Your Guide to Pregnancy: Prenatal Vitamins

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Prenatal Care

Your First Visit Estimating Your Due Date Prenatal Vitamins When to Call Your Doctor

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What Are Prenatal Vitamins?

For a mother's health, and the health of her baby, she is advised to take so-called "prenatal vitamins." These are specially formulated multivitamins that make up for any nutritional deficiencies in the mother's diet during pregnancy. While the supplements contain numerous vitamins and minerals, their folic acid, iron, and calcium content are especially important.

Why Do Pregnant Women Need High Levels of Folic Acid, Iron and Calcium?

Folic acid can reduce your risk of having a baby with a serious birth defect of the brain and spinal cord, called the "neural tube." A baby with spina bifida, the most common neural tube defect, is born with a spine that is not closed. The exposed nerves are damaged, leaving the child with varying degrees of paralysis, incontinence, and sometimes mental retardation.

Neural tube defects develop in the first 28 days after conception, before many women realize they are pregnant. Because about half of all pregnancies are unplanned, the U.S. Public Health Service recommends that all women of childbearing age get 400 micrograms of folic acid each day. In fact, the FDA now requires that all flour products, such as breads, buns and bagels, be fortified with extra folic acid. Women who have had a prior child with a neural tube defect should discuss with her doctor before her next pregnancy about the appropriate dose of folic acid. Studies have shown that taking a larger dose (up to 4,000 micrograms) at least one month before and during the first trimester may be beneficial.

There are natural sources of folic acid: green leafy vegetables, nuts, beans and citrus fruits. It's also found in many fortified breakfast cereals and some vitamin supplements.

Calcium during pregnancy can prevent a new mother from losing her own bone density as the fetus uses the mineral for bone growth.

Iron helps both the mother and baby's blood carry oxygen.

While a daily vitamin supplement is no substitute for a healthy diet, most women need supplements to make sure they get adequate levels of these minerals.

Are All Prenatal Supplements the Same?

No, they're not. Look for one that contains approximately:

• 4,000 and 5,000 IU (international units) of vitamin A
• 800 and 1,000 mcg (1 mg) of folic acid
• 400 IU of vitamin D
• 200 to 300 mg of calcium
• 70 mg of vitamin C
• 1.5 mg of thiamine
• 1.6 mg of riboflavin
• 2.6 mg of pyridoxine
• 17 mg of niacinamide
• 2.2 mcg of vitamin B-12
• 10 mg of vitamin E
• 15 mg of zinc
• 30 mg of iron

Your doctor or midwife can also advise you on certain brands. In some cases, your health care provider will give you a prescription for a certain type of prenatal vitamin.

My Prenatal Vitamin Makes Me Nauseous, What Should I Do?

Some prenatal vitamins can cause nausea in an already nauseous woman. If your prenatal vitamins make you sick, talk to your health care provider. He or she may be able to prescribe a different kind of prenatal vitamins (for example, chewable vitamins as opposed to those you swallow whole may be better tolerated by some women).

Reviewed by The Cleveland Clinic Birthing Services and the Department of Obstetrics and Gynecology.

Edited by Tracy Shuman, MD, November 2005, WebMD.

SOURCE: The March of Dimes.