How Folic Acid Prevents Spina Bifida in Pregnancy: Benefits, Dosage & Myths

Did you know that a small vitamin taken before and during pregnancy can prevent one of the most serious birth defects in babies? That vitamin is folic acid. Often called the “miracle nutrient for mothers-to-be,” folic acid plays a life-saving role in preventing neural tube defects like spina bifida, which affect the baby’s brain and spinal cord. Since most pregnancies are unplanned and the neural tube closes within just 3–4 weeks — often before a woman even realizes she’s pregnant — starting folic acid early is the smartest step for every hopeful or expecting mother.

Folic acid during pregnancy promotes the rapid division of cells, the synthesis of DNA, and the development of tissues. These activities are particularly active in the first few days of pregnancy. Understanding the importance of folic acid in early pregnancy is crucial because most pregnancies are unplanned and the embryo’s start developing even before many pregnant women are aware about their pregnancies.

What is Spina Bifida?

Spina bifida is a neural tube abnormality that occurs when the spinal column fails to close completely during embryonic development. A severe birth abnormality that affects the backbone and spinal cord of the baby is called spina bifida. This may lead to severe health problems that impact the person’s ability to move around, regulate their bladder, and sometimes cognitive function. However, by ensuring adequate folic acid intake, spina bifida can be prevented.

Spina Bifida: Know its types

• Myelomeningocele – Myelomeningocele is the most prevalent and severe kind of spina bifida. Babies with this issue have a part of spinal cord sticking out of the back. A fluid-filled sack that contains the tissues surrounding the spinal cord protrudes from the baby’s back in meningocele, a form of spina bifida. Sometimes skin is placed over the sack. The spinal cord and nerves are generally unaffected or very slightly affected.
• Occulta – This type is also known as ‘hidden spina bifida.’ The back is completely closed. There is a sight deviation in the spine’s bones, but the spinal cord and nerve are generally normal. Unaware that they have Spina Bifida Occulta, some people may never experience any such symptoms. Some people may have tiny patch of hair on the lower back. However, in some people, the condition may result in bladder and bowel issues, back pain or limb weakness.
• Meningocele- A fluid-filled sack that contains the tissues surrounding the spinal cord protrudes from the baby’s back in this kind of spina bifida.

Folic acid role during pregnancy

Red blood cell production, DNA synthesis, and cell division all depend on folic acid. The embryo grows quickly in the early stages of pregnancy and requires more folate. After conception, the neural tube, which eventually becomes baby’s brain and spine, closes within the first 3-4 weeks

The risk of neural tube abnormalities rises, if folate is insufficient during this point because neural tube may not be closed correctly. For this reason, folic acid for preventing birth defects is a highly effective and scientifically proven way to prevent NTDs.

How folic acid prevents Spina Bifida?

Folic acid helps the body make and repair DNA, which allows embryonic cells to grow and divide properly. This is crucial in the first 3–4 weeks of pregnancy, when the neural tube — the structure that forms the baby’s brain and spine — closes. If folate levels are too low during this short window, the risk of neural tube defects like spina bifida increases.

Studies and global health programs show that taking folic acid before and during early pregnancy greatly lowers the chances of these birth defects. This proves that folic acid prevents spina bifida by giving the body what it needs for healthy neural tube closure at the right time.

Recommended dosage of folic acid during pregnancy

• Pregnant women: 400 micrograms (0.4 mg) of folic acid daily. This is the general daily requirement to reduce the risk of spina bifida prevention and other defects caused by folic acid
• Women who are at high risk: For instance, women who had previous pregnancy affected by an NTD, have certain genetic disorders, or are taking some anticonvulsant drugs. They are often advised to take a higher dose around 4,000 micrograms (4mg) daily, under doctor’s supervision.

Citrus fruits, avocado, legumes (lentils, chickpeas), leafy green vegetables including spinach, fenugreek, kale and fortified cereals and grains are all naturally folate rich foods for pregnancy. However, dietary folic acid might not consistently provide enough folic acid required for preventing NTDs, thus, fortification and supplementation are essential.

Myths and facts about folic acid and spina bifida

Myth: You need folic acid only after you conceive.

Fact: The neural tube closes before many women know about their pregnancy; therefore, it is often too late to start taking folic acid once the pregnancy is detected. Start before conception.

