The Best Prenatal Vitamins
Synthetic or Food-Based?
Price per Serving
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.
The Best Prenatal Vitamins
If you’ve looked into prenatal vitamins, you’ve probably come across some confusing and contradictory information about their benefits. Some sources claim prenatals are important for the health of your baby, while other sources suggest they’re generally unnecessary. But the experts we talked to unanimously agreed: Taking a daily regimen of prenatal vitamins will help your health as well as your baby’s.
All our prenatal recommendations include the most important nutrients — folic acid, vitamins A and D, and iron, among others — but our favorite is Deva Vegan Prenatal Multivitamin. It has the highest amount of all-important folate of our top picks, as well as choline to aid spinal cord growth. And at about 11 cents per serving, it’s significantly less expensive than our other top picks.
The Honest Company Prenatal Multivitamin was lower on folate, but right in the middle of the recommended range. And while the lower folate level meant we couldn’t recommend it over Deva, we did like The Honest Company’s higher concentrations of iron, iodine, and calcium, all packed into a naturally vanilla-flavored pill.
For a completely organic, food-based supplement, we like Garden of Life myKind Organics Prenatal Vitamin. It’s organic, vegan, gluten free and non-GMO verified. However, it is about 15 times more expensive per serving than Deva Vegan, and you have to take three pills each day. Again, the folate levels fall short of Deva’s, but if food-based ingredients are important to you, this is your best option.
Keep in mind that women have different nutritional needs. Some need more iron than others (women who are anemic, for example), while others might 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.
How We Found the Best Prenatal Vitamins
We started by compiling a list of all the over-the-counter vitamins we could find that are available from most major retailers, like Amazon, GNC, and Whole Foods. Our starting cohort of 67 brands contained both food-based vitamins (nutrients derived from food) and synthetic vitamins (nutrients created in a lab), since we wanted to find out if one was more beneficial than the other. (Spoiler alert: not really.)
We didn’t include prescription prenatals in this review. As Dr. Brian Levine, practice director at the Colorado Center for Reproductive Medicine (CCRM) New York, says, “Most prescription brands don’t add that much, even though they’re a lot more expensive. The over-the-counter brands of the major pharmaceutical chains, those tend to be really good at a low price.”
To start narrowing down our options, 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
But picking a best required some more digging.
First, we cut any product that wasn't third-party tested.
You might think the government would review any daily health supplement for pregnant women, but the reality is that 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.
Dr. Nicole Avena, author of What to Eat When You’re Pregnant, advises that women avoid vitamins that aren’t vetted and approved by an independent regulator, such as NSF International or the U.S. Pharmaceutical Convention.
“Since vitamins aren’t held to the strict standards that baby foods and other items are, you want to be sure you are buying them from a quality company that is reputable,” she said.
We cut any product without 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. This quickly cut us down to 14 products.
Then we cut any prenatal that didn’t have the recommended dosage of folate or folic acid.
Any OB/GYN will tell you that folate (or its synthetic alter ego folic acid) is a hugely important part of a woman’s prenatal diet. But it’s quickly becoming a hot-button topic as new research uncovers the negative effects of too much and too little. 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. However, too much folate can cause stomach aches, kidney failure, sleep interruption, or (in rare case) seizures, and some studies show that it may increase the risk of autism in babies.
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.
But doctors and researchers widely agree that pregnant women and women trying to conceive should take extra folic acid in supplement form to make up for any dietary gaps. “Even among people who are actually pregnant, only about 60 percent are taking folate,” said Dr. Scott Sullivan, an associate professor at the Medical University of South Carolina. “This is an instance where we can stop devastating, lifelong birth defects by just taking a vitamin — yet we fail.”
Recent research has shown that folic acid is absorbed 70% better than folate. So 800 mcg of folic acid is actually equivalent to 1,360 mcg of folate. We did the math to convert folic acid amounts to their folate equivalents, eliminating all vitamins that didn’t contain a minimum of 400 micrograms of folate, as recommended by the CDC. We also cut any that contained more than the CDC’s tolerable upper limit for pregnant women — about 1,000 micrograms.
And we looked for prenatals that contained sufficient vitamin D.
This is one area where it’s fairly clear that most pregnant women benefit from a dietary supplement. A developing fetus uses vitamin D to grow strong, healthy bones, and it helps boost the immune systems of mothers-to-be. It may also help protect against a host of pregnancy-related problems, including preeclampsia (a condition that can lead to organ failure or seizures in a pregnant woman — and could keep the placenta from getting enough blood).
Our bodies produce vitamin D naturally when exposed to sunlight, but vitamin D deficiency is overwhelmingly common in the US. According to a 2009 study published in Scientific American, at least three-fourths of American teens and adults have a vitamin D deficiency. One study suggests these women take a whopping 1,000-2,000 I.U. of vitamin D a day, but most prenatals don’t have those high levels. We cut supplements that advertised less than 400 I.U. of vitamin D. And if you think you might not be getting enough vitamin D, we’d encourage you to speak with your doctor about adding even more through another supplement if necessary.
We also checked them for other important qualities.
At this point, we were down to just three products, but we still checked them against a few final coonsiderations.
