S2 E4: Prenatal Vitamins 101: What to Take, Why It Matters, and How to Choose Quality (#39)

Summary

In this episode, Taylor Rae Roman dives into the world of prenatal vitamins and supplements, sharing her personal journey from discovering nutritional deficiencies through routine blood work to navigating supplementation during pregnancy. She highlights the critical role prenatal vitamins play in supporting fetal development, preventing birth defects, and addressing common maternal deficiencies.

Taylor explains that not all prenatal vitamins are created equally, pointing out that the FDA doesn’t evaluate these products before they hit the market. She emphasizes the importance of third-party testing and certifications when selecting a supplement. Recommending that women begin taking prenatal vitamins 3–6 months before trying to conceive, Taylor spotlights key nutrients like folic acid, choline, iron, and vitamin D. She also shares her positive experience using Thorne supplements, chosen for their quality standards and encourages listeners to do their own research—even if doctors don’t emphasize brand differences.

KEY MOMENTS

Introduction to Prenatal Vitamins and Personal Experience - 00:00:07: Taylor Rae Roman introduces the topic of prenatal vitamins and shares her personal journey with vitamin supplementation, starting from discovering deficiencies during routine blood work to her current pregnancy experience at 30 weeks.

Purpose and Variations of Prenatal Vitamins - 00:04:23: Taylor explains the primary purposes of prenatal vitamins, including preventing birth defects and supporting fetal development. She discusses how prenatal vitamins differ in formulation and why there's no national standard for their content.

Quality Assessment and Timing - 00:12:29: Taylor outlines criteria for choosing high-quality prenatal vitamins, including third-party testing and certifications. She recommends when to start and stop taking prenatal vitamins, emphasizing the importance of early supplementation.

Essential Nutrients and Their Benefits - 00:15:37: Taylor details specific nutrients essential during pregnancy, including folic acid, choline, iron, vitamin D, and DHA, explaining their benefits for both mother and baby.

Focus on Folic Acid - 00:21:45: Taylor emphasizes the critical importance of folic acid, particularly in the first 28 days of pregnancy, discussing its role in neural tube development and recommendations from major health organizations.

TRANSCRIPTION

Hello, and welcome back. My name is Taylor Rae, and this is On the Outside. In today's episode, we talk about prenatal vitamins and supplements. Is just taking one all-inclusive prenatal vitamin enough?

Why or why not? What does the research say? How do we find the right prenatal? What certifications or things should we be looking for? We get into all of that today, including the purpose of prenatal vitamins, how prenatal vitamins differ and why there are so many different formulations, how to find high-quality prenatal vitamins and why this is important, when you should start and stop taking a prenatal vitamin,

the importance of folic acid above all other supplements, and other prenatal vitamins that might be recommended. I started taking a daily multivitamin about two or three years ago because I found out that I had low iron and some slight deficiencies after getting some regular blood work during a regular routine physical.

One day, I realized that my normal eating habits, they just weren't so great, about four days a week. Especially with grad school and a full-time job, I found myself in this kind of cycle and this is what it looked like.

I'd wake up, I'd grab coffee. Honestly, not because I'm the kind of person that needs their morning coffee, but just because I like it and it's like a fun little drink. So I'd wake up, drink some coffee, go to work, eat a bunch of random snacks at the studio.

This is when I was a full-time trainer. So I'd be eating like Cheez-Its and pretzels in between classes, then be starving, take the train uptown to Columbia, get more coffee, get a donut or a pastry.

or a brownie or like whatever looked good inside the pastry case, run across the street to Pret and get half a sandwich if I had time. Because most of the time I was doing work at the coffee shop, so that's how I ended up there first.

Grab that sandwich if I had time and then go home, be literally starving and eat like two or three portions of dinner because I was so hungry from the entire day. Now, all that is to say, I'm very thankful that I wasn't personally struggling with disordered eating, though I definitely did when I was younger, when I was in college, that was definitely something that was tough for me.

In this era of my life, however, I was really just busy, not prioritizing my eating habits, not planning when I was gonna eat or what I was gonna eat and really just like freestyling it every day in a way that was doing me absolutely no favors.

