A young couple walks into a pharmacy in Melbourne’s west, both excited and anxious. Their parents are overseas. Friends and relatives mean well but send a flood of messages: “Buy the most expensive prenatal.” “Take extra iron just in case.” “You must use methylfolate because of MTHFR.” The shelves are packed with bright labels promising a “smarter pregnancy” and a “healthier baby”.
For many multicultural women in Australia, especially first-time mums without close family support, supplements become emotional insurance. The fear is real: what if I miss something and my baby isn’t healthy? But here is the truth I often share in clinic: more pills do not automatically mean more protection. Sometimes, it means unnecessary cost, confusion, and even risk.
The two essentials most women need
If you remember only two words, make them: folic acid and iodine.
Folic acid (the supplement form of folate, vitamin B9) is most important in the earliest weeks of pregnancy, often before a woman even knows she is pregnant. It helps reduce the risk of serious early birth defects affecting the baby’s brain and spine (neural tube defects such as spina bifida). Most guidelines advise 400 to 600 micrograms daily, ideally starting at least a month before conception and continuing through the first 12 weeks of pregnancy. Some women need a higher dose (often 5 mg daily) if they have specific risk factors, for example a previous pregnancy affected by a neural tube defect, certain medical conditions, or specific medications. That higher dose should be guided by your GP or obstetric team.
Iodine supports the baby’s brain and nervous system development. Women are generally advised to take 150 micrograms daily when planning pregnancy, during pregnancy, and while breastfeeding. Women with thyroid conditions should seek tailored medical advice first.
Australia also fortifies certain staple foods, including some bread products, with folic acid and iodine (via iodised salt in bread). This has helped reduce neural tube defects across the population, but it does not replace correct supplement timing, especially for folic acid early on.
Two nutrients matter most in pregnancy: folic acid and iodine. Folic acid, taken early, helps prevent serious brain and spine defects, while iodine supports the baby’s brain and nervous system development, with supplements needed even alongside Australia’s food fortification
Folic acid vs methylfolate: the marketing confusion
Many newer prenatal brands replace folic acid with methylfolate and advertise it as “more bioavailable”. It is usually more expensive. The important point is this: folic acid is the form with the strongest evidence for preventing neural tube defects.
You may have heard about the MTHFR gene, which is common in many populations. Even with MTHFR variations, most people can still process folic acid. The problem is not your genetics; it is how fear-based marketing can make normal women feel “defective” and pressured into costly choices.
When “more” becomes harmful
In pregnancy, supplement stacking is common: a prenatal multivitamin, plus a “hair and skin” vitamin, plus magnesium gummies, plus an energy drink, plus a morning-sickness tablet. The same nutrients appear in multiple products without you realising.
Vitamin B6 is a classic example. It can be present in pregnancy vitamins, nausea tablets, magnesium blends, and energy products. In high doses over time, B6 can cause nerve damage, and Australia’s medicines regulator has issued safety warnings because harm has occurred, often from taking several products at once.
High-dose vitamin A can also be dangerous in pregnancy. Even for nutrients that are helpful in the right amount, there can be a “sweet spot”: too little is not ideal, but too much may not be helpful and may carry risks depending on the vitamin and the person
High-dose vitamin A can also be dangerous in pregnancy. Even for nutrients that are helpful in the right amount, there can be a “sweet spot”: too little is not ideal, but too much may not be helpful and may carry risks depending on the vitamin and the person.
A safe rule: avoid non-pregnancy multivitamins and avoid taking multiple products unless your clinician has reviewed the full list.
Food first, but make it realistic
A nourishing diet still matters more than any “perfect” supplement. Yet multicultural families face real barriers: nausea, food aversions, long work hours, unfamiliar foods, vegetarian diets, cultural food rules, cost-of-living pressures, and the loneliness of doing pregnancy without the village you expected.
Rather than chasing perfection, aim for practical wins: regular meals, iron-rich foods (or vegetarian iron options), dairy or calcium-enriched alternatives, colourful vegetables when tolerated, and safe protein sources. If you are worried you are not eating well, ask your GP or midwife for a referral to an accredited dietitian, ideally someone comfortable with your cultural foods.
The “bring-peace-of-mind” plan
Choose one pregnancy-appropriate supplement that covers folic acid and iodine at recommended doses. Do not add extra tablets “just because”. If iron or other supplements are needed, they should be based on your history and blood tests, not guesswork.
Here is my strongest tip: bring every bottle, blister pack, powder, and herbal product to one appointment and ask, “Can you check these together?” One careful review can prevent months of confusion and protect you from accidental overdosing.
Pregnancy already comes with enough worry. Your supplement plan should be simple, evidence-based, and personalised, so you can focus less on the pharmacy aisle and more on the joy of meeting your baby.
Myths vs Facts
❌ Myth: “A pregnancy multivitamin is compulsory for every woman.”
✔️ Fact: Most women mainly need folic acid (early) and iodine (through pregnancy and breastfeeding). The rest depends on diet, blood tests, and individual risk.
❌ Myth: “The more vitamins I take, the healthier my baby will be.”
✔️ Fact: More is not always better. Taking several products can push some nutrients too high and cause harm.
❌ Myth: “If I’m tired, I must be low in iron, so I should start iron tablets.”
✔️ Fact: Do not guess. Iron supplementation should be based on blood tests and medical advice.
❌ Myth: “Methylfolate is always better than folic acid.”
✔️ Fact: Folic acid has the strongest proof for preventing neural tube defects. Do not pay extra out of fear.
❌ Myth: “Natural, herbal, or imported tablets are safe because they are ‘traditional’.”
✔️ Fact: “Natural” does not always mean safe in pregnancy. Always check with your GP, obstetrician, or pharmacist before using herbal or imported products.
❌ Myth: “If I didn’t take folic acid before pregnancy, it’s too late.”
✔️ Fact: Start as soon as you know you are pregnant. It still helps.
Dr Preeti Khillan is a Melbourne-based obstetrician and gynaecologist with extensive experience caring for women from diverse cultural backgrounds across all stages of pregnancy and birth.
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