Choline: The American Medical Association recently stated that most prenatal vitamins are severely lacking in choline — a nutrient that develops the baby’s brain and spinal cord, and reduces the chance of birth defects. The CDC recommends 450 mg of choline per day, but vitamin manufacturers haven’t quite caught up to the research yet. However, you can get choline from beef, cauliflower, soybeans, milk, and peanuts. Just two egg yolks will provide 250 mg. Deva and The Honest Company earned points for containing small amounts of this important nutrient.
No vitamin A retinoids: Vitamin A is found in two forms: retinoids and carotenoids. It’s tough to get too much of carotenoids, the type of vitamin A that’s found abundantly in fruits and vegetables. But 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, so this is one area where you can afford to be choosy. None of our top picks contain retinoid forms of vitamin A.
No junk ingredients: Look at most vitamin labels and you’ll probably see line after line of words you can’t pronounce. Some of these ingredients are used as fillers or binders in pills — and while they probably won’t hurt you, they aren’t necessarily good for you either, and there are great options that don’t include any. We looked for artificial coloring or ingredients that are potentially toxic, including titanium dioxide, carmine, butylated hydroxytoluene, benzoic acid, PEG 3350, talc, and magnesium silicate. All of our top picks are free of junk ingredients.
Finally, we tried them.
We tried these vitamins ourselves to understand what it was like to actually take them. We vetted the products to make sure they didn’t smell bad or require swallowing a huge pill (pregnancy isn’t the time for experimenting with your gag reflex).
Our Picks for the Best Prenatal Vitamins
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.
Deva Vegan Prenatal Multivitamin also 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.
The tablets are the smallest of our top picks, smaller than a quarter, and really have no taste at first. But swallow quickly: As its coating wears off a bile-heavy after-taste seeps in. Fortunately, you only need to take one pill per day.
The only drawback when it comes to Deva? 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. This should have knocked it out of consideration, but we felt 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.
But Deva offered otherwise complete nutrition 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 Honest Company Prenatal Multivitamin is solid choice for pregnancy supplementation, with 600 mcg of folate. It contains both synthetic and food-based ingredients.
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. This prenatal vitamin also contains 30 mg of choline. 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.
Though this pill was the largest of our picks — a bit wider than a quarter — it adds natural vanilla for flavor. The immediate aftertaste is surprisingly pleasant as a result, but leave it in your mouth long enough for the coating to come off and you’ll get a terrible almost salt-water fishy taste. If anything, it’ll encourage a quick swallow.
The Honest Company also advertises their multivitamin as being better on sensitive stomachs, as it contains a digestive enzyme blend sourced from pineapple, kiwi, and papaya. The bottle claims you can take them even on an empty stomach, but Amazon reviewers were split. 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. If you’ve got particularly bad morning sickness, some women take their prenatals before bed.
As our only fully food-based recommendation, Garden of Life is great for people who prioritize organics and food-sourced nutrients. 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, but there isn’t conclusive evidence proving they’re superior to vitamins with nutrients created in a lab. In fact, Dr. Sullivan told us he tells his patients to take synthetic vitamins because they contain potassium iodine, which is a more stable and reliable form of iodine than those derived from natural sources such as kelp. And having natural nutrients doesn’t actually mean more nutrients: Compared to our other top picks, Garden of Life has less folate (800 mcg), calcium (15 mg), and iron (18 mg).
One serving is three tablets, which taste noticeably like grass. After taking three of these quarter sized capsules, we found it left a weird dry film in our mouths.
Our Top Picks at a Glance
Did You Know?
Yes, you should be taking a prenatal viatmin.
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, too.
However, in July 2016, a study out of the UK published in the journal Drug and Therapeutics Bulletin cast doubt on that advice.
The researchers concluded that of all the vitamins required by growing fetuses, only folic acid and vitamin D were necessary in supplement form. It resulted in a parade of news stories and handwringing blog posts questioning whether prenatal vitamins are necessary — or if they’re worth the sometimes hefty cost. The most salient question most articles asked was this: If expecting or pregnant women eat healthy diets and take folic acid and vitamin D via daily supplements, do they really need to add additional nutrients in daily pill form?
“Unless you are a die-hard foodie, I would not advise skipping it,” says Dr. Avena. “This is because there are always days that something comes up, and we can’t get all of the right nutrients.”
The doctors we talked to also questioned the recent research out of the UK. “That particular paper, while I think it was a nice review, it wasn’t really a study,” Dr. Sullivan told us. “There wasn’t any new data or anything. It was an opinion piece.”
If possible, start before you get pregnant.
Neural tube defects happen during the first month of pregnancy, when a fetus is in the earliest stages of development. And often, that’s before women even know they’re pregnant. 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).
But know they can't do everything.
Our expert panel also emphasized the fact that prenatal vitamins can’t completely compensate for a poor diet during pregnancy either. Good supplements do precisely what they say: They supplement healthy eating habits and conscientious nutrition.
“Some people feel that, ‘All I’ve got to do is take a prenatal vitamin and I’m good,’” Dr. Sullivan said. “That’s not necessarily true. Some people need even more supplementation; other people need to pay attention their diet as well.”
The Bottom Line
A prenatal vitamin alone won’t ensure a healthy pregnancy, but it will help make up for any nutritional gaps that exist in your diet. Seek out a prenatal that contains essential nutrients such as folic acid, iron, vitamin D, and calcium — and make sure you’re eating a balanced diet with a wide variety of vegetables, fruits, grains, and proteins.
And always consult with your doctor before taking any prenatal vitamin.