Today, I have better eating habits, honestly, than I ever have in my life, primarily because I'm a very hungry, pregnant girl. Though right now, oh, I'm a little over 30 weeks and I feel like I can't even fit food in my body because of how big this baby is in there.

But that being said, I also don't really leave my neighborhood, I don't even leave my house as much because I do a lot of my freelance work from home. So I always have access to tons of food options that are easily accessible and that are healthy for me.

That being said, I'm so happy that I started learning about and taking vitamins years ago. When I was finding that I had some of those deficiencies, vitamins helped fill some of those gaps that I had because I was not eating so great.

And now they're helping me to build the strongest baby possible. Before we dive in, I want to remind you, as I always do, that I'm not a doctor or medical professional. Everything I share in this episode is based on my personal experience and research.

Always check in with your doctor or a qualified healthcare provider before making any decisions about your health, pregnancy, or preconception journey. Let's get into it. Let's start it out with the purpose of prenatal vitamins.

First and foremost, it is just to support fetal development. It's to prevent birth defects, including neural tube defects. Now, neural tube defects are kind of the biggest one in the most researched area, such as spina bifida.

It's also for heart defects, cleft lip and palate, limb defects, brain and cognitive development issues, low birth weight, preterm birth, which just means early birth, and other defects, such as urinary tract defects and congenital heart defects.

So these are kind of all the things to varying degrees. of research that have led experts to recommend that we take prenatal vitamins with neural tube defects being kind of the most researched area. It's also to prevent deficiencies in the pregnant person.

So the way that I was eating and living my life like a hot mess a few years ago, I was the kind of person that had a lot of deficiencies at that time. Thankfully I got my act together in my kind of preconception era stage of my life.

But that being said, prenatal vitamins are a great way to kind of help the pregnant person with any deficiencies they might have. And it can reduce the risk of pregnancy complications and also support postpartum recovery.

Many studies suggest that insufficient vitamin intake is associated with a wide range of pregnancy complications. And this is a direct quote. As always, you can find it cited on my website with all of the other sources.

So pregnancy complications including anemia, cesarean section, depression, gestational diabetes, hypertension, infertility, preeclampsia, and premature rupture of membranes, and infant health problems including asthma, autism, low birth weight, congenital heart defects, intellectual development, intrauterine growth restriction, miscarriage, neural tube defects, or a facial defects and preterm birth.

So insufficient vitamin intake is associated with a wide range of pregnancy complications such as those that I just mentioned. That is why we take prenatal vitamins to answer that first question. Now, how do prenatal vitamins differ and why there's so many formulations?

You can find prenatal vitamins at your Dwayne Reed down the street in New York, at your CVS, at your Walgreens, you can find them at your supermarket, at your local mom and pop pharmacy, you can find them online.

You can find your fav influencers constantly showing you tons of different vitamins and supplements. If I see another greens powder, babe, I'm gonna lose my mind. So we have access to so many different kinds of vitamins, but they're not all equal.

So we're gonna get into how they differ and why they differ. Prenatal vitamins can differ significantly from one to one another, from one to the other. In terms of the specific amount of vitamins and minerals that they each contain, including key nutrients.

So prenatal specifically, we're talking about things like folic acid, iron, calcium, and vitamin D with variations depending on the brand, the formulation, and even the type of pill. So by type, I mean things like gummy versus a tablet.

So it's important to compare labels and consult your healthcare provider to find the best option for you because not all prenatal vitamins are created equal. Unfortunately, there is no national standard for the- of prenatal vitamins.

So they vary widely on their content and may contain only a few vitamins. And that means packed into a prenatal multivitamin, right? Sounds good. Sounds like that's all that I need. It might not really have all that you may want, right?

Because they're each formulated differently and they each have a different amount of each different supplement and maybe not even the exact amount that you want, which is wild. And there's a lot to say about the different type of pill, a gummy versus a tablet, et cetera.

Overall, now this is just my humble opinion based on what I've learned. I would steer clear of the gummy variety. There's a lot more that has to go into it to make it taste good, to make it look good, to make it have that gummy texture.

Realistically, if you can swallow a standard tablet or capsule that is not a gummy, that is gonna just deliver those vitamins and supplements right where they need to go, versus having them needing to be packaged in this sweet, fun, little gummy shape, which adds a lot more to it and doesn't really do you any favors.

