Mamas on Bedrest: Are You on Prenatal Vitamins?

May 27th, 2011

I assumed that pregnant women all take prenatal vitamins, but recently have found that this is an erroneous assumption. In the past month or so, I have had inquiries from pregnant or immediately post partum women who are not taking prenatal vitamins and what’s more, when they asked their obstetricians (Not a slam against OB’s, it just so happens that the women who have inquired about prenatal vitamins were all being cared for by OB’s) which vitamins they should be taking, they were told, “any of the prenatal vitamins from the store will do.”

I’m going on the record right now to say that I disagree.

Every Pregnant, Trying to Conceive or Nursing Woman should be taking Vitamins

First and foremost, I believe that EVERY pregnant woman, trying to conceive woman and nursing mother should be taking a good quality dietary supplement. In an ideal world, women would be able to receive all the nutrients that they need from the foods that they eat. Sadly, with the depletion of nutrients in our soil, the hormones and antibiotics injected into our meets, the wide array of processing of our foods and other environmental factors, our food supply is not as nutritionally dense as it once was. Couple that with the fact that most Americans get far fewer servings of recommended fruits, vegetables, whole grains and lean meats and it’s safe to say that most of us are “under nourished”.

So what does that mean for a pregnant, trying to conceive or nursing mother? It means that she may not have adequate energy and nutrient supplies within her body to adequately nourish herself and her growing baby. How does this manifest? In women trying to conceive, it may manifest as difficulty conceiving or early miscarriages. In pregnant mamas it may manifest as deficiencies in mama’s body such as anemia, bone loss or stress fractures, cavities or other anomalies. Post partum, it may manifest as low milk production or even birth defects such as spina bifida in the baby. So yes, I firmly believe that any woman trying to conceive, who is pregnant or breastfeeding needs to be on a high quality vitamin or supplement that will provide her with the extra nutrients that she needs to not only produce a healthy baby and generous, nutrient dense breast milk, but will also supply her body with what it needs to sustain her health as well.

What types of Vitamins are Best?

The Vitamin and supplement industry is not regulated. The US Food and Drug Administration (FDA) classifies dietary supplements as a category of foods and not as drugs. While pharmaceutical companies are required to obtain FDA approval which involves assessing the risks and benefits of drugs prior to their entry into the market, dietary supplements do not need to be pre-approved by FDA before they can enter the market. Consequently, any manufacturer can produce a dietary supplement, claim that it contains certain vitamins, mineral or dietary enhancements and there really is no one to hold that manufacturer to his word. For this reason, many physicians don’t advocate taking vitamins or supplements unless a patient wants “expensive urine” meaning that most of the ingredients in many supplements merely wash through the body.

But are all supplements bad? Are they unnecessary? Of course not. Just like anything else, there are “good” brands of vitamins and supplements and “not so good” brands of vitamins and supplements. What I have learned is that it is best to take vitamins or supplements that are manufactured according to GMP* or Good Manufacturing Processes. These regulations, which have the force of law, require that manufacturers, processors, and packagers of drugs, medical devices, some food, and blood take proactive steps to ensure that their products are safe, pure, and effective. What this means is that products manufactured by companies that make the effort to ensure that their products meet these stringent guidelines will contain the ingredients that they say they contain and at the strengths stated. In this way, consumers can be sure that the potency and efficacy is as stated.

For women trying to conceive, who are pregnant or nursing, I usually suggest that they do some research on prenatal vitamins and look for one that is manufactured using GMP. This information can be obtained from various guides to nutritional supplements as well as some online websites (see the resources below).

So What Should My Prenatal Vitamin Contain?

According to the Mayo Clinic, prenatal vitamins should contain Folic Acid, Calcium, Iron, Omega 3 Fatty Acids and Vitamin D. While this is a good start, how much? The Cleveland Clinic gives the following recommendations:

  • 4,000 and 5,000 IU (international units) of vitamin A
  • 800 and 1,000 mcg (1 mg) of folic acid
  • 400 IU of vitamin D
  • 200 to 300 mg of calcium
  • 70 mg of vitamin C
  • 1.5 mg of thiamine
  • 1.6 mg of riboflavin
  • 2.6 mg of pyridoxine
  • 17 mg of niacinamide
  • 2.2 to 12 mcg of vitamin B-12
  • 10 mg of vitamin E
  • 15 mg of zinc
  • 30 mg of iron

These are good starting points. So as you are researching prenatal vitamins, look for brands that contain at least the amounts indicated above (The Cleveland Clinic is a highly reputable institution and I feel VERY comfortable echoing their recommendations) and look for companies that use GMP to produce their products.

The Bottom Line

Prenatal Vitamins can help reduce the incidences of birth defects such as spina bifida as well as the risk of developing a low birth weight baby. Studies have shown that even in women who eat a “healthy and nutrient dense” diet, the bodily demands of pregnancy and lactation are often more than their bodies can meet on their normal diets alone. Hence, even though many obstetricians and midwives won’t give a specific recommendation, they all generally agree that most women need some sort of vitamin supplementation during pregnancy.

If you are confused or overwhelmed with what your body needs in terms of vitamins and supplements during pregnancy, Let’s talk about it. Sign up for a Complimentary 30 Minute Bedrest Breakthrough Session and we can go over your nutritional needs and your supplement options. To schedule your complimentary session, send an e-mail to



The US Food and Drug Administration

ISPE – ISPE, the International Society for Pharmaceutical Engineering, is the world’s largest not-for-profit association dedicated to educating and advancing pharmaceutical manufacturing professionals and their industry.

The World Health Organization (WHO)

How to find out which companies manufacture according to GMP

Nutritsearch Comparative Guide to Nutritional Supplements by Lyle MacWilliam, MSc. FP. Copyright 2007, NutriSearch Corporation.

NSF International – The Public Health and Safety Company™, a not-for-profit, non-governmental organization, is the world leader in standards development, product certification, education, and risk-management for public health and safety. examines the research literature to understand the chemical makeup of products that have been shown useful in clinical (i.e., human) research studies—and establishes standards of quality for that product.

Natural Products Association

US PharmacopeiaThe USP Dietary Supplement Verification Program is a voluntary testing and auditing program that helps dietary supplement manufactures ensure the production of quality products for consumers.

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