When I came home from my first prenatal check up, I was carrying a bag loaded with pills and my husband asked, with a bewildered look on his face “I thought pregnant women are not supposed to take any drugs?!”
Well, yes and no. The thing is, what I was carrying at that time were my prenatal vitamins. I never took any vitamin pills before I got pregnant. My diet sufficiently provided all the nutrients and minerals I needed. But pregnancy changed all that. After all, my body was carrying and nurturing another body (in my case two bodies since I was carrying twins) and I needed all the help I could get it terms of vitamin supplements. This would ensure that the baby(ies) get all they needed to develop and grow normally without starving mommy in the process.
What Are The Prenatal Vitamins We Need?
According to the recommendations of the American College of Obstetricians and Gynecologists, we need higher doses of vitamins and minerals during pregnancy. Most of these we can get in a proper healthy diet while avoiding certain foods, but sometimes we need extra supplementation for others.
Those vitamins that are sufficiently available from our daily diet, thus not routinely recommended for supplementation during pregnancy are:
- Vitamin A, available from green leafy and yellow-orange vegetables
- Vitamin B-1 or thiamine, available from milk and whole grains. Vitamin B-2
- Vitamin B-2 or riboflavin, available from green vegetables, dairy products, eggs and fish.
- Vitamin B-6, available from most vegetables you eat
- Vitamin B-12, available from animal proteins
- Vitamin C or ascorbic acid, available from fruits and vegetables
- Vitamin D or the sunshine vitamin, available from exposure to sun and vitamin-D-fortified milk
- Vitamin E, available from animal fats and proteins
- Vitamin K, available from green leafy vegetables, tomatoes, dairy products, and eggs
- Niacin, available from poultry, fish, and nuts
Some vitamins and minerals are not sufficiently available in our daily diet for many reasons. Thus, in order to ensure the well-being of both mom and baby, supplementation is recommended.
Most Commonly Prescribed Prenatal Vitamin Supplements
- Folic acid/folate is available in vegetables and grains but in small amounts. In the US and many countries, flour is fortified with folate, the synthetic version of folic acid. However, even this fortification is not sufficient for pregnant women, thus folic acid supplement is highly recommended during pregnancy. Folic acid deficiency has been linked to neural tube defects in fetus (e.g. spina bifida) and to maternal megaloblastic anemia. If you are planning to get pregnant, taking folate supplements in advance is advisable. The recommended daily allowance (RDA) of folate supplement for pregnant women is 0.6 mg. In women who had a previous child with neural tube defects, the RDA may even be increased up to 10 mg.
- Iron is available in our daily food but the absorption in the gastrointestinal tract is rather inefficient. Iron is essential for the production of hemoglobin that enables our blood to transport oxygen. In a pregnant woman, hemoglobin is very important in supplying blood to the placenta and the fetal tissues. Iron deficiency anemia is a common complaint during pregnancy. Thus, iron supplementation is highly recommended, with an RDA of 30 mg.
- Calcium is essential in the synthesis of bones. It is not surprising that as the baby grows in the uterus, the calcium requirement of the mother also increases. The RDA for calcium in pregnant women is 1200 mg.
I remember that I took my vitamin supplements each separately. However, nowadays, there are certain formulations which put the needed nutrients (and then some) in one multivitamin pill. According emedicine WebMD, the standard prenatal vitamin pill should contain the following:
- Iron – 30 mg
- Zinc – 15 mg
- Calcium – 250 mg
- Vitamin B-6 – 2 mg
- Folate – 0.4 mg
- Vitamin C – 50 mg
- Vitamin D – 5 mcg
The formulations, however, can vary and in some cases and may be customized to a woman’s specific nutritional needs. The following situations, for example, require special supplementation considerations.
When Special Supplementation May Be Needed
- Vegetarian diet – When a woman is vegetarian or vegan, then she would need supplementation of vitamins the she can only get from animal fats and proteins (e.g. Vitamins B12 and E).
- Lactose intolerance – Women who are lactose intolerant and therefore cannot drink milk or eat dairy products may need extra calcium supplementation.
- Cultural and behavioral considerations – In some countries, women may have minimal exposure to the sun, e.g. women in Muslim countries wearing the veil, or those intentionally avoid the sun for aesthetic or medical reasons. In such cases, pregnant women are usually prescribed vitamin D supplements.In developed countries, some women, especially the very young, might have the fear of having the so-called “baby fat” during pregnancy and would therefore try to cut down on their food intake. In these cases, obstetricians as well as family members should watch out for eating disorders to make sure the baby is not starved.
Multiple growing babies require more vitamins and minerals than just one. I remember that when I was carrying my twins, my doctor had to increase my supplementation at a certain point. Folate and iron supplements may be increased and Vitamin B-6 supplement may be prescribed.