By April Segal, PharmD, BCPS, APh

Clinical Pharmacist + Founder

updated 3/6/2023

I love supporting moms through pregnancy with natural options. For some women, it is an impetus to start being cognizant of what we put in our bodies. Whether it's weekend indulgences or medications you have been on for years, pregnancy is an important time to really assess the risks and benefits of the things we expose ourselves to, and now, importantly, our babies as well. 

As a second-time mom, I not only pull on my clinical training as an integrative pharmacist to help moms through this time, but also my own experiences. So, today I will go over a few of my favorite supplements and tips to help mamas!

First, A Word on Medications in pregnancy

If you are on medication and have recently found out you were pregnant, you should immediately assess the pros and cons of continuing or discontinuing the medication. We (Remedy Pharmacists) are also more than happy to have these conversations with our patients and we also always recommend talking with the doctor who prescribed it for you. The best case scenario is to consider your medication regimen prior to conception and make a plan with ample time to decide what is best for you and your future baby (read more about our trimester zero tips here). Many times (and especially for psychiatric medications) a slow tapering off is the best option. We sometimes will even use compounding to allow us to do long tapers of medications that are especially tricky to get off of without significant side effects. 

Supplements for pregnant moms

When it comes to supplements in pregnancy,  there are the general things that all women should take (think prenatal vitamin and omega supplement), but you also have the unique needs that come up during every pregnancy. Every pregnancy is different in this way! With my first pregnancy, my major issue was heartburn; in my second, it was leg cramps. The pregnancy ailment people are most familiar with is, of course, morning sickness but there are (unfortunately) a whole slew of symptoms that can come up at various stages, including anemia, joint aches, heart burns, migraines, acne, and constipation. Whew! Sounds like fun right? Despite all of that, it is STILL such an amazing process. And if all of these changes affect you emotionally, we have options to help with that too. Despite these challenges, I am still in awe at the entire process. Our bodies are so amazing!

So with that being said, I am going to go over my top picks for supplements to use during pregnancy! These products are the best of the best and I have recommended them to all my friends, family and patients who are expecting. 

The Two Baics: Prenatal Multivitamin and Omega-3 Supplements

So I could do a whole article on prenatal vitamins but hands down the MOST important thing is the type of folate (vitamin B1) in your prenatal. Many women may have a MTHFR gene mutation leading to poor methylation. If you are a poor methylator, your baby could be at higher risk of birth defects, and you could be at risk for higher rates of miscarriage if you do not take a prenatal with methylated folate. It's just not even worth chancing taking a prenatal with the unmethylated folate version, especially since there is no downside to taking methylfolate. I can not tell you how disappointed I am in prenatal vitamins that use synthetic folic acid. This includes prescription grade prenatal vitamins, which I would never recommend - these are some of the lowest quality prenatals of all. You should ensure that your prenatal says methylfolate on the label or that it is a whole-food based prenatal, like my favorite Baby and Me by Innate Response. The other B-vitamins are important for you and baby as well. Vitamin B5 helps reduce leg cramps and promotes needed hormone production. Vitamin B6 helps reduce nausea and vomiting and can even be taken in higher strengths independently as a morning sickness remedy, but having it already in your prenatal is a win-win!

B Vitamin	Role in supporting Pregnancy
B1 (folate)	Prevent Birth Defects
B5 (pantothenic acid)	Reduce Leg Cramps, Hormone production
B6 (pyridoxine)	Reduce Nausea

 

Another consideration is whether or not your prenatal contains iron. Iron can be one of the main reasons that a prenatal vitamin might make someone nauseous (or constipated for that matter, another common pregnancy issue). On top of that, not all women require extra iron supplementation or if they do, it might not be needed at all stages of pregnancy. I would suggest a prenatal that has a whole-food based form of iron (you will see that the whole-food based version is a trend here!) which is easier on the stomach. If you can't tolerate that, then it may be best to get an iron free version and then supplement with high-iron foods or a supplement like Floradix, which is the iron supplement that I have seen have the best tolerability of all. Lastly, if your prenatal has a little bit of vitamin C in it, that will help you get the most out of your iron, as it helps with absorption, which is a notorious problem with iron.

Vitamin D, K and Calcium are all important for healthy baby bone development. I prefer a prenatal that does not have calcium though. Mostly because it can interfere with absorption of other nutrients. Secondly, most people can get enough of this in their diet, even if they are vegan! 

Omega 3s (EPA and DHA)

The guidelines suggest that pregnant women should make sure to get at least 300 mg DHA, but I think that stops short. DHA and EPA are both forms of essential omega 3 fatty acids. DHA is essential for both neurological and early visual development of the baby, but EPA has an important role too. EPA and DHA have been shown to prevent preterm labor and delivery, lower the risk of preeclampsia, and increase birth weight. Omega-3 deficiency also increases the mother’s risk of depression. When picking your source of omega-3, it really should be marine or algae based (for vegans) and not plant-based. That is because plant-based sources (like flaxseed or chia seeds) typically only contain alpha-linolenic acid (ALA). ALA is not as active in our body and must be converted to EPA and DHA by your body and unfortunately, our body’s ability to convert ALA is limited. Only about 5% of ALA is converted to EPA, while less than 0.5% is converted to DHA. 

Omega 3 supplements should never smell or taste fishy; if they do then do not take them - that is a sign that they have turned rancid. I have experienced this firsthand when sampling lower-quality supplements. If you get “fish burps” after taking omega 3 supplements, try keeping your supplement in the fridge. I also find that this can vary between products. I am a big fan of the tried and true Nordic Naturals brand. I love their quality standards related to mercury testing as well as their sustainable approaches (also, it is the one brand I have never had the “fish burps” on!)

