Vitamins and Herbal Supplements During Pregnancy
We recommend all women take a prenatal vitamin with iron and folic acid, preferably prior to becoming pregnant. Folic acid is a necessary for prevention of neural tube defects. “Neural tube defect” describes an incomplete closure of the fetal spine that can result in spina bifida or anencephaly. All women should take 400 micrograms of folic acid daily for at least 1 month before pregnancy. Women who have had a child with a neural tube defect are more likely to have another child with this problem. These women should take 4 milligrams of folic acid a day for at least 1 month before pregnancy and during the first 3 months of pregnancy. This should be taken as a separate supplement to the prenatal vitamin.
In 1994, Congress passed the Dietary Supplement Health and Education Act (DSHEA). According to the FDA’s website,
“A dietary supplement is a product taken by mouth that contains a “dietary ingredient” intended to supplement the diet. The “dietary ingredients” in these products may include: vitamins, minerals, herbs or other botanicals, amino acids, and substances such as enzymes, organ tissues, glandulars, and metabolites…
…Before this time, dietary supplements were subject to the same regulatory requirements as were other foods. This new law, which amended the Federal Food, Drug, and Cosmetic Act, created a new regulatory framework for the safety and labeling of dietary supplements….
….dietary supplements do not need approval from FDA before they are marketed. Except in the case of a new dietary ingredient, where pre-market review for safety data and other information is required by law, a firm does not have to provide FDA with the evidence it relies on to substantiate safety or effectiveness before or after it markets its products….
….Unlike drug products that must be proven safe and effective for their intended use before marketing, there are no provisions in the law for FDA to “approve” dietary supplements for safety or effectiveness before they reach the consumer.”
Because herbal medications are not regulated by the FDA and the safety of these medications in pregnancy has not been federally established and guaranteed, as a general rule, we recommend that all pregnant patients stop taking herbal medications. If you are taking any herbal medication, discuss this with your doctor at your prenatal visit.