Pregnant or trying to conceive? Then you already know prenatal vitamins are essential. But with so many options on the market, you might be overwhelmed by the differences in formulation philosophy, clinical backing, and ingredient quality.

We enlisted the help of Registered Dietitian Breanna Woods MS, RDN, to help us understand what to look for (and avoid) in a prenatal vitamin.

Together, we evaluated four of the most top prenatal brands: Ritual Essential Prenatal, Perelel Trimester Prenatal Packs, Needed Prenatal Multi, and Thorne Basic Prenatal on ingredients & formulation, clinical evidence & expertise, ease of use, quality & purity, and price & value. Read on to find out which one wins.

What to Look for in a Prenatal Supplement

Prenatal vitamins help to ensure you get vital nutrients to support baby’s development that you may not otherwise get from food.*

There are a lot of supplements on the market, with new entrants growing year over year. Because supplement regulations differ from traditional pharmaceuticals,¹  finding one that's easy to tolerate, made with high-quality ingredients, backed by expert formulation, and supported by clinical research can be hard to identify with all the noise and product claims.

According to Woods, a prenatal should “provide the nutrients pregnant women commonly lack and fill nutritional gaps.” Look for: 

• Vitamin D: Important role for bone health, immune function, and inflammation.² An estimated 90% of pregnant women in the US have vitamin D intakes below the recommended adequate intake, which helps support overall maternal health.³ 
• ‍Folate: Plays a key role in fetal development and supports neural tube formation (embryo brain and spine development that take place in the first month of pregnancy).⁴ About one third of pregnant women in the US have intakes below what's recommended.⁵‍
• ‍Choline: Important for nervous system development and may help neural tube formation; most pregnant women in the US do not get enough from diet, and fewer than half of prenatal supplements on the market even contain it.⁶‍
• Iron: Essential for red blood cell formation and oxygen transport in the blood ⁷‍
• DHA (Omega-3): Supports brain and eye development.  Most pregnant women likely do not get get enough DHA daily so supplementation is often needed for women who don't eat seafood or other omega-3-rich foods regularly.⁸‍
• Biotin: Contributes to critical steps in the metabolism of fatty acids, glucose, and amino acids.⁹

Beyond specific nutrients, also look for:

• Ingredient quality and bioavailability: ensure the forms of each nutrient are ones the body can actually absorb and use. 
• Clinical validation: see if the finished product has been studied with sound study design (e.g. randomized, double-blind, controlled trials). Peer-reviewed publications are an additional signal that the research has been accepted by experts in the field. These ensure the supplement is not only safe, but effective too.
• Tolerability: is how well a supplement can be managed. This is especially important during the first trimester, when nausea is a significant factor.
• Quality and purity: third-party testing, supply chain traceability, contaminant screening.

Prenatal Vitamins, Compared

Ingredients & Formulation: Ritual Wins With a Formulation That Covers Key Essential Nutrients

When looking at ingredients, more is not always better. “Certain nutrients compete for absorption, meaning you won’t benefit from their inclusion,” Woods explains. “For example, calcium and iron compete for absorption – if taken together in a supplement, calcium will prevent your body from absorbing iron.”

Ritual Essential Prenatal is the only formula we tested that covers all six key nutrients (vitamin D, iron, folate, choline, biotin and Omega-3 DHA) while deliberately keeping its ingredient list to 12 to prevent absorption conflicts. Ritual uses NHANES population data, a US-wide assessment of women’s diets, taking a food-first approach to formulation and filling in the gaps where most women already get enough of through food.¹⁰ That targeted approach means the supplement is designed for women to get only the nutrients they actually need, while maximizing absorption. For example, Ritual contains no calcium, allowing for full potential absorption of iron, a key nutrient for helping red blood cells deliver oxygen to baby. "Ritual helps fill the gaps most commonly left by diet, in combinations designed to maximize absorption," Woods says.

Perelel's Trimester Prenatal Packs come in second. It covers five of the six key nutrients, leaving biotin out of its formulation. Additionally its broader formula carries a higher risk of absorption conflicts. Perelel contains calcium and iron in the same pack, which can potentially reduce iron absorption.

