Prenatal vitamins explained: folic acid

It's hard not to feel overwhelmed after talking with your doctor about planning a pregnancy. In addition to the joys and concerns, you leave with a laundry list of recommended vitamins and prenatal supplements to take. Trying to remember what each vitamin does can make your head spin.

According to Dr. Mimi Shaffer, an OBGYN with Sharp Rees-Stealy, the value in including folic acid in your pregnancy plan is clear. "Folic acid is a B vitamin, also known as vitamin B-9," she says. "It is an essential building block of the DNA of all cells."

Folic acid helps to prevent the development of neural tube defects, such as spina bifida. Spina bifida occurs when the protective covering that grows around an unborn baby's spinal cord doesn't properly close, leading to a possibility of permanent nerve damage and sometimes, paralysis.

Because neural tube defects usually happen at the earliest stages of pregnancy, it is important to begin taking folic acid as early as possible. "Women should begin taking folic acid at least four weeks prior to conception," says Dr. Shaffer. "Some experts even suggest starting to take folic acid 10 to 12 weeks prior to conception."

If you are already pregnant but aren't taking folic acid, start taking the supplement as soon as possible. You should take folic acid supplements through at least the 12th week of pregnancy, Dr. Shaffer advises.

Getting the appropriate amount of folic acid

Folic acid supplements can be purchased at any pharmacy and are recommended as the best way to get the appropriate dose of folic acid. However, Dr. Shaffer suggests you also seek natural sources of folic acid-rich foods.

"Several foods contain folic acid, including leafy green vegetables like spinach, citrus fruits like oranges and lentils," she says. "Several carbohydrate products are also fortified with folic acid, including rice, pastas, breads and cereals."

Check food labels to see how much folic acid is already in your daily diet. For the average woman with no risk factors for the development of neural tube defects in the fetus, Dr. Shaffer recommends taking a supplement of 400 micrograms of folic acid daily — the amount in a standard prenatal vitamin. To be sure, she suggests meeting with your OBGYN to discuss your pregnancy plan and nutritional needs.

"Women with a previous baby affected by a neural tube defect should speak to their doctors about the right dose of folic acid, as it will be an increased amount," says Dr. Shaffer. "Folic acid for high-risk women has been proven to decrease the rate of recurrence of neural tube defects by 70%."

With so many things to worry about when thinking about getting pregnant, here's one to strike off your list: Dr. Shaffer ensures that you do not have to worry about taking too much folic acid.

"Theoretically, increased folic acid in pregnancy could mask vitamin B12 deficiency," says Dr. Shaffer. "However, no scientific studies have found any evidence that too much folic acid causes any adverse effects during pregnancy."