The Significance of Folic Acid during Pregnancy

by | Jan 21, 2021

Guest post by Lyla Joffe


Folic acid is the synthetic form of folate (vitamin B-9), essential for the cell regeneration occurring daily. During pregnancy, the body is supplying nutrients for itself as well as for the fetus, and so requiring increased stores for erythropoiesis, or, red blood cell production. Red blood cells carry oxygen in the body, as well as remove carbon dioxide from the body, so without adequate stores, optimal organism functioning is inhibited. Folate is found naturally occurring in several food sources including avocado and kidney beans. Folic acid is not the same as folate (although it is commonly confused as such), and is generally available in supplement form, taken orally. As a means of preventing folate deficiency too, several food products and in particular certain breads and flours have been fortified with folic acid. In the case of fortification, the product will note this on the packaging. Folic acid consumption of at least 400mg is recommended for pregnant women, or women trying to get pregnant as it has been shown to dramatically reduce the baby’s risk for neural tube defects.

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Folate deficiency is rare in the United States, however folic acid supplementation is still recommended to assure appropriate consumption since it is so vital for fetal development. One of the first body parts to develop is the spinal cord. Folate plays a massive role in nervous system operation and repair. In the case of a folate deficiency, spina bifida in the fetus can result. Spina bifida is a birth defect occurring when the spine and spinal cord do not develop how they should; this deficiency is referred to as a neural tube defect. The neural tube is the structure in the embryo that over time, will develop into the brain, spinal cord and the tissues that surround and protect them. The neural tube in healthy embryos, forms within 28 days after conception, with improper formation ranging from mild to severe depending on the type, size and location in the body.

Neural tube defects

Spinal bifida occulta, or, the hidden version, is the least severe and also the most common form of the condition resulting because of one or more open spaces in the spine. Oftentimes, this condition goes unrecognized and does not pose any great risk. Myelomeningocele, or open spina bifida, is severe and is characteristic of several openings along the spinal canal. In the case of myelomeningocele, the spinal nerves create pressure at these open spaces, thus forming a sac which exposes and makes vulnerable various tissues and nerves. There are major consequences of this condition such as paralysis and bowel dysfunction. Diagnosis generally occurs after birth with treatment sometimes necessitating surgery. 

Image credit: Mayo Clinic

Since the risks of folate deficiency are so great for the developing embryo, it is essential that mothers take the necessary precautions through folic acid supplementation. Spina bifida occurs so early on in pregnancy too, that women attempting to get pregnant or of child bearing age are recommended to engage in supplementation as well. Many women do not find out they are pregnant for several weeks, when the damage could have already occurred and prevention is possible through supplementation.

Folate-rich foods

Folate can be found naturally in some food items like broccoli, brussel sprouts, leafy green vegetables like kale, peas, chickpeas and kidney beans. Consuming a diet high in fruits, vegetables and whole grains should satisfy folate requirements, however additional supplementation for child-bearing aged females is a mode of assuring this.

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Guidelines & recommendations

For women of childbearing age or pregnant women:

  • Remember to schedule your regular OBGYN visits
  • Take your prenatal vitamins (if pregnant)
  • Consume a diet rich in fruits, vegetables and whole grains
  • Schedule an appointment with a Registered Dietitian (like Dina!) to help choreograph a healthy diet before, during, and after pregnancy 

Looking to get more folate into your diet?

If you need more folate-rich inspiration, check out these creative and healthy recipes.


  1. BSc, A. A. (2019, August 19). Folic Acid vs. Folate – What’s the Difference? Retrieved from
  2. Folic acid: Importance, deficiencies, and side effects. (n.d.). Retrieved from
  3. Fuentes, A. (Ed.). (2018, October). Folic Acid and Pregnancy (for Parents) – Nemours KidsHealth. Retrieved from

Lyla Joffe is a dietetics student at the University of Northern Colorado and holds a bachelor’s degree in Communication from NYU.


I’m Dina R. D’Alessandro, MS, RDN, CDN. I am a Registered Dietitian Nutritionist based in New York City, and I provide nutrition counseling to women.

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