So that's just, that's from Taylor's little opinion right there. The Food and Drug Administration or the FDA does not evaluate the effectiveness safety or quality of dietary supplements or the ingredients in them before they enter the marketplace.

Now that is wild because there is actually no administration, organization, oversight organization that is looking at and testing each and every supplement that is out there. I know that sounds completely bonkers if you've never really gave it a second thought, but that is very true.

And that is again, why every prenatal is not equal. I didn't find that my OBGYN was overly concerned about my prenatal vitamins. And I don't think she would have been unless my blood work showed significant deficiencies.

I was taking my prenatals for six months before getting pregnant. So my blood work didn't show any deficiencies, didn't show any issues. That being said, well, running all questions by your doctor is of course crucial, as I say in every episode.

It's not likely that your doctor will have specific recommendations ahead of pregnancy for what prenatal you should take. It's definitely worth asking, especially if you're gonna do a physical or blood work or any kind of exam before you even start trying to get pregnant.

That would be a great time to be able to look at your blood work, see if you have any deficiencies, talk with your healthcare provider, see if they have any specific recommendations. But I found that when I had this discussion with my OB, all she asked was, are you taking prenatals?

Okay, great. She wasn't really interested in the brand. the kind, the specific vitamins I was taking, the other supplements I was taking, because my blood work didn't show any deficiencies, therefore there were no issues, therefore it wasn't really something that she was deeply concerned about.

Now for context, I go to a really incredible OB. It was super, super hard to get her to get an appointment. I go to Weill Cornell Medical Center. This is one of the foremost experts in terms of OB-GYNs, birth and delivery, and they don't really care that much.

So I think it's really important to understand that your doctor can be an amazing doctor. They can have tons of research. They could have written amazing papers. They could have gone to an amazing school and they still may not care that deeply about this unless they're given a reason to care.

So that's why listening to a little episode like this and continuing to do your own research is also super. important because unless the deficiencies are there, which at this point, it may be too late, right?

If you don't find this out until you're already taking your blood work, I'm not saying it's too late just in general. Of course you can get on your supplements, your doctor will help you, that's great.

But you could have this information earlier on either by getting it checked out earlier on or just starting a prenatal sooner so you kind of cover all of your bases before you even start trying to conceive.

Now let's talk about how to find high quality prenatal vitamins and why this is important. Being that the FDA is not regulating this, you may be thinking, Taylor, tell me how I'm supposed to know what prenatals are good and what I should be taking.

Some useful criteria in choosing a prenatal vitamin is as follows, third-party testing, that's definitely something you wanna see, a certificate of analysis or COA, which is awarded by an independent third-party company.

And there are several certifications available. So these are just a few. The National Sanitation Foundation or NSF, the NSF offers product and ingredient certification for supplements and they also have a list on their own website.

The United States Pharmacopeia or USP, the USP, verified market, means a product has been tested for ingredients and contaminants. They also have a list of verified supplements on their website, as well as the Natural Products Association or NPA.

An NPA certification is given to supplements adhering to their standards for good manufacturing practices. So these are just a few certifications. You definitely want to be looking out for that third-party testing and an award from a third-party company as a strong indicator.

I personally use Thorne supplements, which I've said in a few episodes now. They have... certifications, they have third-party testing, I really trust them and they were recommended to me actually by a friend that's a dietitian that is an expert in so many things and I really trust that guidance so I love my thorn supplements personally.

Now when you should start and stop taking a prenatal vitamin? Ideally you want to start three to six months before trying to conceive but absolutely you should be taking them within the first 12 weeks of your baby already being in your belly.

If you're not breastfeeding you can stop taking prenatal vitamins after birth. Otherwise, you can continue them if you are breastfeeding. There are also a lot of postnatal supplements popping up on the market now.

This is not something that I've looked into because I'm going on this journey as my body goes through it. So once baby boy is here, that's definitely something that I'll be looking to a bit more. But I also do know that I can just continue my prenatals if that's what's working for me.

Some postnatal vitamins are specifically formulated for breastfeeding and they may have things like more DHA and omega-3s for brain development, higher vitamin D since breast milk is often low in it.

And a lot of times you have to supplement your breast milk with vitamin D. So that's something that might be in a postnatal supplement as well as extra choline and iodine for cognitive growth. The current prenatals I take do have choline and iodine for example, but these are some of the things you might get from a postnatal vitamin.

