Why getting enough folic acid is one of the most important actions you can take to ensure a healthy pregnancy
- Folic acid is the synthetic form of vitamin B9, which is important for cellular growth and repair.
- Enough vitamin B9 in early pregnancy reduces the risk of certain birth defects, especially of the spine.
- It can be hard during pregnancy to get enough vitamin B9, so folic acid supplements can help.
In early pregnancy, folic acid is crucial for the development of the neural tube, which will grow to become the spine and brain.
That's why, taking the recommended daily amount of folic acid can reduce the chance of a baby having a neural tube birth defect, like spina bifida, by up to 70%.
Because of that, anyone of reproductive age who could become pregnant should take a folic acid supplement.
"It is recommended for all people planning pregnancy or capable of becoming pregnant," says Suzanne West, MD, an OB/GYN with Spectrum Health. This is especially important since roughly 45% of pregnancies in America each year are unintended.
Here's what you should know about folic acid, its critical role during pregnancy, and how to get enough of it.
Folic acid vs. folate
Folic acid is a synthetic, or man-made, form of folate. Folate is vitamin B9, which is found naturally in food including dark leafy greens, grains, and meat, says Anita Mirchandani, RD, a nutritionist with Maven Clinic.
The terms folate and folic acid are often used interchangeably, because in the body they act the same.
Benefits of folic acid for pregnancy
The most critical role of folic acid during pregnancy is supporting the development of the neural tube, which will become the brain and spinal cord as a fetus grows.
The neural tube forms very early in the first trimester, before most people know they are pregnant. Because of that and the powerful protective effects of folic acid, the CDC urges anyone who could potentially become pregnant, even those not planning a pregnancy, to take a folic acid supplement.
Doctors don't yet understand why folic acid reduces the risk for neural tube defects, but it could be because the vitamin supports rapid cell growth.
"Folate is especially critical during periods of rapid growth and development," says Mirchandani.
Neural tube defects are linked to miscarriage, stillbirth and lifelong disability for the fetus, so taking folic acid benefits both the parent and fetus.
Since folic acid supports healthy cell growth, it's a good idea to continue to supplement in the postpartum period and while breastfeeding, says Mirchandani.
"Pregnancy depletes nutrients including folate and with the body going through repair and rebuilding postpartum, it is important for adequate consumption of folate," she says.
Other health benefits of folic acid
Folate helps support many metabolic processes in the body, including the formation of RNA, DNA and red blood cells.
"Folate is an important B vitamin at all times," Mirchandani says.
Most people who are not pregnant or lactating get enough folate from their diets, and don't need to take a supplement. Many American breads, cereals, and grains are fortified with folic acid, which is why folate deficiency is rare; however, being deficient in folate can lead to conditions including anemia.
"While folate is particularly important for pregnant women in their ability to grow another human, every single person needs it for their overall health and wellness," says Mirchandani.
How much folic acid do I need?
If you are pregnant or have any chance of becoming pregnant, you should consume 600 mcg of folate each day.
That amount can be tricky to get through food alone, so the American College of Obstetricians and Gynecologists recommends anyone who may become pregnant take a vitamin that contains at least 400 mcg of folic acid each day. This may also be labeled as 667 mcg DFE, or dietary folate equivalents.
Anyone who could possibly become pregnant should take a vitamin containing folic acid, even if they're not planning a pregnancy. Supplementing with folic acid ensures that people are getting enough folate to protect against neural tube defects if they should become pregnant.
"It's better to be safe than sorry," says West.
Quick Tip: If you have had a family history of neural tube defects, you are considered high risk for a pregnancy with neural tube defects. In this case, speak with your doctor who will likely recommend a very high dose of 4,000 mcg of folic acid daily for prevention. This should be done from three months before pregnancy until the 12th week of pregnancy.
How to get more folic acid and folate
Here's how to ensure that you're getting enough folate, especially if you are planning to or could get pregnant.
1. Look for supplements that list at least 400 mcg of folic acid
The safest way to ensure that you're getting enough folic acid, West says, is to take a supplement containing at least 400 mcg of folic acid. That, combined with folate from food, will ensure you get the 600 mcg of folate each day recommended for people who may become pregnant.
Over the counter prenatal vitamins typically fit your needs. Remember that the prenatal may also be labelled as 667 mcg DFE.
2. Eat folate-rich foods
You should also focus on eating a varied diet rich in foods that contain folate, says Mirchandani. Many foods are fortified with folic acid and some foods naturally contain folate.
These five foods are among the highest in folate:
Food and Serving Size | Mcgs folate (Percent Daily Value) |
Beef liver, 3 ounces | 215 (54%) |
1/2 cup spinach | 131 (33%) |
1/2 cup black-eyed peas | 105 (26%) |
1/2 cup white rice | 90 (22%) |
1/2 cup Brussels sprouts | 78 (20%) |
Insider's takeaway
Folate and its synthetic form, folic acid, support healthy cell function. During early pregnancy, getting enough folic acid can reduce the risk for neural tube defects like spina bifida by up to 70%.
Although most Americans get enough folate from their diets, it can be difficult to get enough to prevent neural tube defects from diet alone. Because of that, the CDC recommends that anyone who could possibly become pregnant take a folic acid supplement.
"Take a multivitamin with folic acid in it if you are capable of becoming pregnant, even if not planning on pregnancy," says West.