No, $50 prenatal vitamins will not prevent a miscarriage

(even though Perelel hints at it on their Instagram...)

Let’s talk about something that made me see red this week: a Perelel Instagram post featuring a note where someone claimed that after multiple miscarriages, they’re pregnant again—because they took Perelel’s (expensive) trimester-specific prenatal vitamins:

I need to be very clear about something: No prenatal vitamin—fancy or basic—can be proven to “treat” a history of pregnancy loss.

And suggesting otherwise? That’s not just misleading marketing. It’s cruel.

If someone believes this, I am in no way trying to challenge their belief. But Perelel sharing this on their social media is irresponsible, and they should know better.

My history with Perelel

If you haven’t heard of Perelel, I love that for you. They are a bougie vitamin brand that uses all the typical marketing tactics: chic branding, ‘founded by an OB/GYN,” and the typical buzzwords like ‘holistic’. They have vitamin packs that are different for each trimester. For egg freezing. For ‘recovery support.’ SO MANY VITAMINS. And they are expensive: their prenatal vitamins run $50-$58 A MONTH.

Perelel is not a fan of me and has me blocked on Instagram…probably because they really didn’t enjoy my YouTube video where I went item-by-item calling out their BS marketing. Which if you’re interested in…you can watch here:

But anywhoo. When a follower sent me a screenshot of the above post, I knew I had to cover it in this week’s newsletter. Because even for them, this felt like a new low.

Guilt in a bottle?

When brands imply that their premium vitamins are the reason someone finally had a successful pregnancy after loss, they’re sending a devastating message to anyone who has experienced miscarriage: Maybe if you’d just bought the right vitamins, your baby would be here.

That’s not science. That’s guilt wrapped in millennial packaging.

The truth is that about 1 in 3 pregnancies end in miscarriage, and the vast majority happen because of chromosomal abnormalities that occur randomly during cell division. No amount of “targeted nutrients” can fix a chromosomal error that happened at conception.

If fancy vitamins prevented miscarriage, I’d prescribe them in a heartbeat. I’d hand them out like candy.

But they don’t, and pretending they might? That’s playing on the fears and grief of people who’ve already been through hell.

What you actually need

Here’s what a good prenatal vitamin should contain—and why. These recommendations come straight from ACOG (the American College of Obstetricians and Gynecologists), not from an influencer’s affiliate link¹:

• Folic Acid (400 mcg) This is the MVP. Folic acid reduces the risk of neural tube defects like spina bifida, and you need 600 micrograms daily during pregnancy. Because it’s hard to get this much from food alone, you should take a daily prenatal with at least 400 micrograms starting at least 1 month before pregnancy and during the first 12 weeks. This alone is why we recommend starting prenatals when you’re trying to conceive. If you’ve previously had a baby with a neural tube defect, you’ll need a higher dose (4 mg), but that’s a medical situation you’d discuss with your provider.

• Iron (27 mg) When you’re not pregnant, you need 18 mg of iron per day, but during pregnancy you need 27 mg. Pregnancy increases your blood volume by about 50%, and you need iron to make all that extra blood. Iron deficiency increases the risk of preterm birth and low birth weight.

• Calcium (1,000 mg for ages 19+, 1,300 mg for ages 14-18) Calcium builds your baby’s bones and teeth. Your baby will take what they need—from your bones if necessary—so this helps protect your bone density. Most prenatals don’t contain enough or any at all (since it can block iron absorption), but you can get calcium from food (milk, yogurt, cheese, fortified foods, leafy greens) or a separate supplement if needed.

• Vitamin D (600 IU) Vitamin D works with calcium to help your baby’s bones and teeth develop and is essential for healthy skin and eyesight. Many people are deficient in vitamin D, especially if you live somewhere with dark winters (like where I am in Portland, Oregon…).

• Iodine (220 mcg) Iodine is essential for healthy brain development. This is often overlooked but important. Make sure your prenatal includes it!

• Choline (450 mg) Choline plays a role in your baby’s brain development and may help prevent some common birth defects. Here’s the catch: choline is not found in most prenatal vitamins, so you’ll need to get it from food (chicken, beef, eggs, milk, soy products, peanuts) or a separate supplement.

• DHA/Omega-3 Fatty Acids (200-300 mg) Omega-3s may be important for brain development before and after birth. Some prenatals include it; others require a separate supplement. Either approach is fine. You can also get omega-3s from eating fish—two to three servings per week—just avoid high-mercury fish like swordfish and king mackerel.

• B Vitamins (including B6 and B12) B vitamins give you energy, supply energy for your baby’s development, promote good vision, and help build the placenta. Your prenatal should have the right amounts.

• Vitamin C (85 mg for ages 19+, 80 mg for ages 14-18) Vitamin C is important for a healthy immune system and helps build strong bones and muscles.

That’s the list.

Notice what’s NOT on it: trimester-specific formulations, proprietary blends, or anything that costs $58/month.

