One small daily tablet can greatly reduce the risk of serious birth defects of the baby’s brain and spine. The catch is timing: these develop in the first weeks of pregnancy, often before you know you’re pregnant. That’s why folic acid matters before conception.
Imagine finding out you’re seven weeks pregnant. You’re thrilled, then anxious: you haven’t been taking any vitamins. A midwife reassures you to start folic acid now, and explains why, for a future pregnancy, it’s best to begin before you start trying.
Why folic acid matters
Folic acid (a form of folate, vitamin B9) helps prevent neural tube defects such as spina bifida and anencephaly. The neural tube closes around four weeks after conception.
How much and when
- Most women: 400 micrograms a day, ideally starting at least a month before trying to conceive and continuing until 12 weeks of pregnancy. The World Health Organization and many health bodies recommend this.
- Higher dose: a doctor may prescribe a higher dose if you or your partner have had a neural tube defect, a previous affected pregnancy, diabetes, take certain epilepsy medicines, have a high BMI, or have other risk factors.
A healthy diet with leafy greens, beans and fortified foods helps too, but it’s hard to get enough from food alone, which is why supplements are advised.
But what if I didn’t take it?
Don’t panic. Start as soon as you know you’re pregnant and continue until 12 weeks. Most babies are born healthy. Talk to your midwife or doctor about routine scans, which check the baby’s development. Many pregnancy vitamins also include vitamin D and iodine; ask which supplements are recommended in your country.
Your next step: If there’s any chance you could become pregnant in the next year, start a 400 microgram folic acid supplement now, or ask your doctor if you need a higher dose.
Sources: World Health Organization (Periconceptional folic acid supplementation), US Centers for Disease Control and Prevention (Folic acid), NHS (Vitamins, supplements and nutrition in pregnancy). This guide is for general information and does not replace advice from your own midwife, nurse, doctor or pharmacist.
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