For medical experts, preparations for pregnancy should begin long before conception. Ideally, they say, a woman should make nutritional and lifestyle changes before becoming pregnant. This way, she can protect her health and the health of her fetus. Taking folic acid before and during pregnancy is one of the most important nutritional changes a woman can make in order to protect her fetus. This is because folic acid is known to protect a fetus against a form of birth defect known as Neural Tube Defects (or NTDs).

NTDs are birth defects of the brain and spine, and it occurs in two forms namely spina bifida and anencephaly. Spina bifida refers to a condition in which a baby's spinal cord is partially exposed due to incomplete closing of the spinal column. Anencephaly, on the other hand, is caused by incomplete closing of the skull, thus leaving part of the brain exposed. In United States, 2,500 to 3,000 babies are born with NTDs each year, and an estimated 1,500 pregnancies are terminated because of these defects.

All infants with anencephaly die before or shortly after birth, whereas most babies born with spina bifida grow to adulthood with varying degrees of paralysis and disability. The annual medical and surgical costs for persons with spina bifida in the United States exceed $200 million. Even worse, caring for these individuals for the rest of their lives often places families under enormous financial and emotional stress.

The good news though is that NTDs can be prevented. In 1992, the U. S. Public Health Service (USPHS) published a recommendation requiring all women of childbearing age to consume 0.4 mg (or 400 micrograms) of folic acid EVERYDAY, even when they are not planning to become pregnant. An additional measure was put in place in 1998 when the Food and Drug Administration (FDA) implemented the Fortification Program, which requires all enriched grain products to be fortified with folic acid. These measures have been proven to be effective in reducing the incidence of NTDs. The results of studies done before and after these measures were put in place show a 30 - 59% reduction in the incidence of NTDs.

If you are not planning to become pregnant, why is it important for you to get at least 400 micrograms of folic acid a day? The reason is simple: NTDs occur as early in a pregnancy as 3 - 4 weeks after conception, a period when most women do not know that they are pregnant. Furthermore, about half of all pregnancies in U.S. are unplanned. So, if a woman waits until she confirms her pregnancy before increasing her folic acid intake, it may be too late for her baby.

The next question then becomes this: How can a woman be sure that she is getting at least 400 mcg of folic acid each day? Well, the Center for Disease Control (CDC) thought about this problem and came up with a solution. Because it is hard for a woman to determine the amount of folic acid she gets from food each day, the CDC recommends that women should take a supplement that provides 400 micrograms of folic acid per serving per day, in addition to the amount they get from food. This guarantees that she meets her minimum folic acid requirement each day. There is no harm in getting extra folic acid from food because the amount of the nutrient found in food is nontoxic.

Examples of supplements that can help you meet this recommendation include standard multivitamins and folic acid supplements. Before buying a multivitamins or folic acid supplement though, read the "supplement facts" label on the supplement bottle. First, locate folic acid on the label and then read across. If it is the right one, you will see 400 mcg under "amount per serving" and 100% under "%DV".

NTDs are serious birth defects that can cause death. A baby born with the nonfatal form of NTD will grow up with serious disabilities. Fortunately, these defects can be prevented. By taking one or two pills of a supplement containing 400 micrograms of folic acid each day, a woman can protect her baby against these birth defects. It is one of the most important things you can do to protect your unborn. Best of all, it's simple and easy; any woman can do it.