Discovering you’re pregnant brings a whirlwind of emotions, excitement, joy, and often a healthy dose of anxiety about doing everything right for your baby. Among the countless decisions you’ll make,
Understanding which supplements you need and why they matter can feel overwhelming.
You’ve probably heard conflicting advice from well-meaning relatives, seen countless products at the pharmacy, and wondered whether you really need all these pills. The truth is, while a balanced diet forms the foundation of a healthy pregnancy, certain supplements play crucial roles in supporting your baby’s development and protecting your own health during these transformative nine months.
Let’s break down the three most essential pregnancy supplements: calcium, iron, and DHA, so you can make informed decisions with confidence.
Why Do Pregnant Women Need Supplements?
Pregnancy dramatically increases your nutritional requirements. Your body is literally building another human being, which requires significantly more vitamins, minerals, and nutrients than your regular diet typically provides.
What supplements should I take during pregnancy?
While individual needs vary, most healthcare providers recommend prenatal vitamins containing folic acid, iron, calcium, vitamin D, and DHA (omega-3 fatty acids). These nutrients support critical developmental processes and prevent deficiencies that could affect both you and your baby.
Even women who eat nutritious, balanced diets often struggle to meet the elevated requirements through food alone. Morning sickness, food aversions, and dietary restrictions can make adequate nutrition even more challenging during pregnancy.
Calcium During Pregnancy: Building Strong Bones
Calcium is the most abundant mineral in your body, and during pregnancy, its importance multiplies. Your baby needs calcium to develop strong bones and teeth, a healthy heart, nerves, and muscles. If you don’t consume enough calcium, your body will draw from your own bone stores to supply your growing baby, potentially compromising your bone health for years to come.
How Much Calcium Do You Need?
Pregnant women require approximately 1,000-1,300 mg of calcium daily, depending on age. Women under 18 need slightly more (1,300 mg) because their own bones are still developing.
What does calcium do for pregnancy?
Beyond bone development, calcium helps regulate blood pressure, reduces the risk of preeclampsia (a serious pregnancy complication), supports proper blood clotting, and aids muscle and nerve function in both mother and baby.
Best Sources of Calcium
Food sources include:
- Dairy products like milk, yogurt, and cheese (one cup of milk provides about 300 mg)
- Fortified plant-based milk alternatives
- Leafy green vegetables like kale and collard greens
- Canned sardines or salmon with bones
- Tofu processed with calcium
- Fortified orange juice and cereals
When supplements are necessary:
If you’re lactose intolerant, vegan, or simply struggle to consume enough calcium-rich foods, supplementation becomes essential. Many prenatal vitamins contain some calcium, but rarely the full daily requirement you may need an additional calcium supplement.
Calcium Supplement Tips
Take calcium supplements in divided doses (500 mg or less at a time) for better absorption. Calcium carbonate absorbs best with food, while calcium citrate can be taken anytime and is easier on sensitive stomachs. Don’t take calcium simultaneously with iron supplements, as calcium can interfere with iron absorption. Space them several hours apart.
Iron During Pregnancy: Preventing Anemia
Iron deficiency is one of the most common nutritional problems during pregnancy, affecting approximately 40% of pregnant women worldwide. Understanding iron’s role and ensuring adequate intake is crucial for both maternal and fetal health.
Why Iron Matters More Than Ever
What does iron do during pregnancy?
Iron is essential for producing hemoglobin, the protein in red blood cells that carries oxygen throughout your body and to your baby. During pregnancy, your blood volume increases by about 50%, requiring significantly more iron to support this expansion.
Without adequate iron, you risk developing anemia, which can cause severe fatigue, weakness, shortness of breath, difficulty concentrating, increased susceptibility to infections, and, in severe cases, complications like preterm delivery or low birth weight.
Your baby also relies on your iron stores for their own development, particularly during the third trimester when they’re building iron reserves to last through the first six months of life.
Iron Requirements and Sources
Pregnant women need 27 mg of iron daily, nearly double the amount required before pregnancy. This increased requirement is challenging to meet through diet alone, which is why iron supplementation is typically recommended.
Best food sources of iron include:
Heme iron (from animal sources, more easily absorbed):
- Red meat, particularly beef and lamb
- Poultry, especially dark meat
- Fish and seafood
Non-heme iron (from plant sources, less easily absorbed):
- Fortified cereals and grains
- Beans, lentils, and chickpeas
- Spinach and other dark leafy greens
- Tofu and tempeh
- Dried fruits like apricots and prunes
Absorption enhancement tip: Consume vitamin C-rich foods (citrus fruits, tomatoes, bell peppers) alongside iron-rich meals to boost absorption. Conversely, avoid drinking tea or coffee with meals, as these contain compounds that inhibit iron absorption.
