Prenatal vitamins are commonly prescribed during pregnancy. Although it is possible to get most needed vitamins from a healthy diet, doctors and patients know that pregnant women may not always eat a diet which will ensure they get all the needed vitamins. Therefore, daily vitamins for pregnant women is an easy way to make sure.
Vitamins for Pregnant Women: Do You Need Them?
Prenatal vitamins come in prescription and non-prescription forms. Prescription vitamins contain more iron and sometimes more folic acid than over-the-counter (OTC) products. For otherwise healthy women, the amounts of vitamins in the OTC brands are sufficient.
Generic and store brand prenatal vitamins are usually equivalent to brand-name products but are less expensive.
Which Prenatal Vitamins Are Best?
Some prenatal vitamin brands advertise the fact they contain omega-3 oils which they claim will help your unborn baby develop a better brain. Indeed, fortifying the diet of pregnant laboratory animals with omega-3 oils has been shown to result in offspring with larger brains.
Whether these findings are applicable to humans and will make your baby more intelligent is not known. Nonetheless, there is probably no harm in taking prenatal vitamins containing omega-3s and there is a possible benefit. Therefore, if you are so inclined, go ahead and take these vitamins for pregnant women.
Special Needs
For most women, the amount of iron in a prenatal vitamin (at least 27 milligrams of elemental iron) is adequate to meet the needs of pregnancy.
However, women who are iron deficient at the onset of pregnancy (your doctor will test you for this at your first visit) require additional iron during the pregnancy. Large amounts of iron can cause constipation in pregnant women (see below).
Special Needs for Vegetarians and Vegans
Vegetarians and vegans need to take vitamin B12 when pregnant as well as when not pregnant. This is because the only food that naturally contains sufficient quantities of B12 are in animal meat. Dairy products are usually fortified with vitamin D.
Therefore, strict vegans require an outside source of vitamin D since they do not eat dairy. Prenatal vitamins provide appropriate amounts of vitamins B12 and D for those who do not get them in their diet.
It is well known that sufficient amounts of folate (folic acid) in the diet consumed in the period of time will decrease the risk of the baby having a neural tube defect. Neural tube defects (NTD) are serious birth defects involving the fetal brain and spinal cord.
Examples of NTDs are incomplete brain development (anencephaly) or openings in the spinal column (Spinal Bifida). Neural tube development begins very early in pregnancy, often before the woman even knows she is pregnant.
Folic Acid
For this reason, it is recommended that women planning to become pregnant should start 0.4 milligrams (400 micrograms) of folic acid at least 6 weeks before conception. Folic acid is one of the most important vitamins for pregnant women. Since many pregnancies are unplanned, most experts believe that all women of reproductive age take 0.4 milligrams of folic acid daily. This is the amount of folic acid in most adult multivitamins.
Women who have a history of having a fetus with an NTD in a previous pregnancy should consume ten times as much folic acid (4 milligrams or 4000 micrograms) daily prior to conceiving. This amount of folic acid will require a prescription from your doctor. The same advice applies to women who take anti-epileptic drugs during pregnancy. These drugs can interfere with the absorption of folic acid so increased doses in the peri-conceptual period are required.
Weight Loss Surgery and Vitamin Deficiencies
Women who have had weight loss surgery, especially stomach bypass surgery, may have serious vitamin deficiencies. Supplementing women with extra doses of multivitamins is discouraged since toxic levels of some vitamins (notably Vitamin A) can accidently occur in this manner. Instead, a detailed nutritional evaluation to see which vitamins are required and at what doses should be carried out at the first prenatal visit and again in the second and third trimesters.
Side Effects of Prenatal Vitamins
The most common side effects of prenatal vitamins are nausea, indigestion, and constipation. These side effects are mainly due to the iron in the prenatal vitamin. For this reason, early in pregnancy, when many women are struggling with nausea, I advise them to delay starting the prenatal vitamin but instead to substitute an over the counter vitamin without iron. This will provide the important vitamins you need such as B vitamins, vitamin D, and folate without the iron, which can upset the stomach.
Later on when the nausea has remitted the patient can start the prenatal vitamin with iron. The additional iron demands from pregnancy don’t start until later in the pregnancy anyway.
As mentioned, iron causes constipation for many pregnant women. Increased fluids, prunes and prune juice and increased fiber in the diet such as from bran cereals and lots of fruits and vegetables can often alleviate these symptoms. If these things don’t work ask your doctor about prescribing a mild laxative or switching to a slow-release form of iron.