Now, let's get into a little bit more of the nitty gritty for prenatal vitamins that are currently recommended. I consulted a very thorough and lengthy study which I linked on my website which you can get to on the show notes.

I'm only going to talk through a few of the supplements because honestly friends, there are so, so many. What's great is that if you're getting a prenatal multivitamin, you're going to see it has tons and tons of different vitamins in it already.

So a lot of these might just be all in one but there's also a few that I've noted that might need to be taken separately such as choline, which I take separately or folate, which I take additional one separately.

So that being said, let's go through just a few important vitamins. First one is folic acid or folate. For mom, it supports red blood cell production and helps prevent anemia for babies. It is crucial for neural tube formation, which we talked a little bit about in the beginning of the episode, which develops into the brain and spinal cord.

It prevents neural tube defects like spina bifida. The recommended form of folic acid or folate is methylated folate for better absorption. And that's exactly the kind that I take. Choline, for mom, it supports liver function and helps prevent pregnancy complications.

For baby, it is essential for brain development, memory, and neural tube formation. Now, many prenatal vitamins lack choline, so I take mine separate, for example. There may be a multivitamin that contains it, but I've yet to find it.

Iron is the next one on the list. For mom, it supports increased blood volume and prevents anemia, which may reduce fatigue and dizziness. While you're pregnant, you gain... up to 50% more blood in your body as a pregnant person.

So you got a lot of blood pumping around there. I've already been tested for iron deficiency twice during my pregnancy. Thankfully, I was taking iron pills before, way before I was even thinking about getting pregnant because I've been an anemic girl for most of my life.

And thankfully my iron is doing well. And I know that's because I'm taking it every day in my prenatal. Now for baby, iron ensures proper oxygen delivery to the fetus for healthy growth. Now too much iron can cause constipation.

So you want to balance it with fiber and hydration. And while you're pregnant, constipation is already an issue that is ongoing. Let me tell you, babe. Next vitamin up is vitamin D. For mom, it supports bone health and immune function.

For baby, it helps with calcium absorption for strong bones and teeth. Next up, we have a DHA or omega-3 fatty acids, which I also take in a separate supplement from my multivitamin, multiprenatal. For mom, it supports heart health and reduces the risk of postpartum depression.

Ooh, we love to hear it. For baby, it is crucial for brain and eye development. You can also look for DHA from algae-based sources if you're vegan. So that's definitely something to look into for my vegan friends.

I am not vegan anymore. I was once upon a time. So I take it in the form of a pill that does have fish oil in it, but there's vegan alternatives. So love that for you. Iodine. For mom, it supports thyroid function and prevents hypothyroidism during pregnancy.

For baby, it's crucial for brain development and metabolism regulation. My multiprenatal vitamin specifically shouts out that it contains iodine. So that's one reason why. I chose it. Calcium is up and X.

Calcium prevents bone loss since the baby takes calcium from the mother's bones. So that's what it's doing for mom. For baby, it's essential for developing strong bones, teeth, and heart function. Of course, B12.

B12 helps with energy production and prevents anemia. For mom, for baby, it supports brain development and nerve function. This is again super important for vegan moms. I remember when I was vegan, B12 was something I was constantly supplementing.

So that is definitely something to think about. Magnesium. For mom, it helps with muscle relaxation, reduces leg cramps, and prevents high blood pressure. For baby, it supports proper bone and muscle formation.

I know my multi has magnesium in it. Thankfully, I have not gotten any crazy leg cramps yet, but I have heard horror stories about it. So I love that it can help with that. We only have a couple more.

Zinc supports immune function and wound healing for mom. For baby, it's crucial for cell division and tissue growth. Next up, vitamin A. You want it in the beta-carotene form versus, for example, you may have heard about vitamin A and the risks of it if you continue using retinol, for example, or retin-A because you don't want vitamin A, you don't wanna have too much vitamin A in the body.

But this form of vitamin A supports immune health and vision. It's essential for organ development, including heart, lungs, and kidneys for the baby. You do, like I said, want to avoid retinol or retin-A and excess because high doses can be harmful.

