Knowing when and what type of prenatal vitamins to take can be confusing. For starters, they’re called prenatal vitamins even though women take them before, during and after pregnancy. And how long to take them before and after also remains in question. But luckily, LivingHealthy expert Ashley Koff, RD, is schooling us on everything there is to know about prenatals.

Many women, especially in cases of unplanned pregnancy, don’t start taking prenatals until they have already conceived—which, surprisingly enough, isn’t optimal, according to Koff. “I understand why [women aren’t taking prenatals earlier]. It can feel off-putting to take a prenatal in the early years of our lives because we aren’t actively trying to get pregnant. Most women don’t think about taking a prenatal supplement until they start family planning. That may be when they get married or when they stop using birth control,” she tells LivingHealthy.

But is that too late? Just how early should a woman start taking a prenatal? The good news is that for the first pregnancy, both mom and baby get the benefit of the nutrient stores that the mother’s body has built up over decades, according to Koff. That said, oftentimes our teen years and early 20s aren’t full of nutrient-dense choices, and factors like birth control or other medications can contribute to less-than-adequate nutrient levels to support a healthy pregnancy (for both mom and baby’s needs). Thus, Koff, who encourages her clients to think about the quality (which she calls the “nutrient density”) of what they are consuming during the early years of menstruation, says that ideally women should consider a prenatal as their first multivitamin after they go through puberty, and certainly if they are taking an oral birth-control medication (several of which have shown to interfere with key nutrients like B vitamins). The upsides to taking prenatal vitamins earlier in life are significant; teen girls and young women often report better energy, healthier hair and skin, and even mood benefits. To the shock of parents, Koff has recommended prenatals to clients as young as 14. But, she reminds us, “they are called prenatal, not perinatal [after the baby is born], for a reason, emphasizing that in the ideal world, the nutrient support comes long before the pregnancy.”

The nutrients in a quality prenatal are designed to support the baby (or the growing body). Once there is a fetus, nutrients in the mom’s body go preferentially to the baby, so the prenatal vitamins ensure there is enough to go around to both mom and baby. Of course, mom’s healthy diet will contribute nutrients, but prenatal vitamins give mom the extra kick her body needs.

All of this information begs the question: If prenatals are so critical, why aren’t doctors recommending them to patients earlier? Koff says that although most doctors recommend a multi for teens and young women, they often don’t specify a prenatal, as they too consider those solely for pregnant women.

As for picking the right prenatal, Koff explains that there are a few key factors. She uses the term “supplemental food” instead of “dietary supplements” to remind us that 1) we are choosing prenatals to enhance nutrient intake and 2) they are likely consumed daily.

“I have a standing rule: Your supplement should be at least as good a quality as the average quality of your diet,” she tells LivingHealthy. “That means if you are avoiding artificial ingredients, GMOs, etc., then your supplemental food shouldn’t contain them, either. Likewise, if you eat mostly whole foods, not highly processed ones, then your supplement shouldn’t be made of a bunch of chemical isolates; rather, it should be made from whole food complexes wherever possible.”

Koff says she is frequently asked, “Is it OK for me to take a prenatal that’s different than the one my doctor recommends?”—often because the recommended prenatal doesn’t align with the patient’s dietary choices (vegan, gluten-free, organic, whole food, etc.) or makes her nauseated. “My answer is yes, as long as you let your doctor know what you’re taking. Doctors [and dietitians] are always learning from patients, so you should feel comfortable explaining your choice.”

The single biggest reason women don’t take or stop taking their prenatal? Their body can’t tolerate it, Koff says. It’s a losing situation (literally) if your prenatal makes you nauseated, because not only do you throw up your prenatal, but this often impacts the quality of food you can consume (white crackers, anyone?). Koff recommends trying a prenatal that’s made from fermented nutrients as well as changing the time of day that you take your prenatal if nausea is an issue.

Need help navigating your way through all the prenatal and postnatal vitamin brands? Koff seeks out the better-quality vitamins and minerals on the market and shares them with you—for free—in the AKA (Ashley Koff Approved) Healthy Grocery List Planner section of her website (see Sources below).

So there you have it. While taking prenatal vitamins is a personal choice, now you have proof that you don’t need to wait until the last minute to start popping those nutrient supplements. In fact, you and your not-yet-conceived child will be better off in the long run if you start taking them now! As for what to take after your baby arrives, stay tuned for our upcoming story on prenatal’s new sidekick: postnatal vitamins.


  1. Ashley Koff Approved