Managing Iron Supplement Side Effects
What helps with iron absorption during pregnancy?
Taking iron supplements can cause constipation, nausea, or stomach upset—common complaints that lead many women to skip doses. Here’s how to minimize discomfort:
Start with a lower dose and gradually increase to let your body adjust. Take supplements with a small meal or snack if they cause nausea, though they’re best absorbed on an empty stomach. Increase fiber and water intake to combat constipation. Try different formulations—some women tolerate slow-release or liquid iron better than standard tablets.
If side effects remain severe, discuss alternative options with your healthcare provider. Never stop taking prescribed iron supplements without medical guidance, as the consequences of deficiency are serious.
DHA During Pregnancy: Brain Development Support
DHA (docosahexaenoic acid) is an omega-3 fatty acid that’s become increasingly recognized as essential for healthy pregnancy outcomes. While it hasn’t always been emphasized as much as calcium or iron, research increasingly demonstrates its critical role in fetal development.
What Is DHA and Why Does It Matter?
What does DHA do in pregnancy?
DHA is a primary structural component of the brain and retina. During the third trimester and first year of life, your baby’s brain undergoes rapid growth, and adequate DHA is crucial for optimal brain and eye development.
Studies suggest that sufficient DHA intake during pregnancy may support cognitive development, improve visual acuity in infants, reduce the risk of preterm birth, support healthy birth weight, and potentially lower the risk of postpartum depression in mothers.
DHA Requirements and Sources
Pregnant women should aim for at least 200-300 mg of DHA daily, though some experts recommend up to 500 mg. Unfortunately, most women fall far short of this target.
Best food sources of DHA:
- Fatty fish like salmon, sardines, and anchovies (choose low-mercury options)
- Fish oil or algae-based omega-3 supplements
- DHA-fortified eggs
- Some brands of milk and yogurt are fortified with DHA
Mercury concerns: While fish provide excellent DHA, pregnant women must be mindful of mercury content. Choose low-mercury options like salmon, sardines, anchovies, and trout. Avoid high-mercury fish, including shark, swordfish, king mackerel, and tilefish.
Choosing a DHA Supplement
Many prenatal vitamins now include DHA, but check the amount; some contain only 50-100 mg, which may be insufficient. If your prenatal doesn’t contain adequate DHA, consider adding a fish oil or algae-based omega-3 supplement.
Vegetarian and vegan options: Algae-based DHA supplements provide an excellent plant-based alternative to fish oil and are equally effective. These are particularly important for women following plant-based diets, as plant sources of omega-3s (like flaxseed and walnuts) contain ALA, which the body must convert to DHA a process that’s often inefficient.
How to Take Pregnancy Supplements Effectively
Having the right supplements is only half the battle; taking them correctly ensures you’re getting maximum benefit.
Timing Matters
Morning routine: Take your prenatal vitamin and DHA supplement with breakfast. The fat from your meal helps absorb fat-soluble vitamins and DHA.
Afternoon or evening: Take calcium supplements separately from iron (space them at least 2-3 hours apart). If calcium causes constipation, taking it at night with dinner and plenty of water may help.
With iron: If iron causes morning nausea, try taking it before bed with a small snack. Some women find this reduces digestive discomfort.
Consistency Is Key
What supplements are important during pregnancy only work when taken regularly. Set phone reminders, keep supplements visible where you’ll see them daily, use a pill organizer to track daily doses, and pair supplement-taking with an existing habit like brushing your teeth.
Medstown’s medicine delivery app can help ensure you never run out of essential prenatal supplements. With convenient home delivery and reminder features, you can maintain consistency throughout your pregnancy without worrying about pharmacy trips or stock-outs, particularly helpful during those exhausting first and third trimesters when leaving the house feels like a major undertaking.
What Happens If You Don’t Take Pregnancy Supplements?
Understanding potential consequences of deficiencies can motivate consistent supplementation, though this isn’t meant to create anxiety. Most deficiencies develop gradually and can be corrected with proper supplementation.
Calcium Deficiency Risks
What causes low calcium during pregnancy?
Insufficient dietary intake, vitamin D deficiency (which impairs calcium absorption), and certain medications can all contribute to inadequate calcium levels.
Without enough calcium, your body draws from your bones to supply your baby, potentially increasing your risk of osteoporosis later in life. Severe deficiency may contribute to preeclampsia, muscle cramps, and dental problems.
Iron Deficiency Consequences
What happens when iron is low in pregnancy?
Maternal anemia causes persistent fatigue, weakness, pale skin, dizziness, rapid heartbeat, and difficulty concentrating.
