support Pack or trimester-specific vitamins, and track the symptoms of early pregnancy or find out the best time to take a pregnancy test with the Natural Cycles app.

This offer expires Saturday, November 15th at 11:59pm PT. Save 20% for your first purchase of the Conception Support Pack, Fertility+ Support, 1st Trimester Prenatal Powder, and all Trimester Support Packs. Cannot be combined with other offers, discounts or applied to prior purchases. Limited to one use per customer and new customers only. Offer excludes gift cards, gift kits, apparel and accessories. Purchases are limited to 1 units per SKU.