So the beta-carotene version is safer. Lastly, we have vitamin C. Vitamin C for mom boosts immunity and enhances iron absorption. So it's helping that iron really get all up in there. And for baby, it supports collagen formation for skin, cartilage, and blood vessels.

So that was a lot of vitamins, and honestly, friend, there were so, so many more that were listed, but I was like, these are the most important ones, so we're just gonna talk those through. Now, our final section on today's episode, really, I just wanted to dive into the importance of folic acid above all other supplements.

Folic acid, or Foley in its natural form, is considered the most critical prenatal nutrient because it plays a key role in what? Neural tube development. You already know because I mentioned it a few times, which occurs within the first 28 days of pregnancy, often before many women even know that they are pregnant.

Their neural tube develops into the baby's brain and spinal cord, and a deficiency in folic acid can lead to birth defects. So again, this is one reason why I really, advocate for taking prenatals, especially folate, three to six months before trying to conceive, but really as soon as you find out that you are pregnant, you wanna get in on that because of the first 28 days of pregnancy are a very crucial time in that neural tube development.

The key benefits of folic acid are, of course, prevents neural tube defects. The most well-reasoned for folic acid supplementation is the ability to prevent major birth defects. Now, again, this becomes the baby's brain and spinal cord, so that neural tube is very important.

It also supports DNA synthesis and cell growth, which is essential for the rapid cell division required for fetal development. It prevents anemia in the mother, as I mentioned earlier, because it aids in red cell production, reducing the risk of anemia, which can reduce the risk of pregnancy complications.

It also reduces the risk of preterm birth and low birth weight. Some studies suggest it may lower the chance of preterm delivery and underweight newborns. Something else I wanna shout out is that as a black woman, I'm always thinking about preeclampsia, especially because it can be more prevalent in women of color.

And I've read some studies that talk about a link between having not enough folate supplementation and potentially having preeclampsia. So this is another indication of why making sure we take those folate supplements is very important.

Now, something to note is that the World Health Organization actually specifically recommends folate supplementation and also notes that if you have a high risk pregnancy or potentially may have a high risk pregnancy, that it's important to take some additional folate beginning at least one month before conception.

The CDC also recommends folic acid for all women of childbearing age. The CDC urges women to start supplementation at least one month before conception and to continue throughout pregnancy. So very similar to the World Health Organization.

And lastly, the American College of Obstetricians and Gynecologists, okay, tongue twister, also recommends supplementing with folic acid. So again, we have three organizations right here that highly recommend taking folate specifically and giving it at least a month before trying to conceive to really build up some stores of folate.

Now, friend, if you hear me gasping for air in this episode, it is because my son is, last I was told, five inches above my belly button. That's where my uterus is currently ending. So I have basically no space in my entire body for my lungs, my organs, or any food to fit.

So if I'm gasping for air, that is literally why. I hope that you got some really useful information in today's episode. I think it can be very confusing what supplements to take and why you might wanna take them, what brand to take and how to know if a vitamin or supplement is good quality and if it is the right one for you.

So I hope this helped a little. Of course, definitely take that opportunity to run it by your doctor if you have the opportunity. And I bet there are some doctors out there that might have some really strong opinions about prenatal vitamins.

I haven't met them. Usually they're just like, cool, you're taking a prenatal, amazing. But I'm sure there are doctors out there that might give you a little bit more insight. And if you find them, I love that for you.

I love it. Now on next week's episode, I'll be discussing what to expect when it comes to doctor's appointments, genetic testing and other tests during pregnancy. I'll also be talking about some common interventions during labor and delivery.

So we're getting a little bit medical in the next episode. I'm honestly just breaking down a lot of things that I never heard of before I got pregnant. And I think it would be super, super useful so you know a little bit more of what to expect.

You can follow me at Taylor Rael Montay everywhere. As always, a full transcription of the episode along with citations can be found on my website. All of those links are available in the show notes.

See you out there.

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Disclaimer: The information shared on On the Outside is for informational and educational purposes only. I am not a doctor, medical professional, or licensed healthcare provider. The content of this podcast is based on my personal experiences and research, but it should not be taken as medical advice. Always consult with your doctor or a qualified healthcare professional before making any decisions related to your pregnancy, health, or well-being. Every pregnancy is unique, and what works for one person may not be right for another.