For your baby, severe maternal anemia increases risks of premature birth, low birth weight, developmental delays, and insufficient iron stores at birth. During delivery, anemic mothers face higher risks of complications, including excessive bleeding.
DHA Deficiency Impact
What are the effects of low DHA during pregnancy?
While deficiency effects are less immediately obvious than with iron or calcium, inadequate DHA may result in suboptimal brain and eye development, increased risk of preterm birth, potentially lower cognitive scores in childhood, and increased maternal risk of postpartum depression.
Beyond the Big Three: Other Important Nutrients
While calcium, iron, and DHA are crucial, a comprehensive prenatal vitamin should also include:
Folic acid (400-800 mcg): Prevents neural tube defects and should be taken even before conception if possible.
Vitamin D (600-800 IU): Works with calcium for bone health and supports immune function. Many women are deficient, especially those with darker skin or limited sun exposure.
Vitamin B12: Essential for nerve development and red blood cell formation, particularly important for vegetarians and vegans.
Iodine (150-220 mcg): Supports thyroid function and fetal brain development.
Choline: Emerging research suggests it plays important roles in brain development, though it’s not yet in all prenatal vitamins.
Choosing the Right Prenatal Supplement
Best supplements for pregnancy aren’t necessarily the most expensive brands—they’re the ones you’ll actually take consistently, and that meet your individual needs.
What to Look For
Choose a prenatal vitamin containing at least 27 mg iron, 200-300 mg DHA (or plan to supplement separately), 400-800 mcg folic acid, and adequate vitamin D, B12, and iodine. Check that it’s third-party tested for quality and purity.
Avoid excessive amounts of vitamin A (retinol), which can cause birth defects in high doses. Beta-carotene, a safe vitamin A precursor, is fine.
Prescription vs. Over-the-Counter
Medicine for pregnancy supplements may be prescribed by your doctor, particularly if you have specific deficiencies or risk factors. Prescription prenatals aren’t necessarily better than quality over-the-counter options, but they may be covered by insurance, making them more affordable.
Your healthcare provider might recommend prescription supplements if you have documented deficiencies, a history of pregnancy complications, dietary restrictions, or multiple pregnancies (twins or more).
Special Considerations and Individual Needs
Vegetarians and Vegans
Plant-based diets during pregnancy require extra attention to ensure adequate iron (less bioavailable from plant sources), vitamin B12 (found almost exclusively in animal products), DHA (choose algae-based supplements), and potentially zinc and calcium depending on food choices.
Work with a registered dietitian familiar with plant-based pregnancy nutrition to ensure all needs are met.
Women with Medical Conditions
Certain health conditions affect supplement needs. Women with thyroid disorders should space calcium and iron supplements away from thyroid medication. Those with diabetes may need adjusted supplementation based on blood sugar management. Women with digestive disorders like Crohn’s or celiac disease may require higher doses due to absorption issues.
Always inform your healthcare provider about existing medical conditions when discussing prenatal supplementation.
Multiple Pregnancies
Carrying twins or multiples increases nutritional demands significantly. You’ll likely need higher doses of many nutrients, including iron, calcium, and folic acid. Follow your healthcare provider’s specific recommendations, which will be individualized based on your situation.
When to Call Your Healthcare Provider
What to take for pregnancy health should always be discussed with your doctor or midwife, but certain situations require immediate attention:
- Severe side effects from supplements (allergic reactions, extreme nausea, or persistent vomiting)
- Signs of anemia despite supplementation (extreme fatigue, weakness, dizziness, pale skin)
- Difficulty swallowing pills or keeping supplements down due to morning sickness
- Concerns about interactions with other medications you’re taking
- Questions about supplement quality or appropriate dosing
Don’t hesitate to reach out your healthcare team is there to help you navigate these questions.
Making Supplementation Easier
How can I remember to take pregnancy supplements? Consistency challenges are common, especially when dealing with morning sickness, fatigue, and the general chaos of life.
Practical strategies that work:
Keep supplements next to your toothbrush or coffee maker so you see them during morning routines. Use a daily pill organizer to track whether you’ve taken each supplement. Set recurring phone alarms with descriptive labels. Keep a backup supply in your purse or desk for days you forget at home.
If morning sickness makes early-day supplementation impossible, talk to your doctor about splitting doses perhaps prenatal and calcium in the morning, iron and DHA in the evening.
Medstown simplifies the logistical aspects of maintaining supplement routines. With scheduled deliveries, you won’t experience that panic when you open your last bottle and realize you need to get to the pharmacy. The app can also send reminders when it’s time to reorder, ensuring you maintain consistent supplementation throughout your entire pregnancy journey.
