I'm asked about prenatal vitamins constantly, and I understand why. Options run from $10 drugstore bottles to $60+ formulas, and the labels don't make it easy. The good news is that supporting a healthy pregnancy doesn't require the most expensive bottle on the shelf. It requires the right nutrients, in the right amounts, for you.

Here's what the research says, and how to choose.

The Nutrients That Matter Most

Folate (or folic acid): This is the best-studied prenatal nutrient. Adequate intake before and early in pregnancy lowers the risk of neural tube defects by 50-70%. The standard recommendation is 400-800 mcg daily, and some women need a higher dose, so check with your provider. Both folic acid and methyl-folate are reasonable forms. Methylated folate is recommended for those with known MTHFR mutations.

Choline: Choline supports fetal brain and spinal cord development throughout pregnancy. The recommended intake is 450 mg daily (550 mg while breastfeeding), yet many prenatals contain little or none, and most women fall short through diet. Eggs (about 150 mg each), meat, fish, and soybeans are good sources, but many women still need a supplement or a prenatal that includes it in adequate amounts.

Iodine: Iodine supports thyroid hormone production, which is essential for fetal brain development. Pregnant women need about 220 mcg daily, and many prenatals don't include it. Check your label. Iodized salt, dairy, eggs, and seafood help, but they often don't close the gap on their own.

Vitamin D: Vitamin D supports bone development, calcium absorption, and immune function. Low levels are common, especially with darker skin, limited sun, or northern winters. The research on vitamin D and complications like preeclampsia is still developing, but keeping your levels adequate is a sound goal. Your provider can test yours and recommend a dose. Many high quality prenatal vitamins contain adequate amounts.

DHA (omega-3): DHA supports fetal brain and eye development, and research shows it can reduce the risk of early preterm birth. Aim for about 200-500 mg of DHA daily from a supplement, from low-mercury fatty fish (like salmon, sardines, or trout) a couple of times a week, or both. Most prenatals include little or no DHA - supplement this separately unless you are a frequent fish eater!

Magnesium: Magnesium is important for hundreds of processes in the body, and many women find it helpful for sleep and muscle cramps. The research on cramps is mixed, so think of it as worth trying rather than guaranteed. Pumpkin seeds, almonds, spinach, beans, and whole grains are good food sources. Check your prenatal vitamin to see how much is in there - you want at least 300mg.

Iron: Iron needs rise to 27 mg daily as blood volume expands, and anemia in pregnancy is linked to fatigue and higher risks of preterm birth and low birth weight. But more isn't better. Too much iron can cause side effects and may be harmful for women who aren't deficient. Ask your provider to check your hemoglobin and ferritin so you can supplement based on your actual levels rather than guessing. I typically recommend supplementing iron separately - because it is best absorbed when taken every other day.

How to Choose a Prenatal

Look for:

• Folate, choline, iodine, vitamin D, and B12 in meaningful amounts
• Iron that matches your needs (a version with iron, or without it if you aren't deficient)
• Third-party testing (such as USP or NSF seals) for purity and potency
• A capsule count and form you'll actually stick with, because the best prenatal is the one you take consistently

One more note: avoid prenatals with high doses of preformed vitamin A (retinol). Beta-carotene is fine.

Options I Often Recommend

Needed Prenatal Basic or Pro: A comprehensive, high-quality formula without iron, which suits women who aren't anemic. They have capsules, gummies, and powder which can be helpful if you are someone who struggles with pills.

Seeking Health Optimal Prenatal: A comprehensive, high-quality formula without iron, which suits women who aren't anemic. It costs more and dosage is 8 capsules a day.

Seeking Health Prenatal Essentials: A simpler option with fewer capsules, available as a chewable or capsule. Its vitamin D is lower than I'd like, so you may need to add a separate vitamin D.

When to Start (and How Long to Continue)

Neural tube development happens in the first weeks of pregnancy, often before you know you're pregnant, so it's best to start a prenatal at least one to three months before trying to conceive. If you're earlier than that, starting sooner is fine and builds a healthy foundation. Continue through pregnancy and for as long as you're breastfeeding or pumping, since both draw on your own nutrient stores.

Food First, Supplements Second

Think of your prenatal as nutritional insurance. It fills gaps, but it can't replace the fiber, protein, healthy fats, and plant compounds found in whole foods.

Your needs are individual, so please review any supplement plan with your OB or midwife, especially if you have a medical condition or take medications. And if you'd like help building a plan that fits your body and budget, reply to this email. I'm happy to help and can set you up through my FullScript storefront.

With peace and love,

Dr. Ellyn Halley, DC, Doula, Coach
​Doc Halley Solutions​

Follow me on Instagram + TikTok for more content - ellynhalley.dc

​​

In person chiropractic care! You can find me at 1500 Green Bay St, La Crosse WI 54601 within the same space as the Parenting Place and The Motus Project. I am excited to offer in person care to women in the Coulee Region, and offer hybrid care - in person + online. You can book your first appointment or schedule a consult below!

If you're looking for an "all in one" program that includes a prenatal exercise program, birth education, pelvic prep + mobility, nutrition information, and more - combined with regular support + check ins - I have you covered. Check out my Empowered Pregnancy program for incredible prenatal support.

Looking for more support around exercise, pelvic health, and nutrition (and birth prep if you're pregnant!)? Apply for 1:1 coaching with me:

**Disclaimer: The content in this email is not intended to be medical advice. The content here is for informational purposes only. Please consult with your healthcare provider regarding any medical or health related diagnosis or treatment options.