Do I Need Prenatal Vitamins?

Do I need prenatal vitamins? Salad vs pills.
Do I need prenatal vitamins if I eat healthily? What is the best prenatal vitamin for me?

Often, I am asked by pregnant women, “Do I need prenatal vitamins? What is the best prenatal vitamin for me?” The women who ask me this question do so for a variety of reasons. Sometimes, women who know about good nutrition during pregnancy and are conscious of keeping a wonderful diet wonder if they need the nutrients supplied by the prenatal vitamins in addition to their healthy diet. Other pregnant women have morning sickness / pregnancy nausea and prenatal vitamins trigger their nausea. Some women find that multivitamins cause constipation. I also speak with women who are concerned that standard prenatal vitamins aren’t manufactured to the high standards they have for themselves and their babies. And some pregnant moms cannot swallow pills without triggering the gag reflex.

While a prenatal vitamin should not be considered a replacement for a great diet, for most women it is beneficial to take a prenatal vitamin. Prenatal vitamins aren’t perfect, and I understand women who have concerns. With trial and error, or some good advice, most women are able to find a prenatal vitamin that works for them!

The Best Prenatal Vitamin

Many women want to know which is the best prenatal vitamin. My suspicion is that the “best” prenatal vitamin is unique to each woman, depending on her specific needs. I have called a number of companies to ask about the testing they have done to verify the effectiveness of their prenatal vitamin. To my surprise, none of the companies I have called have research of this type behind their vitamins – including the companies that talk a lot about research in their marketing, such as Garden of Life and New Chapter. Everyone I called referenced the same research, primarily studies on the importance of specific nutrients during pregnancy.

This means that basically every reputable vitamin contains the recommended nutrients in the recommend quantities. The additional ingredients and the quality of the source of each nutrient vary greatly from vitamin to vitamin, and these differences likely do have a big impact on how effective the vitamin will be in your body, but there is no research that has tested this difference. So you will need to be your own investigator when it comes to finding the best prenatal vitamin for you. How do you feel about the extra ingredients? Are there fillers or artificial ingredients in your vitamin that bother you? Do the extra ingredients add value or cause harm? It may be necessary to call the manufacturer and discuss things with your doctor or an herbalist to answer these questions. Most importantly, pay attention to how you feel after a few days. Is your energy improved? Discomforts lessened? If you feel good, chances are your vitamin is working well for you.

Here are a few prenatal vitamins that have worked for some of my clients who were not able to take standard vitamins:

Best Prenatal Vitamin for Women With Nausea

The New Chapter Perfect Prenatal has worked well for women who become nauseous after taking standard prenatal vitamins. These vitamins avoid unhealthy fillers found in vitamins that are difficult for some women. They also contain probiotics and other digestive support. Three pills per day are recommended, but they can be taken with or without meals, and spaced throughout the day or taken all at once.

A Single Tablet Prenatal Vitamin

The Rainbow Light Prenatal One is preferred by many because you only need to take one tablet daily. It is a fairly large pill. It contains botanical enzymes that help with digestion.

Can’t Swallow Prenatal Vitamins? Take A Liquid Prenatal!

Liquid vitamins are a wonderful option for people who struggle to swallow prenatal vitamins. Some in the natural health community rave over liquid vitamins in general, claiming better absorption. The Prenatal Plus DHA from Buried Treasure combines a multivitamin with DHA, an additional supplement that is wonderful for pregnancy.

Do I need prenatal vitamins if I already eat a well-balanced diet?

Vitamins are an inferior source of the nutrients you need, compared to fresh foods, because they are harder for the body to use, and they do not contain phytochemicals, enzymes, and other benefits of whole foods. While it is challenging to know if our diet meets our nutrient needs, it is possible to calculate, and with an excellent diet, a prenatal vitamin is not necessary. If you are considering opting out of prenatal vitamins, I recommend you track your daily intake of nutrients closely with a pregnancy food log.

In addition to meeting these recommendations for a balanced diet, be sure to include dark leafy greens and citrus everyday as well as a wide variety of whole grains, nuts and seeds, legumes and fish, or sea vegetables weekly. Do not skimp on nutrients! Women who don’t take prenatal vitamins intentionally often add an herbal infusion of Red Raspberry and Nettles for vitamins A, D, K and calcium, potassium, and iron, as well as seaweed and sea salt for trace minerals, both now and while breastfeeding. Adequate folic acid is preventative for birth defects. If you are not certain you are taking in 400-800mcg of folic acid every day supplement your folic acid to prevent birth defects.

Whether or not you are taking a prenatal vitamin, nutrients can affect your blood pressure and risk level for conditions such as pre-eclampsia, and enhance hormone balance and fetal growth. Your body will do its best to provide your baby with the nutrients your baby needs, but if they are not coming from your diet they will come from the stores in your bones, which increases your risk of osteoporosis and other health concerns in the years when you want to be enjoying your grand-babies! Take care to assure you give your body and your baby the nutrients you need.

What about Iron and Calcium?

Because the blood volume increases, the concentration of iron in the blood does go down during pregnancy. This is part of the healthy physiological changes of pregnancy and should not be considered true anemia. Anemic women will experience symptoms such as fatigue. Floridix is a wonderful herbal iron supplement that doesn’t cause constipation and raises iron levels in most women.

The body’s demand for calcium does increase significantly during pregnancy, but there are physiological changes that provide for this need. There is hyper absorption of calcium, renal conservation of calcium and temporary liberation of calcium from the skeletal system. In a well nourished woman, the amount of calcium released from bone does not create risk for osteoporosis later in life, but getting enough calcium postpartum to replenish these stores is important. A big increase in calcium intake is not necessary unless you are experiencing symptoms such as leg cramps or an inability to release muscle tension. Adequate dietary intake of calcium will usually suffice.

Are there additional supplements I should take?

Working closely with your midwife, doctor, or someone else well educated about nutrients and herbs can help you make decisions about additional supplements during pregnancy. DHA is beneficial for nearly all unborn babies pregnant women. It supports brain and eye health, as well as healthy hormone production.  Vitamin D is another important supplement if your levels are low or your prenatal multivitamin is not sufficient for you. Vitamin C in pregnancy has been shown to decrease the rates of premature rupture of membranes. There are many other vitamins, minerals, herbs, and homeopathic remedies that may be beneficial or helpful for you, but deciphering deficiencies is a very individual matter.

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References

Daub C, Daub H. Common Sense Nutrition.  Birth Works Press; 2000.

Arnold SM, Lynn TV, Verbrugge LA, Middaugh JP. Human biomonitoring to
optimize fish consumption advice: reducing uncertainty when evaluating
benefits and risks. American Journal of Public Health. 2000;95(3):393-397. doi:10.2105/AJPH.2004.042879.

Prentice A. Calcium in pregnancy and lactation. Annual Review of Nutrition. July 2000;20:249-272. doi:10.1146/annurev.nutr.20.1.249.

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