The Bottom Line: Supporting Your Pregnancy Journey
The best way to take pregnancy supplements combine quality products, consistent timing, and realistic strategies that fit your lifestyle. These three essential nutrients calcium for bone development, iron for blood health and oxygen delivery, and DHA for brain and eye development—form the foundation of prenatal supplementation.
Remember that supplements enhance a healthy diet; they don’t replace it. Focus on eating nutrient-dense whole foods whenever possible, use supplements to fill gaps and meet increased demands, stay consistent with your supplementation routine, and communicate openly with your healthcare provider about your needs and any concerns.
Pregnancy is a time of profound physical changes and emotional adjustments. Taking care of your nutritional needs including appropriate supplementation is one of the most important ways you can support both your own health and your baby’s development. Be patient with yourself as you establish routines, and don’t hesitate to ask for help when you need it.
Frequently Asked Questions
Q1: Can I take all my pregnancy supplements together at once?
It’s generally fine to take your prenatal vitamin and DHA supplement together, preferably with a meal containing some fat for better absorption. However, calcium and iron should be taken separately space them at least 2-3 hours apart because calcium can interfere with iron absorption. If you’re taking multiple supplements, consider splitting them between morning and evening doses.
Q2: What should I do if prenatal vitamins make me nauseous?
Try taking your prenatal with food or right before bed. Switch to a different brand or formulation. Some women tolerate gummy prenatals better, though these often contain less iron. Take the supplement in smaller divided doses throughout the day if your prenatal can be split. If nausea persists, talk to your healthcare provider about prescription options or alternative supplementation strategies.
Q3: How long should I continue taking pregnancy supplements after giving birth?
Continue taking prenatal vitamins throughout breastfeeding, as your nutritional needs remain elevated. Your body is still supporting another person through breast milk production. Iron supplementation duration depends on your delivery experience and postpartum blood work. Women who experienced significant blood loss may need continued supplementation. Discuss your specific situation with your healthcare provider at your postpartum checkup.
Q4: Are expensive prenatal supplements better than affordable options?
Not necessarily. What matters most is the nutrient content, not the price tag. Compare labels to ensure adequate amounts of essential nutrients like iron, folic acid, and calcium. Look for third-party testing certifications (USP, NSF, or ConsumerLab) which indicate quality regardless of price. The remedy for pregnancy nutritional needs is consistent supplementation with appropriate nutrients, whether from budget-friendly or premium brands.
Q5: Can I get enough nutrients from food alone without supplements?
While a nutrient-dense diet is crucial, meeting all pregnancy nutritional requirements through food alone is extremely challenging. The iron requirement alone (27 mg daily) would require eating about 5-6 servings of iron-rich foods daily. DHA targets are difficult without eating fish several times weekly, and many women struggle with food aversions during pregnancy. Supplements ensure you consistently meet elevated requirements even on days when eating well is difficult.
Q6: What if I forget to take my supplements for several days?
Don’t try to “catch up” by taking multiple days’ worth at once; this can cause side effects and doesn’t improve outcomes. Simply resume your regular schedule. One of the benefits of gradual fetal development is that occasional missed doses don’t cause immediate harm. However, consistent supplementation is important, so implement reminder strategies to minimize forgotten doses in the future.
Q7: Do I need supplements if I’m not pregnant but trying to conceive?
Yes, starting prenatal supplements before conception is ideal, particularly folic acid. Neural tube development occurs in the first few weeks of pregnancy often before women realize they’re pregnant. Beginning supplementation at least one month before conception (ideally three months) ensures adequate nutrient stores from the very beginning. If you’re actively trying to conceive, start taking prenatal vitamins now.
Q8: Are there any supplements I should avoid during pregnancy?
Avoid high-dose vitamin A supplements (retinol form, not beta-carotene), which can cause birth defects. Herbal supplements should be used cautiously many aren’t adequately studied for pregnancy safety. Avoid supplements containing iodine levels exceeding 500-600 mcg daily. Weight loss supplements and products containing stimulants should be avoided entirely. Always consult your healthcare provider before adding any supplements beyond your standard prenatal vitamin.
References
[1] Institute of Medicine. (2011). Dietary Reference Intakes for Calcium and Vitamin D. National Academies Press. https://doi.org/10.17226/13050
[2] Coletta, J. M., Bell, S. J., & Roman, A. S. (2010). Omega-3 Fatty Acids and Pregnancy. Reviews in Obstetrics and Gynecology, 3(4), 163-171. PMCID: PMC3046737
[3] World Health Organization. (2016). WHO recommendations on antenatal care for a positive pregnancy experience. Geneva: World Health Organization. ISBN: 978-92-4-154991-2
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