Thorne Basic Prenatal also covers five of the six key nutrients and has the highest nutrient count of the group at 25, but it skips DHA entirely: a nutrient Woods calls “non-negotiable for fetal brain and eye development.” "Its formula also provides several B vitamins at amounts above the RDA for pregnancy”. Because individual nutrient needs can vary, higher amounts are not necessarily needed by everyone who is already meeting recommended intake levels."¹¹

‍Needed Prenatal ranks last. It's missing two of the six key nutrients: no iron and no DHA. Pregnant women only get about 50% of the RDA for iron,¹² and 15% of the RDA for DHA per day from diet.¹³ This means Needed is lacking key ingredients that contribute to baby’s brain and eye development, and oxygen transport. Needed also provides 4000 IU of vitamin D per daily serving, which is the established Tolerable Upper Intake Level for adults. The Recommended Dietary Allowance for adults is 600–800 IU per day. 

Clinical Evidence & Expertise: Ritual Wins As the Only Brand With a Gold Standard Clinical Trial

Currently, there is no regulation around the term 'clinically studied' in the supplement industry. Many brands will claim that their formula is clinically studied when their product contains clinically studied ingredients, but no study has been completed on the entire formula. Studying the finished product is also important to ensure that no ingredients interact negatively with each other, and that it is designed to be safe and effective at the highest level. Ritual is the only leading prenatal backed by its own randomized controlled trial that was peer-reviewed and published in two peer reviewed journals.¹⁵ It was clinically proven to provide bioavailable folate, and help support metabolic demand, baby's bone health, and mom's cortisol levels.*^† Needed conducted an IRB-approved observational study, but it wasn't randomized and hasn't been published in a peer-reviewed journal. Thorne and Perelel have no published clinical research on their finished prenatal products on a pregnant population.

"A randomized clinical trial provides data about the efficacy of a supplement," Woods notes. "This is especially important for a prenatal because women's health is notoriously under-researched. Women deserve all the information they need to choose the best supplement."

Ease of Use & Tolerability: Ritual Wins with a Delayed-Release Design and High Tolerability

Testers preferred Ritual's two-capsule routine, the lowest pill count of the group. Its patented delayed-release capsule design allows it to be taken with or without food, which is very important for women managing morning sickness. It also uses a chelated iron form (ferrous bisglycinate) that's designed to be gentle on the stomach, plus a citrus-essenced scent tab and orange oil in the formula that moms found made it easy to take.*^† 

Thorne's three-capsule routine was straightforward for testers, and it uses that same gentle iron bisglycinate form. Needed, also at three capsules a day, includes a citrus scent insert in the bottle (rather than in the capsule itself) to help mask the smell: a nice touch, though testers noted it still asks for more capsules than Ritual and doesn't include iron in its core formula. 

Perelel was the most demanding for testers, with 4-5 pills a day in daily sachets that can present a tolerability challenge.

Safety & Third Party Testing: Ritual Wins With the Most Comprehensive Safety and Transparency Measures

‍Ritual holds the Clean Label Project Purity Award, screening for 200+ contaminants, and is the only brand in this review that publicly discloses full supply chain traceability: 100% of its active and other ingredients are traceable to their supplier and place of manufacture. Perelel and Needed both hold the Clean Label Project Purity Award as well, but neither publishes full supply chain details Thorne holds no Clean Label Project award and publishes no supply chain details.

Price & Value: It’s a Tie Between Ritual and Thorne 

Ritual Essential Prenatal comes in with the lowest price at $29.25 for the first month with HD’s discount ($39/month after), with Thorne Basic Prenatal coming in at a similar monthly investment of $37/month. Needed Prenatal and Perelel Trimester Prenatal Packs are more expensive at $42.99/month and $49.50/month respectively.

Our #1 Choice For Prenatal Vitamins: Ritual Essential Prenatal

For women prioritizing clinical validation, tolerability, ingredient transparency, and cost, Ritual is the clear choice. It's backed by the only published clinical trial among the leading prenatal brands in this review, and it's designed with an evidence-based, practical formulation, helping to fill the nutrient gaps pregnant women commonly have while maximizing absorption.

Woods, our Registered Dietitian, agrees: " I recommend Ritual," says Woods. "It's all about meeting expectant mothers' needs, with extra steps of third-party testing and a clinical trial to prioritize safety and transparency."

Ready to try Ritual?

References

1. FDA regulation
2. Vitamin D
3. Vitamin D deficiency
4. Folate
5. Folate deficiency
6. Pregnancy nutrients
7. Anemia
8. Omega-3 during pregnancy
9. Biotin
10. Nutrient deficiency in pregnant women
11. Excess B vitamins
12. Iron intake
13. NHANES data on DHA
14. ACOG safe recommendation
15. Ritual clinical trial

* These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

†Based on a 24-week, randomized, double-blind, controlled clinical trial on 62 second and third trimester pregnant women.