The Nutrient Every Woman Needs Before Pregnancy

Folic acid, or vitamin B9, is an essential nutrient that every woman should take, whether planning to get pregnant or not.

If you’re planning to become pregnant, you already know how important a healthy diet, exercise and getting plenty of sleep are, but one of the most important ways to ensure a healthy pregnancy is to get enough folic acid prior to conception.

Folic acid, the synthetic form of folate or Vitamin B9, is one of many super-star nutrients that our bodies need to run on all cylinders. Everyday new cells are rapidly reproducing in every organ of our bodies but without folic acid, none of it would happen.

“Folic acid has a very important role in making those cell reproductions possible and happen in an efficient manner,” Tama Bloch, RDN, a pediatric research scientist with Abbott says.

During pregnancy, folic acid becomes even more important because of its role in the prevention of neural tube defects (NTDs).

Why Folic Acid is Important

Neural tube defects are birth defects of the spinal cord such as spina bifida, the brain such as anencephaly, and Chiari malformation, another type that causes brain tissue to descend into the spinal canal.

Neural tube defects affect approximately 300,000 babies worldwide each year but between 50 and 70 percent of neural tube defects can be prevented when women take folic acid in a prenatal vitamin or supplement.

The key, however, is to take folic acid everyday whether you’re actively trying to conceive or holding off on having children for awhile.

That’s because the moment you become pregnant­—before you get a positive pregnancy test—your baby is already reproducing those important neurological cells that are vital for the development in his brain and spine, Bloch says.

You should also take folic acid everyday even if you don’t have plans to have children or if you think you can’t get pregnant. Since 40 percent of pregnancies worldwide are unplanned, getting enough folic acid is a good plan should you have a surprise. 

Research shows folic acid may do more than prevent neural tube defects. In fact, eating folic acid-fortified foods was associated with an 11 percent reduction of congenital heart defects, a recent study in the journal Circulation found.

Another study suggests that adequate levels of folate may even lower the risk of having a child who is obese.

Folic Acid and Folate: Make It a Daily Habit

Although experts say any woman who can become pregnant should take folic acid, approximately 22 percent of women between 12 and 49 years old don’t have enough folate in their bodies to prevent neural tube defects, a study by the Centers for Disease Control and Prevention (CDC) found.

Not only is it important to get enough folic acid before pregnancy, you should continue to take it throughout your pregnancy both for your own health and to support your baby’s growth and development.

Unlike fat soluble vitamins (A, D, E, and K) that are readily stored in the body, folate is a water soluble vitamin so you need to get it on a daily basis to make sure you always have enough available. “This nutrient needs to be constantly replenished to maintain healthy levels,” Bloch said.

Folic Acid: How Much Do You Need?

In the U.S., most women should take a multivitamin that contains 400 micrograms (mcg) of folic acid every day, or the same amount in a separate supplement, before they get pregnant.

During pregnancy, women need 600 mcg and if they breastfeed, 500 mcg. In other countries, the recommendations might vary slightly.

Some women may need to take very high doses—as much as 1,000 micrograms a day—but this should always be done under a doctor’s supervision. These include women who have a family history of neural tube defects, those with sickle cell disease or those who have Inflammatory Bowel Disease (IBD), Celiac disease or malabsorption problems.

Women who take certain medications for cancer, autoimmune diseases or epilepsy may have to take larger doses too.

Although folic acid is more efficiently digested and absorbed, you also need to get folate by eating foods such as leafy green vegetables, citrus juices, beans, nuts and seeds, and breads and cereals that are fortified with folic acid.

The good news is that you can never get too much folate regardless of how many folate-rich foods you eat along with your folic acid supplement. So kick off your day with a green smoothie, beet juice, or a vegetable frittata along with your supplement and you’ll be off to a great start.