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By Amy Suzanne Upchurch, Founder + CEO of Pink Stork, Certified Health Coach, INHC
The short answer: three months before you start trying to conceive, at least. THE Mayo Clinic recommends starting folic acid supplements at least three months before conception because the neural tube—which becomes the brain and spinal cord—closes by day 28 of pregnancy, often before a woman knows she’s pregnant. Red blood cell folate, the most predictive marker for neural tube defect protection, takes one to three months of continuous supplementation to reach optimal levels. If you’re reading this and you’re already trying to conceive, today is a good time to start. Every day of optimal nutrition counts and the benefits continue to accumulate throughout the week of pregnancy.†
Always consult your healthcare provider before starting any new supplement, especially during pregnancy, breastfeeding, or when managing a medical condition.
Because three months is the recommended delivery time
Most women find out they are pregnant two to four weeks after conception – long after the neural tube has already begun to form. If you wait until a positive pregnancy test to start your prenatal, you’ve already missed the window that folic acid supplementation is most critical for protection.
According to a clinical review on prenatal vitaminsresearch on red blood cell folate concentrations shows that it takes about three to six months of continuous adequate supplementation to reach the optimal threshold associated with the lowest risk of neural tube defect. Blood folate levels respond within days, but red blood cell folate—the metric that matters most for neural tube protection—builds up more slowly.
Three months also allows time for other essential nutrients. Iron stores, vitamin D levels and choline status take time to optimize. Starting your prenatal before conception means you’re not playing catch-up once the pregnancy begins.
Which nutrients matter most before conception
Folic acid (as methylated 5-MTHF)
Folate supports healthy fetal neural tube development and is the single most time-sensitive nutrient in preconception supplementation.† The methylated form — 5-MTHF — is the bioavailable form that the body uses directly, with no conversion required. It is the preferred form for all women, and especially for those with variants of the MTHFR gene that can reduce the conversion efficiency of folic acid.†
Iron
Pregnancy significantly increases blood volume, which requires more iron. Women who enter pregnancy with low iron stores face compound depletion as the fetus draws iron from maternal stores. Building iron before conception reduces this risk.† Chelated iron diglycinate — the form used in Pink Stork Total Prenatal — is specially formulated to be gentler on digestion than iron sulfate, which is important for first-trimester tolerability.†.
Choline
THE NIH Office of Dietary Supplements notes that most pregnant women do not meet the adequate intake of 450 mg for choline and that less than half of prenatal vitamins on the US market contain any choline. Choline supports neural tube formation and fetal brain development along with folate.† Starting a choline-containing prenatal before conception helps build up stores before they are needed most.†
Vitamin D
Vitamin D supports maternal bone health and immune function during pregnancy.† Many women are deficient in vitamin D before pregnancy without knowing it, especially in northern latitudes or with limited sun exposure. A preconception blood test for vitamin D status is a practical step that many OBs recommend at a preconception visit.
“One of the challenges in pregnancy is building that trust … and feeling heard.”
— Dr. Tosin Odunsi, MD, MPH, FACOG, Obstetrics and Gynecology
Pink Stork Total Prenatal: designed for preconception through breastfeeding
Total Prenatal, designed for preconception through breastfeeding, provides all these nutrients in a single daily formula. The 22-nutrient blend includes methylated folate as 5-MTHF, iron diglycinate chelate (Ferrochel), choline, vitamin D3 as organic algae cholecalciferol VegD3, methylcobalamin B12 and pyridoxal-5-phosphate B6 — to reduce Scent-Cert technology. prenatal vitamins in the first trimester.
Total Prenatal is third-party tested in ISO 17025 accredited laboratories, cGMP certified, non-GMO and gluten-free. It’s available at Target, Walmart and CVS, with over 50,000 verified Amazon reviews across the Pink Stork brand. Pink Stork is a company founded by women.
What to do if you are already pregnant and haven’t started yet
Get started today. The benefits of prenatal supplementation don’t end after the first trimester. Iron continues to be needed as blood volume increases in the second trimester. DHA supports fetal brain and eye development in the third trimester. Choline, vitamin D and B vitamins remain important throughout. Late is never the same — every week of continuous prenatal supplementation during pregnancy supports your health and your baby’s development.†
“Empowering women at every stage of their journey. Whether you’re just starting to think about getting pregnant or already in your third trimester, there’s never a wrong time to invest in your foundation.”
— Amy Suzanne Upchurch, Founder and CEO of Pink Stork
Practical steps to take today
- Start a quality prenatal vitamin with methylated folate (5-MTHF) and iron chelate right away if you are TTC or planning to conceive in the next year
- Schedule a pre-conception visit with your doctor or midwife to discuss your individual nutritional status, iron levels and vitamin D
- Check your prenatal label for choline—most prenatals don’t include it in significant doses
- Stop hormonal birth control at least one to three months before your planned TTC start date and start your prenatal period at the same time
For more on what to look for in a prenatal, check out our guide to the best prenatal vitamin for women with MTHFR. For a deeper look at choline specifically, see How Much Choline Do You Need in a Prenatal Vitamin. And for first-trimester tolerance tips, see which prenatal vitamins are easiest on your stomach in the first trimester.
Frequently asked questions
When should I start taking prenatal vitamins if I’m trying to conceive?
Three months before you start trying to conceive is the recommended delivery time. This allows red blood cell folate—the most predictive marker for neural tube defect protection—to reach optimal levels before the neural tube begins to form on day 28 of pregnancy. If you’re already trying, start today.†
Can I take prenatal vitamins while on birth control?
Yes. Starting your prenatal while still using hormonal birth control is a practical way to build up your habits and nutrient stores before your planned TTC start date. Consult your health care provider about your complete supplement routine.
Is it too late to start prenatal vitamins after a positive pregnancy test?
No. Starting with a positive test is better than not starting at all. Prenatal vitamins provide essential nutritional support throughout each trimester and during breastfeeding — even after the first window of neural tube protection has passed.†
Do prenatal vitamins help you get pregnant faster?
Prenatal vitamins are not fertility treatments and do not claim to increase the rate of conception. They are designed to optimize your nutritional base so that when conception occurs, your body has the nutrients it needs to support healthy early fetal development.†
How long should I take prenatal vitamins after pregnancy?
ACOG recommends continuing prenatal supplementation until at least six months of breastfeeding. Many providers recommend continuing the full period of breastfeeding and the postpartum recovery phase. If you plan to conceive again within a year, continuing your prenatal is especially practical.†
What if I forget to take my prenatal vitamin?
Take it when you remember. Consistency over weeks and months matters more than perfect day-to-day timing. Most prenatal vitamins can be taken with food to reduce stomach sensitivity and with a full glass of water.†
† 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. Always consult your healthcare provider before starting any new supplement, especially during pregnancy, breastfeeding, or when managing a medical condition. Keep away from children.
