You know that you should eat healthy foods, drink plenty of water, and stay active during pregnancy. However, you might not be as clear on what non-food substances are safe or even beneficial for you and your tiny one. Let’s take a look at vitamins, safe medications, and supplements during pregnancy.
Before we get started, though, know that this is not medical advice and is not intended to replace that of your doctor or midwife. As a Registered Nurse, I’m careful about my research and take seriously my commitment to bring you information that is in line with current medical standards. However, your trusted doctor or midwife should be the top source of information about your body and your pregnancy.
Vitamins
Before pregnancy, you may not have been in the routine of taking a regular multivitamin. However, healthcare providers agree that most pregnant women should take a daily prenatal vitamin (1). In theory, a woman who eats a varied, high-quality diet may not need to supplement. There are some vitamins that are so important for a healthy pregnancy, though, that most doctors recommend being safe and taking a prenatal vitamin.
I go deep into prenatal vitamins in Prenatal Vitamins: Why Folic Acid? What NOT to Take? The basics are that during pregnancy, your body needs more of certain vitamins and minerals. One of the most talked about is folic acid (vitamin B9) which helps protect against neural tube defects. Another big player is iron, which helps your body produce the extra 50% of blood you have circulating during pregnancy. Other important vitamins include calcium, zinc, and vitamin C.
You should steer clear of getting too much of certain vitamins, like Vitamin A and Vitamin E, but prenatal vitamins contain a safe amount.
For even more reading, the March of Dimes has a great resource about vitamins and other nutrients during pregnancy.
Which Prenatal Vitamin to Choose?
Fortify Your Life
In my own research about prenatal vitamins, I turned to Dr. Tieraona Low Dog’s book, Fortify Your Life. I absolutely love this book and highly recommend it to anyone wants to take an evidence-based approach to supplements for themselves or their family. In regard to the vitamins we mentioned earlier, Dr. Low Dog suggests:
FOLATE: Women who could become pregnant should supplement with 400mcg per day of folic acid. Pregnant women should take 600mcg per day. Use the active form of folic acid, usually listed as L-methylfolate or 5-methyltetrahydrofolate.
IRON: Unless your doctor finds that you are anemic and need additional iron, follow the Food and Nutrition Board’s recommended daily allowance (RDA) of 27 mg. Iron can be constipating or hard on the stomach. Chelated forms of iron are often better tolerated. Look for iron bisglycinate, ferrous bisglycinate, or iron glycinate.
VITAMIN D: Our body uses cholecalciferol, or vitamin D3. When buying a supplement, be sure the D is listed as cholecalciferol.
Ensure that your prenatal includes 150-250 mcg iodine, 200 mg DHA, 200-500 mg choline, 300 mcg biotin, and 400-600 mcg methylfolate. Maintain vitamin D level at greater than 30 ng/mL. (Discuss vitamin D levels with your doctor.)
My Prenatal Vitamin
There are certainly many great options for a high-quality prenatal vitamin. Here’s the prenatal vitamin that I personally use. I chose this vitamin because it’s entirely food-based and non-synthetic and comes closest to the recommendations made by Dr. Low Dog.
Safe Medications During Pregnancy
It might seem easy enough to give the advice to just never take any medications in pregnancy, just in case. But for most of us, that’s not realistic advice. You may need meds to manage chronic conditions or for illness that arises during your pregnancy.
Fortunately, there are a great many safe medications that you can take during pregnancy, should you and your doctor determine that you need them. For starters, always tell your healthcare providers about any medications you are already taking. (Same goes for vitamins and supplements.) Discuss together any medication you’re thinking of starting so you can be sure it’s safe, not only for pregnancy but also in conjunction with your other medications.
FDA Resources
The U.S. Food and Drug Administration (FDA) evaluates information about a medication and determines if it may be harmful when taken during pregnancy (2). You can find information about whether a drug is safe to use during pregnancy right on the packaging and materials that come with it. Or check out this handy online medication guide database. Use this in addition with talking to your doctor to determine the safety of a given medication. In other words, I don’t think you should get the go-ahead from a website alone.
Steps to Do Before Taking a Medication:
Before taking any medication during pregnancy, first follow these 4 simple steps (3,4):
Ask Questions – Discuss any medications with your doctor or phramacist before starting or stopping them.
Read the Label – Laws dictate that all medications in the U.S. are labeled with information about how the med might affect a pregnant woman or her unborn baby. You can also talk to your doctor or pharmacist to help you understand the labeling.
Be Careful Online – Don’t take a medication based solely on information you read online or heard about in an online group or chat room. A source could have good intentions but still spread incorrect information.
Report Any Problems – First, tell your healthcare provider right away if you have a problem with any medication. Then you can also report any serious problems directly to the FDA.
Safe Medications During Pregnancy: Herbs, Essential Oils & Natural Supplements
Some pregnant moms may not realize that it’s also important to talk to their doctor about supplements or natural remedies they may take. Be aware that something isn’t necessarily safe for your baby just because it’s labeled as natural.
For example, the following herbs are a few of the many that should be avoided during pregnancy, typically because they stimulate uterine contractions or cross the placenta (5):
- Black Cohosh
- Blue Cohosh
- Goldenseal
- Pennyroyal
There’s also evidence that essential oils can cross the placenta to your baby, compounded by a frustrating lack of information regarding the toxicity of essential oils during pregnancy (6). However, it’s generally agreed that pregnant moms should avoid the use of the following essential oils:
- Sassafras
- Wormwood
- Cassia
- Pennyroyal
- Mustard
- Cinnamon
- Any oils that contain high levels of phenols, ethers, or aromatic aldehydes
Takeaway About Safe Medications During Pregnancy: Talk to Your Doctor
You’ve heard the same advice over and over in this post, and seen that both the Food and Drug Administration and Centers for Disease Control and Prevention agree. Talk to your care provider about any vitamin, medication, or supplement you take or are thinking of taking. Your doctor, nurses, dentist, and pharmacist have all had extensive training in this matter. They are there to help you, and you should never hesitate to bring them questions about vitamins, safe medications, and supplements during pregnancy.
References:
1. Simkin, P. (2010). Pregnancy, Childbirth and the Newborn, 4th edition. Meadowbrook Press.
2. The American College of Obstetricians and Gynecologists. (2010). Your Pregnancy and Childbirth Month to Month, 5th edition.
3. Commissioner, Office of the. “Medicine and Pregnancy – Fact Sheet.” U.S. Food and Drug Administration, FDA, www.fda.gov/consumers/free-publications-women/medicine-and-pregnancy.
4. “Pregnant or Thinking of Getting Pregnant?” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 8 Nov. 2019, www.cdc.gov/pregnancy/meds/treatingfortwo/facts.html.
5. Belew, C. (1999). Herbs and the childbearing woman: Guidelines for midwives. J Nurse-Midwifery. 44:231-252.
6. National Association for Holistic Aromatherapy. Retrieved from https://naha.org/index.php/explore-aromatherapy/safety#pregnancy
7. International Federation of Professional Aromatherapists. (2013). Pregnancy Guidelines. Retrieved from https://naha.org/assets/uploads/PregnancyGuidelines-Oct11.pdf
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