Prenatal vitamins

Prenatal vitamins are supplements designed for people who are pregnant or preparing for pregnancy, but you do not necessarily need a long list of nutrients in one tablet. In the UK, the main supplements specifically recommended in pregnancy are folic acid and vitamin D, while other supplements may be advised depending on your diet, blood tests, medicines or individual circumstances.

If you choose a prenatal multivitamin, the label matters. Pregnancy supplements should not contain vitamin A in the form of retinol, and the NHS advises against taking cod liver oil during pregnancy.

It is also worth remembering that a supplement is there to support your diet, not make it perfect. Your midwife, GP or pharmacist can help if you are unsure what you need.

What are prenatal vitamins?

“Prenatal vitamins” is a general term for supplements intended for use before or during pregnancy. They may contain several vitamins and minerals in one product, although the exact ingredients and amounts vary between brands.

Some people prefer a combined pregnancy multivitamin because it puts several nutrients in one tablet. Others take individual supplements recommended for them.

The important point is not how many ingredients a product contains. It is whether it provides what you actually need without including ingredients that pregnancy guidance advises you to avoid.

Which vitamins are recommended during pregnancy?

Current NHS and NICE guidance places particular emphasis on folic acid and vitamin D.

Folic acid

The NHS recommends taking 400 micrograms of folic acid every day when trying to get pregnant, ideally starting three months beforehand, or as soon as you find out you are pregnant. It should be taken for the first 12 weeks of pregnancy.

Folic acid helps reduce the chance of neural tube defects, which affect the development of the brain or spine.

Some people are advised to take a higher dose because of their medical history, medicines or other risk factors. This higher dose should be discussed with a GP or another appropriate healthcare professional rather than chosen without medical advice.

If your prenatal vitamin already contains folic acid, check the label so you know how much it provides.

Vitamin D

The NHS currently recommends 10 micrograms of vitamin D each day during pregnancy between early October and late March, when the body cannot make enough vitamin D from sunlight in the UK.

Some people may need to take vitamin D throughout the year, including those who have little exposure to sunlight. NHS guidance also says people with black or brown skin should consider taking vitamin D throughout the year because skin pigmentation affects how much vitamin D the skin makes.

Your midwife or GP can advise you if you are unsure what applies to you.

Do you need iron in a prenatal vitamin?

Iron is important during pregnancy, but that does not mean everyone needs a separate iron supplement.

The NHS says iron levels are checked during routine pregnancy blood tests. If your healthcare team finds that you have anaemia, your GP or midwife may recommend an iron supplement.

RCOG similarly advises that most people do not need extra iron routinely during pregnancy. Taking iron unnecessarily can also cause digestive side effects in some people.

If a prenatal vitamin contains iron, or you are considering adding a separate iron product, discuss it with your midwife, GP or pharmacist if you are uncertain whether it is appropriate for you.

What should you avoid in prenatal vitamins?

One ingredient deserves particular attention: vitamin A in the form of retinol.

The NHS advises against taking supplements containing vitamin A during pregnancy because too much can harm a baby’s development. Cod liver oil should also be avoided for the same reason.

Vitamin A may appear on labels as retinol, so check the ingredients rather than relying only on the words “prenatal” or “pregnancy” on the packaging.

RCOG also advises avoiding high-dose vitamin supplements unless they have been prescribed for a specific reason.

Is a pregnancy multivitamin necessary?

Not necessarily.

The NHS advises eating a healthy, varied diet during pregnancy because food can provide most of the vitamins and minerals you need. Folic acid and vitamin D are the main routine supplements highlighted in UK pregnancy guidance.

A combined prenatal vitamin can be a convenient way to take recommended nutrients, but an expensive or complicated formula is not automatically better. RCOG notes that there is no evidence that expensive pregnancy vitamin brands are better than cheaper ones.

If you choose a multivitamin, check that it is intended for pregnancy and review the ingredients carefully. A pharmacist can help if the label is confusing.

Can you take several pregnancy supplements together?

Taking several products can make it easier to accidentally duplicate nutrients.

For example, a prenatal multivitamin may already contain folic acid, vitamin D, iron or other nutrients that are also sold as individual supplements.

Before combining products, check each label. If you are taking prescribed medicines, have been advised to take a particular supplement or are unsure whether two products can be used together, ask a pharmacist, midwife or GP.

Do not stop prescribed medicines or replace them with vitamins or supplements without discussing this with the healthcare professional responsible for your care.

What if you are vegetarian or vegan?

A vegetarian, vegan or otherwise restricted diet does not automatically mean you need every supplement marketed for pregnancy. Your nutritional needs depend on what you eat and your individual circumstances.

The NHS recommends a healthy, varied pregnancy diet and advises speaking to a healthcare professional if you have questions about getting enough nutrients.

If your diet excludes several food groups, mention this to your midwife. They can discuss your diet with you and, where appropriate, arrange further advice or recommend specific supplementation.

How to choose a prenatal vitamin

A simple label check can make choosing a supplement less confusing.

Look for a product intended for pregnancy and check whether it provides the nutrients recommended for you. Make sure it does not contain vitamin A in the form of retinol or fish liver oil.

Avoid assuming that a product with more ingredients, a higher price or larger nutrient amounts is automatically more suitable.

If you already take separate supplements, compare their labels with the prenatal vitamin before combining them. Your pharmacist can help you check for duplication and identify ingredients that may not be suitable during pregnancy.

What if you forgot to take prenatal vitamins?

If you have only just discovered that you are pregnant and were not taking folic acid beforehand, the NHS advises starting folic acid as soon as you find out you are pregnant.

Pregnancy can be unpredictable, and not everyone has the opportunity to start supplements before conception. If you are concerned about what you have or have not taken, speak to your midwife or GP rather than trying to compensate by taking extra supplements.

Your healthcare professional can give advice based on your stage of pregnancy, health and individual circumstances.

When to get professional advice

Speak to your midwife, GP or pharmacist if you are unsure which prenatal vitamins you need, if you take prescribed medicines, have a medical condition, follow a restricted diet or are considering taking several supplements together.

Ask for professional advice if you think you may need a higher dose of folic acid. Higher-dose folic acid is recommended for some people with particular risk factors, but it should be discussed with a healthcare professional.

You should also seek advice if blood tests show that you are anaemic or you have been told you may need iron or another specific supplement. Your maternity team can advise you based on your results rather than general supplement recommendations.

If you realise that you have been taking a supplement containing vitamin A or cod liver oil during pregnancy, contact your midwife, GP or pharmacist for individual advice rather than making assumptions about what this means for your pregnancy.

For urgent medical concerns during pregnancy, contact your maternity unit or the appropriate healthcare service. NHS 111 can provide urgent advice when you are unsure where to seek help, while 999 is for life-threatening emergencies.