What I Recommend for Prenatal Vitamins (And What Actually Matters More)
As a midwife, I get a lot of questions about which prenatal vitamin to take. And while I definitely have some favorites (more on that below), I want to start by zooming out a bit.
First Things First: Food, Movement, and Mental Health Come First
Ideally, your diet during pregnancy is rich in nourishing whole foods: colorful vegetables, whole grains, quality proteins, healthy fats, and enough calories to support a growing baby. That’s always the goal.
When people ask about prenatal vitamins, I remind them that on the hierarchy of importance, a multivitamin is actually pretty low. What matters more? Gaining a healthy amount of weight (not too much, not too little), staying active, and taking care of your mental and emotional well-being. Those are the things that really move the needle on outcomes—for both you and your baby.
Why Folic Acid Is Still the Gold Standard
Now let’s talk folate. You’ve probably seen prenatal vitamins that contain folic acid, and others that advertise “methylfolate” or “active folate” instead. Here’s the bottom line:
Folic acid is the only form of folate that’s been proven in large, high-quality studies to reduce the risk of neural tube defects (NTDs). These include serious conditions like spina bifida. Supplementation with folic acid before and during early pregnancy can reduce the risk of NTDs by up to 70%. That’s huge.
Some newer prenatals use methylated folate, which may be better absorbed by some people, especially those with MTHFR gene variants. That’s totally fine to take—but just know that no large studies have shown methylfolate reduces NTDs the way folic acid does. If you’re taking a prenatal with methylfolate, make sure it contains the recommended equivalent of 400–800 mcg of folic acid per day.
Research indicates that methylfolate may have a slight edge in bioavailability over folic acid, particularly at the start of supplementation. However, over time, both forms achieve similar levels in the body. Studies have shown that both folic acid and methylfolate effectively raise blood folate concentrations, which is essential for preventing NTDs.
It's important to note that while folic acid's role in preventing NTDs is well-documented, there is currently no direct evidence proving that methylfolate offers the same protective benefit. The Centers for Disease Control and Prevention (CDC) emphasizes that no scientific studies have demonstrated that supplements containing methylfolate can prevent NTDs.
Not All Supplements Are Created Equal
Something else I always mention: the supplement industry isn’t well regulated. Just because something is expensive or has pretty branding doesn’t mean it’s better. In fact, testing has shown that some high-end brands don’t contain the nutrients listed on the label. Look for brands that are third-party tested (like USP or NSF certified).
Also: if your prenatal contains both iron and calcium, they may compete for absorption. Many good-quality prenatals avoid putting both in the same pill, or they suggest taking them at different times.
Key Nutrients to Look For
Here’s what really matters in a prenatal:
Folic acid (400–800 mcg) – to prevent neural tube defects
Iron (27 mg) – to support increased blood volume
Vitamin C – to help with iron absorption
DHA (200–300 mg) – for fetal brain and eye development
Vitamin B12 – especially important if you’re vegetarian or vegan
Vitamin D and Iodine – most prenatals include these; if not, take separately
My Go-To Prenatal Vitamin Picks (All Available in the U.S.)
Affordable
1. Nature Made Prenatal + DHA
One softgel daily. Contains 800 mcg folic acid, 27 mg iron, 200 mg DHA. USP verified. Widely available and gentle on most stomachs.
Mid-Range
1. OLLY Ultra Strength Prenatal Softgels
Includes folic acid, iron, DHA, and key vitamins C, E, and B-complex. Designed to support brain and spinal cord development. Readily available and gentle on digestion.
2. Nature’s Nutrition Prenatal + DHA
Contains 400 mcg folic acid, iron, and DHA. Third-party certified for quality, formulated to support both mother and baby’s health throughout pregnancy.
Premium
1. TheraNatal Complete by Theralogix
Very comprehensive. Includes 1,000 mcg folic acid, 27 mg iron, 300 mg DHA, 250 mg choline, vitamin D, B6, B12, and more. NSF certified. Requires 3 pills/day.
2. New Chapter Advanced Perfect Prenatal
Made with organic whole-food ingredients. Contains folic acid, iron, and a full range of vitamins and minerals to support pregnancy. Easy on the stomach and made without synthetic fillers.
Ultimately, the best prenatal vitamin is the one you can afford, tolerate, and remember to take. If you're not sure which is right for you, ask your provider—or feel free to reach out. I'm always happy to help.