…And what you DON’T

• Trimester-specific formulations. Let me be clear: your nutritional needs don’t change so dramatically by trimester that you need completely different supplement packs. I didn’t miss that day in medical school, because that day didn’t exist. Your body is designed to support pregnancy from start to finish without switching up your vitamins every 12 weeks.

  This isn’t based on evidence. It’s based on a business model.

• A handful of pills a day. Some brands like Perelel want you to take five pills a day in the first trimester (when nausea is often worst—how thoughtful!) including anti-nausea medication you might not even need. Then they add calcium and magnesium in the second trimester for “aches and pains” that not everyone experiences. Then they throw in probiotics in the third trimester.

• Probiotics in your prenatal. Speaking of those third-trimester probiotics: if a company is going to charge you $58/month and claim to be “science-backed,” the least they could do is include the probiotic strain with the most evidence for vaginal health—Lactobacillus crispatus. Spoiler alert: Perelel doesn’t.

  If you want to take a probiotic, great! But there’s no evidence it needs to be bundled in your prenatal or that you need these “pregnancy-specific” strains. And you certainly don’t need to wait until the third trimester to start.

• Proprietary blends with sky-high levels of some nutrients. More isn’t always better. Some expensive prenatals contain 357% of the recommended B12. Your body will just pee that out. You’ll have very expensive urine, but not a healthier pregnancy.

• Methylfolate instead of folic acid (unless you actually need it). Some brands use methylfolate and make it sound super special. Here’s the thing: methylfolate probably won’t hurt, but it’s not FDA-approved as the form of folate proven to prevent neural tube defects. That’s regular folic acid.

  The whole MTHFR gene mutation thing has been blown way out of proportion. For most people, regular folic acid works perfectly fine. If you have a specific medical reason to take methylfolate, your provider will tell you. Or, ask if you’re concerned.

And let’s end on this…

At Perelel’s price point, you’re spending nearly $600 during your pregnancy. That’s…

• a pricey stroller

• childcare for a few weeks

• therapy sessions to process all the guilt-inducing marketing you’re encountering from brands like this

The “Founded by an OB/GYN” marketing trick

Let’s address something else: many of these premium brands love to plaster “founded by an OBGYN” all over their marketing.

I’m an OBGYN, and that credential means nothing when it comes to supplement quality.

Being a doctor doesn’t automatically make you a nutrition expert or give you special insight into creating supplements. It certainly doesn’t mean the product is evidence-based or superior to basic prenatals. It’s a marketing tactic designed to make you trust the brand and open your wallet.

“But aren’t expensive brands higher quality?”

Look, I get it. When you’re pregnant, you want to do everything right. But here’s the thing: prenatal vitamins sold in the US are regulated by the FDA, and reputable brands—yes, including the generic ones—have to meet quality standards.

If you want extra peace of mind, look for brands that have been third-party tested by organizations like USP, NSF, or ConsumerLab. But plenty of affordable prenatals have these certifications.

A study from 2023 looked at 48 different brands of prenatal vitamins, and you know what they found? The more expensive brands were no better in what they contained than the cheaper ones.

So what IS the best prenatal vitamin, Dr. Jen?

The good news: great vitamins can be very inexpensive.

The bad news: most brands (even the pricey ones!) don’t have everything that is recommended by ACOG for what you should get in pregnancy.

That same study I mentioned above that looked at 48 types of vitamins? None of them had the suggested amount of the top 5 vitamins and nutrients. But some were better than others, which influences what I’m highlighting here.

Fun fact: While laws mandate honest vitamin labeling, no laws dictate what must be in a prenatal vitamin. Isn’t that great? If we wanted to focus on useful MAHA legislation, this would be a great place to start…

In light of this, Nature Made Prenatal All-in-one Softgels are pretty darn close at having almost all of the key nutrients, and at $5.50 for a month’s supply it won’t break the bank. It lacks choline, so either getting that in your diet or a separate supplement is a good idea.

And their Instagram doesn’t claim to have prevented miscarriages.

That’s a winner in my book.

The Bottom Line

Your body doesn’t care if your prenatal comes in a pretty box with a motivational quote on it. It cares about getting the nutrients it needs.

That $10 bottle of prenatals from Walgreens? It’s doing the same job as the $50 subscription service. The expensive ones aren’t keeping your pregnancy safer. They’re not preventing miscarriage. They’re not giving your baby superpowers.

They’re just costing you more money.

If it makes you feel good to take Perelel vitamins, please feel free to continue! But if you were doing it because you felt pressured by guilt, I hope you can release yourself from that.

And to anyone reading this who has experienced pregnancy loss: It wasn’t because you didn’t buy the right vitamins. It wasn’t because you didn’t do enough. Miscarriage is heartbreaking and common, and it’s almost never something you could have prevented.

You deserved better than to have brands profit off your grief.

Fancy vitamins, in this economy? Spend it on something more fun.

Until next time,

Dr. Jen

1. note: higher doses of some vitamins are recommended for specific scenarios like carrying multiples, being vegan, or prior birth defects. Your doctor or midwife can guide you.