Pregnant and lactating women need more from their multivitamins, including increased folic acid and iron. Experts also recommend a slightly higher percentage of vitamin A in the safer form of beta-carotene to help prevent birth defects. The current guidelines recommend 600 mcg of folic acid per day, up from 400 mcg for premenopausal women, and 27 mg of iron, up from 18 mg. Pregnant women also have slightly higher needs for magnesium, selenium, zinc, copper, vitamin C, riboflavin and niacin. Based on the latest guidelines, calcium and vitamin D needs remain the same as before pregnancy; however, these needs can change during pregnancy and are highly individual. A full list of recommended amounts is available in our Useful Links section.
Pregnant or breastfeeding women also want their multis to be as safe and toxin-free as possible. When the FDA tested 324 multivitamins for lead in 2007, several prenatal multis were found to contain larger amounts even though none exceed the provisional total tolerable intake (PTTI) levels of 25 mcg of lead per day for pregnant or breastfeeding women. Sound Formulas' After Baby Boost 1 (*Est. $50 for 120 tablets), for example, contains an estimated daily exposure of 8.97 mcg. Experts say lead exposure at this level is unlikely to be dangerous, but the vitamin-testing specialists at ConsumerLab.com recommend avoiding any unnecessary exposure because pregnant women are probably exposed to lead in other areas of their lives, as well. Sound Formulas changed manufacturers in January 2008 and duplicated the test in an independent lab; the new formula has an estimated daily exposure of 0.328 mcg of lead per day.
Two prenatal formulas found to have low levels of lead in FDA testing are Rite Aid Prenatal Tablets with Folic Acid (*Est. $18 for 225 tablets) and Pregnancy Plus Prenatal (*Est. $17 for 60 tablets) -- 1.31 mcg and 0.180 mcg of lead, respectively. Both are well-reviewed prenatal vitamins that are approved in ConsumerLab.com testing.
Rite Aid Prenatals contain 800 mcg of folic acid, 400 IU of vitamin D and 28 mg of iron. In an older formula, only 25 percent of vitamin A was available as beta-carotene; now it's 100 percent. It has only 200 mg of calcium, so ask your doctor if you need an additional calcium supplement. As a bonus, it's one of the least expensive prenatal multis with an estimated cost per day of 4 cents. Experts say store brands are equal to more expensive name brands, so there's no reason not to take a less pricey option. Rite Aid Prenatal Tablets with Folic Acid get overall good reviews from users for value, but some say the pills are large -- a common issue with prenatal vitamins.
Pregnancy Plus Prenatal scores highly in an older test conducted by ConsumerLab.com, but isn't included in its most recent roundup. Pregnancy Plus contains many of the recommended nutrients for pregnant women, including 5,000 IU of vitamin A, all in the safer form of beta-carotene; 600 mcg of folic acid; and 27 mg of iron. The multi contains only 40 mg of calcium -- 4 percent of DV -- so pregnant women should talk to their doctors about an additional calcium supplement to meet the recommended 1,000 mg per day. While some users say the Pregnancy Plus Prenatal has a strong vegetable smell, others say it's easy to swallow.
Rainbow Light Just Once Prenatal One (*Est. $8.50 for 30 tablets) gets very high marks at Amazon.com, where users give it an average 4.45 stars out of 5 in 180 reviews. Most consumers note few side effects, and vegans and vegetarians especially like that this prenatal multi is certified free of animal-derived ingredients. However, a few critics say the strong smell exacerbates their morning sickness. The Rainbow Light prenatal contains 800 mcg of folic acid, 30 mg of iron and 4,000 IU of vitamin A, half as beta-carotene. It has only 200 mg of calcium and 400 IU of vitamin D, which are less than the recommended amounts for pregnant women. In an earlier ConsumerLab.com evaluation, Rainbow Light Just Once Prenatal One was found to contain only 41.3 percent of the vitamin A listed on the label and was not approved.
GNC Women's Prenatal Formula with Iron (*Est. $15 for 120 caplets) contains 1,000 mcg of folic acid, 600 mg of calcium and 18 mg of iron; experts recommend 27 mg of iron for pregnant women. It also has 4,500 IU of vitamin A, all in the safer beta-carotene form. GNC Women's Prenatal Formula isn't in ConsumerLab.com's latest test, but it is one of three prenatal multivitamins approved by the organization in an older report. The few user reviews on Drugstore.com are positive, saying the vitamin is easy on the stomach.