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:

But picking a best required some more digging.

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.

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.

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.

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.

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).