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 vitamins and prenatal supplements. Trying to remember what each vitamin does can make your head spin.
"Folic acid is a B vitamin, also known as vitamin B-9," says Dr. Shaffer. "It is an essential building block of the DNA of all cells."
According to Dr. Shaffer, 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," suggests Dr. Shaffer.
While folic acid supplements can be purchased at any pharmacy and are recommended as the best way to get the appropriate dose of folic acid, Dr. Shaffer includes natural places to find 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.
"For women with a previous baby affected by a neural tube defect, 4 milligrams of folic acid is recommended," continues Dr. Shaffer. "Folic acid for these high-risk women has been proven to decrease the rate of recurrence of neural tube defects by 70 percent."
Dr. Shaffer also cautions that women with seizure disorders or who take anti-epileptic medications should take 4 milligrams of folic acid.
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."