Fewer than half of U.S. women take recommended vitamins prior to pregnancy, according to March of Dimes new Prenatal Health & Nutrition Survey

September 19, 2017

Women also worried that changes to healthcare system will have negative effect on prenatal care; cost of care is a significant issue

Women of childbearing age need more education to ensure their own health and that of their babies both before and during pregnancy, according to findings from the new Prenatal Health & Nutrition survey of U.S. women announced today by the March of Dimes. While 97 percent of women 18-45 who have been or are currently pregnant reported taking prenatal vitamins or multivitamins during their current or last pregnancy, only 34 percent said they started taking the prenatal vitamin or multivitamin before they knew they were pregnant, and the number drops to 27 percent for Hispanic women and to 10 percent for African-American/black women. 

The online survey was conducted by The Harris Poll on behalf of March of Dimes in August 2017 among more than 1,000 U.S. women ages 18-45. 

“While it tends to shock some Americans, more than 120,000 babies, or three percent of all births, will be born with birth defects in the United States this year,” said Stacey D. Stewart, President of the March of Dimes. “The results of this survey serve as a reminder of the importance of continually informing women of the benefits of taking a multivitamin with folic acid both before and during pregnancy to improve their own health and that of their future family.”

Taking a multivitamin or prenatal vitamin containing 400 micrograms (mcg) of folic acid every day before pregnancy and during the early months of pregnancy can prevent serious birth defects of the brain and spine known as neural tube defects (NTDs). Because these birth defects happen in the first month of pregnancy, often before a woman knows she is pregnant, and with almost half of pregnancies in the U.S. unplanned, multivitamins are recognized as a key strategy to reduce the risk of NTDs. Babies born to Hispanic women are more likely to be born with NTDs than babies born to non-Hispanic white women and non-Hispanic black women. The March of Dimes says up to 7 in 10 of the 3,000 NTDs that occur each year in the U.S. each year could be prevented if all women capable of having a baby took daily multivitamins containing folic acid. 

After pregnancy begins, the folic acid recommendation increases to 600 mcg daily.  In addition, iron, calcium, vitamin D, DHA and iodine have been found to play a key role in baby’s growth and development during pregnancy.

Racial and Ethnic Disparities in Care among Hispanic and African-American Populations

Highlighting the challenges of access to care, Hispanic women reported the cost of prenatal care having an impact during pregnancy (53 percent), which is significantly higher than among African-American/black women (34 percent) and relatively higher than in the general population (43 percent). 

“Disparities among racial and ethnic groups in birth defects and other birth outcomes, such as preterm birth and infant mortality, have lifelong implications for the health and well-being of families and for our nation,” said José Cordero, MD, MPH, Professor and Director, Department of Epidemiology and Biostatistics, University of Georgia, College of Public Health and a former member of the March of Dimes Board of Trustees. “It is critical that we continue to work to improve access to information and comprehensive prenatal care for mothers in African American/black and Hispanic communities.” 

Cost and Future Support of Prenatal Care an Issue

Survey findings also showed that 77 percent of all women worry that there may be changes to the healthcare system that may negatively impact access to prenatal care.  Also, 43 percent of women who have been or are currently pregnant reported that the cost affected when and whether they sought prenatal care for their pregnancy.

“The March of Dimes is hearing this consistently from women – they are scared that insurance coverage to support healthy pregnancies and full-term babies, such as prenatal care and prenatal vitamins, may diminish or even disappear with the proposed changes in the healthcare system,” said Stewart. 

Of women who reported taking a prenatal or multivitamin during their current/last pregnancy, half took over-the-counter vitamins and half took prescription prenatal vitamins.  Of those women who took prescription prenatal vitamins, 88 percent reported it was covered by their insurance.   

Physicians and Internet Key Sources of Information

Physicians are the number one source of education for women about healthy pregnancies.  Seventy-four percent of women who have been or are currently pregnant reported seeing their physician for information about pregnancy health and childbirth, and 92 percent of women who did take prenatal vitamins/multivitamins during their current/last pregnancy say they did so based on a recommendation from a healthcare professional. 

Nearly half of women who have been or are currently pregnant (48 percent) also reported they sought information online, which the March of Dimes says reinforces both the opportunity to reach millions with prenatal health facts via the internet, and the critical importance of the reliable, medically-vetted news and information the March of Dimes provides on its websites marchofdimes.org and nacersano.org.  

Need for Deeper Understanding of Nutrient Requirements

Other survey findings related to nutrients necessary for healthy pregnancy showed most women reporting they are aware that folic acid is important for health of baby -- but not when to take it, how much to take, or why it is important. Even less understanding was reported around other key nutrients.

•    While nearly two-thirds of all women (63 percent) were able to identify folic acid as a very important nutrient, fewer than 40 percent of women cited iron (36 percent), calcium (33 percent) and vitamin D (29 percent) as vitamins that may help reduce a woman’s risk of having a baby with a birth defect.

•    Eighty-four percent of women who reported being familiar with folic acid either didn’t know (59 percent) or cited an inaccurate recommended amount of the nutrient.

•    Thirteen percent of women weren’t aware that avoiding smoking/tobacco products would help reduce the risk of birth defects, and 12 percent were unaware that eliminating drinking and illegal drugs would do the same.

About the Survey


The Prenatal Health & Nutrition survey was conducted online within the United States by The Harris Poll on behalf of March of Dimes between August 11 and 24, 2017 among a nationally representative sample of 503 women ages 18-45, plus oversamples of 267 Hispanic women ages 18-45 and 243 African American/black women ages 18-45. 
Results were weighted for age within gender, region, race/ethnicity, income, region, household size, marital status and education where necessary to align them with their actual proportions in the population. Propensity score weighting was also used to adjust for respondents’ propensity to be online.
All sample surveys and polls, whether or not they use probability sampling, are subject to multiple sources of error which are most often not possible to quantify or estimate, including sampling error, coverage error, error associated with nonresponse, error associated with question wording and response options, and post-survey weighting and adjustments. Therefore, Harris Poll avoids the words “margin of error” as they are misleading. All that can be calculated are different possible sampling errors with different probabilities for pure, unweighted, random samples with 100% response rates. These are only theoretical because no published polls come close to this ideal. 
The survey was sponsored by Mission Pharmacal. The Harris Poll administered the survey and analyzed the results.

About March of Dimes 

The March of Dimes is the leading nonprofit organization for pregnancy and baby health. For more than 75 years, moms and babies have benefited from March of Dimes research, education, vaccines, and breakthroughs.
For the latest resources and health information, visit our websites marchofdimes.org and nacersano.org. To participate in our annual signature fundraising event, visit marchforbabies.org. If you have been affected by prematurity or birth defects, visit our shareyourstory.org community to find comfort and support. For detailed national, state and local perinatal statistics, visit peristats.org. You can also find us on Facebook or follow us on Instagram or Twitter

About Mission Pharmacal

The Prenatal Health & Nutrition survey was sponsored by Mission Pharmacal, a privately held pharmaceutical company based in San Antonio, Texas. For more than seven decades, the company has been improving the lives of people by identifying unmet needs and delivering innovative, high-quality prescription, over-the-counter, and dietary supplement products, using only the purest ingredients and FDA-approved methods of manufacturing. Mission is recognized as a pioneer and leader in the therapeutic areas of women’s health and urology, and offers leading products through its pediatric, dermatology, primary care, and long-term care service lines. 
With the shared objective of improving the health of all moms and babies, Mission is proud to support the March of Dimes Foundation®, the leading nonprofit organization for pregnancy and baby health.