🔎 Highlights

• 89% of pregnant women have serum 25(OH)D levels below 40 ng/mL; 31% are clinically deficient.
• Vitamin D sufficiency (≥ 40 ng/mL) reduces risk of preterm birth by 46-59%, and lowers rates of preeclampsia, C-sections, gestational diabetes, and fetal growth complications.
• Standard prenatal care fails to screen or supplement adequately.
• A national coalition, co-sponsored by GrassrootsHealth, Organic and Natural Health Association, Organic Consumers Association, My Health Alliance, and OMNS, and others, will advocate this Fall in Washington, D.C. for evidence-based prenatal policy reform.
• All health freedom, maternal advocacy, and micronutrient research allies are invited to participate.

Pregnancy: A Tipping Point for Prevention and Policy

The United States has the highest maternal mortality rate among developed nations-and the burden falls disproportionately on Black and underserved communities. While modern prenatal care increasingly focuses on pharmaceutical screenings and diagnostics, it continues to neglect one of the safest, most affordable, and well-supported interventions available: vitamin D sufficiency.

This is not just a clinical gap-it is a public health injustice and an opportunity for transformation.

The Biology: Vitamin D Is Essential-Yet Ignored

By the 12th week of pregnancy, a woman's body increases production of calcitriol (the active form of vitamin D) by nearly 300%-a level essential for immune tolerance, gene regulation, placental function, and fetal development (2, 8). This physiologic shift is entirely dependent on adequate vitamin D reserves.

Yet:

• 89% of pregnant women have serum 25(OH)D below 40 ng/mL
• 31% fall below 20 ng/mL, the threshold of clinical deficiency
• Black women are 15-20× more likely to be deficient than White women (1)

These statistics are not just numbers. They represent millions of women and babies left unprotected.

What the Evidence Shows

Randomized controlled trials and prospective cohort studies have confirmed that achieving serum 25(OH)D ≥ 40 ng/mL during pregnancy significantly reduces risk of:

• Preterm birth by up to 59% (3)
• Preeclampsia, gestational diabetes, and maternal infections (2, 4)
• Medically necessary C-sections (5)
• Fetal growth restriction, neurodevelopmental disorders, and early childhood asthma (6)

Having sufficient vitamin D levels prior to or as early as possible during pregnancy can help women avoid these risks. In fact, the evidence regarding preconception vitamin D levels and preeclampsia is so strong, the 2024 edition of Feldman and Pike's Vitamin D (considered the authoritative resource on the topic) states, "Entering pregnancy with a circulating 25(OH)D level of at least 40 ng/ml, imparts perfect protection against the development of preeclampsia." (Chapter 32 p.681)

Despite these findings, vitamin D is not routinely tested in prenatal care, and most physicians continue to recommend only 400-800 IU/day-an insufficient dose by modern scientific standards.

A Public Health Imperative

This issue is not just about optimizing pregnancy outcomes-it's about eliminating avoidable harm. Vitamin D is:

• Safe
• Low-cost
• Scalable
• Supported by decades of clinical and mechanistic research

Effective prenatal protocols-based on blood testing and dosing of 4,000-6,000 IU/day-can achieve sufficiency in the vast majority of pregnant women (7). The failure to adopt these practices represents a systemic gap that can and must be closed.