Myth: Spina Bifida can be prevented with a healthy diet alone

Fact: Although a diet high in folic acid is beneficial, dietary folate is not as effective as supplements in terms of absorption and may not reach protective levels, particularly in the absence of fortified foods and pills.

Myth: It’s always better to have more folic acid

Fact: Taking excessive folic acid beyond recommended levels is not beneficial and may highlight symptoms of B12 deficiency. Always follow doctor’s advice, especially when taking high-dose medications.

This clearly underlines the evidence-based position on folic acid deficiency in pregnancy risks and safe practices.

Other folic acid pregnancy benefits

Other benefits of folic acid for the mother and foetus include:

• It prevents anaemia by promoting the formation of red blood cells.
• It supports nutrition transport and helps in growth and functioning of placenta.
• It encourages cell differentiation in overall foetal growth in a variety of systems.

These benefits are often combined as folic acid pregnancy benefits, indicating its broad role in prenatal health.

Smart Ways to Get Enough Folic Acid During Pregnancy

1. Start Early – Don’t wait until you miss your period. Begin folic acid supplementation at least 1–3 months before planning pregnancy to give your body the right nutrient reserves.
2. Take Daily Supplements – The simplest way to meet your folic acid needs is by taking a daily supplement (usually 400 mcg). This ensures consistent protection against neural tube defects like spina bifida.
3. Eat Folate-Rich Foods – Add leafy greens (spinach, kale), legumes (lentils, chickpeas), citrus fruits, and avocado to your daily meals. They are natural sources of folate and support overall pregnancy nutrition.
4. Choose Fortified Foods – Many cereals, breads, and grains are fortified with folic acid. Including them in your diet helps boost intake easily.
5. Go for Advanced Forms – Some women struggle to absorb regular folic acid due to genetic factors (like MTHFR mutation). In such cases, L-methyl folate, an active and highly bioavailable form, works better.
6. Trust Trimacare Prenatal Supplements – Designed specifically for Indian mothers, Trimacare provides L-methyl folate (7x more bioavailable than folic acid) along with trimester-specific nutrition in a single pill. This ensures both mother and baby receive the right nutrients at the right stage of pregnancy.

Conclusion

Folic acid is a little nutrient that has a significant influence. It significantly decreases the risk of spina bifida and other neural tube defects by boosting DNA synthesis and cell proliferation, which allows for timely neural tube closure. Folic acid before conception benefits and early supplementation are a public health priority since the window for prevention is limited to the first three to four weeks following conception.

FAQs

Q1. What if I don’t get enough folic acid when I’m pregnant?

Ans- If you do not have adequate amount of folic acid during pregnancy, the risk of neural tube defects like spina bifida is higher, particularly in the first 3–4 weeks of development. Low folate levels can also increase the risk of anemia, improper placental development, and reduced overall fetal growth.

Q2. Is Folate identical to folic acid?

Ans- No both are not same. Folate is natural form of the vitamin B9(folic acid) that can be found in foods such as leafy greens, beans, and citrus fruits. Folic acid is the synthesised form. Both perform the same functions within the body, but folate are more stable and better absorbed in folic acid form.

Q3. Will excessive consumption of folic acid harm?

Ans- Although folic acid is generally safe, taking higher doses (particularly greater than 1,000 mcg per day without doctor’s recommendation) can lead to the symptoms of vitamin B12 deficiency. For this reason, high-dose folic acid (e.g., 4 mg) is only recommended for women who have certain medical conditions or had a neural tube defect in past pregnancies, under medical supervision.

Q4. Apart from preventing spina bifida, what are the other advantages of folic acid during pregnancy?

Ans- Apart from preventing neural tube defects, folic acid also helps in red blood cell formation , prevents anemia, promotes placental growth, and increases overall fetal growth. Proper folic acid intake also reduces the risk for certain pregnancy complications, that’s why it is an essential nutrient during early pregnancy.

Q5. Do I get sufficient folic acid from food?

Ans. Though foods rich in folate during pregnancy such as spinach, broccoli, lentils, chickpeas, citrus fruits, and avocado are great sources of natural folate, but food alone cannot fulfil the increased folic acid need during pregnancy. Supplements bridge this nutritional gaps.

That is why doctors recommend pregnant women should take a folic acid supplement daily, along with consuming a diet high in folate to provide consistent protection against neural tube defects.