Walk into any chemist and you’ll find rows of prenatals promising to “cover everything.” The reality is, most fall short where it matters for nervous system development, brain development and nutrient repletion for mum. From a clinical and evidence-based perspective, there are three nutrients I pay closest attention to when choosing a prenatal: folate (in its active form), choline, and iodine.
Folate is the obvious starting point. We know it plays a central role in neural tube development, with strong evidence showing adequate intake significantly reduces the risk of neural tube defects. What’s often missed, though, is the form. Many mainstream prenatals still rely on folic acid, a synthetic version that requires conversion in the body. In contrast, 5-MTHF (methylated folate) is already in its biologically active form. While folic acid has robust population-level data, using methylated folate supports more efficient utilisation, particularly in individuals with reduced conversion capacity. It’s a more clinically considered approach, and one I prioritise in practice.
Choline is where most prenatals really fall down. It’s essential for fetal brain development, placental function, and methylation pathways, yet the majority of women don’t meet the recommended intake during pregnancy. Research continues to highlight its role in neurodevelopment and long-term cognitive outcomes, independent of folate. Despite this, many prenatals contain little to none. Even in high-quality formulas, the dose is often modest, which means diet or additional supplementation still needs to be part of the conversation.
Iodine is another non-negotiable. It underpins maternal thyroid function and is critical for the baby’s brain and nervous system development. Mild iodine deficiency is still relatively common, even in developed countries like Australia, making adequate inclusion in a prenatal important. The challenge is that not all formulas include it at clinically relevant doses, or they use inconsistent sourcing.
When you look at prenatals through this lens, the list of options that truly meet the mark becomes quite small.
In clinic, I tend to come back to a few practitioner-grade formulas that consistently align with both the research and what I see clinically.
Tresos Natal by Eagle is one of the most comprehensive options available here in Australia. It uses methylated folate alongside folinic acid, includes iodine at a clinically appropriate dose, and importantly, it does contain choline which immediately sets it apart from most prenatals on the market. The forms of B12 and B6 are activated, and the iron is gentle and well tolerated. It’s a well-rounded foundation that works across preconception, pregnancy and postpartum. That said, even here, choline isn’t at the full therapeutic intake, so I’ll often still build around it depending on the individual.
EverNatal by Naternal takes a slightly different approach. It’s a more modern formulation, designed with current nutrient gaps in mind and a strong focus on bioavailability. It still aligns with a methylated approach and feels less “heavy” than traditional prenatals, which some women prefer, especially if they’re sensitive or navigating nausea as it’s coated in a peppermint taste!
Then there’s Pure Natal by Orthoplex White, which sits firmly in the practitioner-only space. This is a clean formula that does the basics well using high-quality, bioavailable nutrients. It’s not designed to do everything in one capsule, and that’s actually the point. It allows for more precise tailoring adding in choline, iron or DHA separately based on what’s clinically indicated. For women working closely with a practitioner, this can be a really effective way to build a fully personalised protocol.
If you strip it back, what matters most in a prenatal is quite simple:
- Methylated folate (5-MTHF), not just folic acid
- Iodine at an appropriate dose
- Choline either included or intentionally added in
Everything else builds from there.
Even with the best formulas, a prenatal should be seen as a foundation rather than the full picture. Nutrient needs shift depending on the individual, their diet, their labs, and how their body is actually absorbing and utilising what they’re taking.
The goal isn’t to find the “perfect” prenatal.
It’s to choose one that’s thoughtfully formulated and then personalise from there.
Bella Roberton Naturopath (BHSc)