Other Top Picks for Pregnancy Symptoms

Magnesium: For Sleep and Muscle Aches (and constipation) (oh and migraines)

Not every woman who is pregnant needs magnesium and I didn’t start taking this until the end of my second trimester, but boy do I love it now! I took it to relieve muscle cramps and also to help with sleep. I often find myself recommending magnesium glycinate to all types of people that come into Remedy because it is so helpful for these two common complaints. If you suffer from constipation during pregnancy you could try other salt forms of magnesium, such as magnesium citrate which has the added benefit (in this case) of helping with bowel movements. While many times migraines in pregnancy are related to underlying hormonal changes, sometimes Magnesium L-Threonate can help, which is nice since a lot of other options for migraines are not safe to used in pregnancy.

Type of Magnesium	Role in Supporting Pregnancy
Magnesium Glycinate	Muscle Aches, Insomnia
Magnesium Citrate	Constipation
Magnesium L-Threonate	Migraines
Magnesium Carbonate	Heartburn
Magnesium Sulfate (Topically - Epsom Salt)	Muscle Aches

 

Sleepy Nights Tincture for Pregnancy: Mamas with more severe insomnia

I have been a long time sufferer of insomnia. I have been on everything from Ambien to melatonin to CBD to herbal blends. Before I found out I was pregnant, I had my insomnia under control with the use of Remedy Sleep Blend plus a nightly meditation. The sleep blend is actually Remedy’s most popular product; if you have issues sleeping, I highly recommend it. It's a super effective blend of Valerian Root, Hops, Skullcap, Passion Flower, Chamomile, California Poppy, and Melatonin. However, California Poppy, Hops, and Valerian really shouldn’t be used during pregnancy so I recommend Wishgardens’ Sleepy Nights for Pregnancy Tincture. I already loved this brand for all of its thoughtful blends, and I wasn’t let down by this tincture! It is a beautiful blend of Milky Oat Tops, Linden, Passionflower, and Skullcap. It really works, and I love that it is made especially for pregnant women so you can feel super safe to use it!

Stress Ease Tincture: for the Mama with Stress/Anxiety

Another amazing blend by Wishgarden is the Stress Release Tincture for Pregnancy. This highly effective calming tincture features lemon balm, linden leaf, passionflower and milky oat tops. All are safe in pregnancy and super effective at calming the nerves. Milk oat tops (the same plant we get oatmeal from) is also used for nervous exhaustion, to calm anxious states, to nourish and support during times of emotional stress, and for excessive sensitivity. This blend is also great to have on hand for after your delivery as it can also address these symptoms in the post-partum period as well.

If you are expecting, congratulations! If you are trying to conceive, please stop in and talk to us; it is never too early to start thinking about pregnancy and what I like to refer to as trimester zero. We have many products that can help with the unique needs of women pre and post-birth! Women’s health is one of our specialties here at Remedy. If you are contemplating becoming pregnant or are pregnant, I would highly recommend you attend our Natural Fertility and Birth Roundtable Event  later this month. If you would like more individualized care and recommendations, we also offer private 1-hour Herbalist Consultations, both in person or virtually. Please let us know how we can help!ake them - that is a sign that they have turned rancid. I have experienced this first hand when sampling lower quality supplements. If you get “fish burps” after taking omega 3 supplements, try keeping your supplement in the fridge. I also find that this can vary between products. I am a big fan of the tried and true Nordic Naturals brand. I love their quality standards related to mercury testing as well as their sustainable approaches (also, it is the one brand I have never had the “fish burps” on!)

Magnesium

Not every woman who is pregnant needs magnesium and I didn’t start taking this until the end of my second trimester, but boy do I love it now! It has helped so much with muscle tension, cramps, and also to help with sleep. I often find myself recommending magnesium glycinate to all types of people that come into Remedy because muscle aches/cramps + trouble sleeping are so common. My other go-to for both of these problems is CBD, but I don’t feel comfortable taking or recommending CBD for expectant mothers at this point, but thank goodness we have a super safe and effective option - magnesium! If you suffer from constipation during pregnancy you could try other salt forms of magnesium, such as magnesium oxide or a combo magnesium glycinate/magnesium oxide, which has the added benefit (in this case) of helping with bowel movements.

Sleepy Nights Tincture for Pregnancy

I have been a long time sufferer of insomnia. I have been on everything from Ambien to melatonin to CBD to herbal blends. Before I found out I was pregnant, I had my insomnia under control with the use of my Remedy Sleep Blend plus a nightly meditation. The sleep blend is actually Remedy’s most popular product, if you have issues sleeping I highly recommend it. It's a super-effective blend of Valerian Root, Hops, Skullcap, Passion Flower, Chamomile, California Poppy, and Melatonin. However, California Poppy, Hops, and Valerian really shouldn’t be used during pregnancy so I switched to Wishgardens’ Sleepy Nights for Pregnancy Tincture. I already loved this brand for all of their thoughtful blends and I wasn’t let down by this tincture! It is a beautiful blend of Milky Oat Tops, Linden, Passionflower, and Skullcap. It really works and I love that it is made especially for pregnant women so you can feel super safe to use it!

 

If you are expecting, congratulations! If you are trying to conceive, please stop in and talk to us, it is never too early to start thinking about pregnancy and what I like to refer to as trimester zero. We have lots of products that can help with the unique needs of women pre and post-birth! Women’s health is really one of my passions and it's evident when you look at our shelves :)