What are they?
For a mother's health, and the health of her baby, she is advised to take so-called "prenatal vitamins." These are specially formulated multivitamins that make up for any nutritional deficiencies in your diet during your pregnancy. While the supplements contain numerous vitamins and minerals, their folic acid, iron, and calcium content are especially important.

Why do pregnant women need high levels of folic acid, iron and calcium?
Folic acid can reduce your risk of having a baby with a serious birth defect of the brain and spinal cord, called the "neural tube." A baby with spina bifida, the most common neural tube defect, is born with a spine that is not closed. The exposed nerves are damaged, leaving the child with varying degrees of paralysis, incontinence, and sometimes mental retardation.

Neural tube defects develop in the first 28 days after conception. Because about half of all pregnancies are unplanned, the U.S. Public Health Service recommends that all women of childbearing age get 400 micrograms of folic acid each day. In fact, the FDA now requires that all flour products, such as breads, buns and bagels, be fortified with extra folic acid.

There are natural sources of folic acid: green leafy vegetables, nuts, beans, and citrus fruits. It's also found in many fortified breakfast cereals and some vitamin supplements.

Calcium during pregnancy can prevent a new mother from losing her own bone density as the fetus uses the mineral for bone growth.

Iron helps both the mother and baby's blood carry oxygen.

While a daily vitamin supplement is no substitute for a healthy diet, most women need supplements to make sure they get adequate levels of these minerals.

Are all prenatal supplements the same?
No, they're not. Look for one that contains approximately:

• 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 mg of vitamin B-12
• 10 mg of vitamin E
• 15 mg of zinc
• 30 mg of iron

Your doctor or midwife can also advise you on certain brands. In some cases, your health care provider will give you a prescription for a certain type of prenatal vitamin.

My prenatal vitamin makes me nauseous, what should I do?
Some prenatal vitamins can cause nausea in an already nauseous pregnant woman. If your prenatal vitamins make you sick, talk to your health care provider. He or she may be able to prescribe a different kind of prenatal vitamins (for example, chewable vitamins as opposed to those you swallow whole may be better tolerated by some women).

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional written health information, please contact the Health Information Center at the Cleveland Clinic (216) 444-3771 or toll-free (800) 223-2273 extension 43771 or visit www.clevelandclinic.org/health/. This document was last reviewed on: 9/9/2002