…I removed a contraceptive coil for a patient who was planning to get pregnant. I took the opportunity to do brief pre-pregnancy counselling and asked if she was taking folic acid. She replied, ‘no, should I be?’
I do quite a lot of coil removal procedures in my clinic, so this is certainly not an uncommon scenario! Folic acid is extremely important in pregnancy. It plays a critical role in the development of the baby and the health of the mother.
Many women don’t plan their pregnancies, so they miss the critical period (before conception and the first trimester) when folic acid is most effective. Although awareness is improving, there is still more education that needs to be done. The WHO and UNICEF estimate that fewer than 50% of women worldwide know about the benefits of folic acid, and even fewer take it consistently before and during early pregnancy
So, let’s talk about it….
What is folic acid?
Folic acid is a vitamin. It is the name given to vitamin B9. Pregnant women need a good supply of folic acid to help with the development of baby’s spine and brain. Folic acid in early pregnancy reduces the risk of having a baby born with a spinal cord problem such as spina bifida and brain disorders such as anencephaly. Adequate folic acid reduces the risk of these defects by up to 70%. Folic acid also contributes to the formation of the placenta, which is essential for nourishing the growing foetus.
When Should You Start Taking Folic Acid?
Folic acid is most effective when taken at least one month before conception and during the first trimester. Many women don’t know they’re pregnant in the early weeks, so starting supplementation before trying to get pregnant is ideal. The advice is to start as soon as contraception is stopped, or as soon as you are thinking about getting pregnant! It should ideally be continued at least till the end of the 12th week of pregnancy. Some healthcare providers recommend continuing throughout the pregnancy. If you are unexpectedly pregnant and had not been taking folic acid, start taking it as soon as you find out and continue till the end of the 12th week of pregnancy.
What’s the recommended dose of Folic Acid?
For most women, the dose is 400 micrograms (0.4 mg) a day. Women with a higher risk of having a child with a spinal cord problem need to take 5 mg a day – this is only available on prescription. Women needing 5mg a day include those who:
- Have had a previously affected pregnancy.
- Have (or have a partner with or a family member with) a spinal cord defect.
- Are taking medication for epilepsy.
- Have a body mass index (BMI) of 30 or more.
- Have coeliac disease or diabetes.
- Have sickle cell anaemia, or thalassaemia.
Are there foods that can help?
In addition to supplements, folate can be obtained from leafy green vegetables (e.g., spinach, kale), citrus fruits (e.g., oranges), legumes (e.g., lentils, chickpeas), sprouts, fortified cereals and bread, avocados, eggs, and potatoes
So….
Start taking 400–600 mcg of folic acid daily at least one month before trying to conceive. Continue supplementation during the first trimester and as advised by your healthcare provider. Combine supplementation with a healthy diet rich in natural folate.
If you’re pregnant or planning to conceive, you speak to a doctor at 2Me Clinic for tailored advice on folic acid and prenatal vitamins. For more information on Folic acid in Pregnancy, you can download resources from the Patient UK website: https://patient.info/pregnancy/planning-to-become-pregnant#folic-acid-supplements
