Doctors urge all women of reproductive age to take daily folic acid tablets

Folic acid reduces the risk of babies developing neural tube defects, but it does not work if you wait until you are pregnant to start folic acid

Written by Ailbhe DeCastro


Folic acid is a B-group vitamin which is needed for good health. Taking folic acid is very important before and during pregnancy to make sure a baby has the best chance of being born healthy. Folic acid can be taken orally in the form of a tablet, and is also found in certain foods.

Why should people who can get pregnant take folic acid?

Taking folic acid is not only important for good health, it is especially important for women of reproductive age. Folic acid reduces the risk of babies developing an NTD, which stands for neural tube defect. The risk of NTDs can reduced by up to 70% with the correct intake of folic acid. People who can get pregnant who do not take folic acid, or who do not take the correct amount of folic acid, have and increased risk of an NTD.

Since half of all pregnancies are unplanned, the National policy on folic acid in Ireland since 1993 has been to advise "all women of childbearing age who are capable of becoming pregnant, whether planning to do so or not, to take 400 mcg of folic acid daily as a supplement."  

Types of NTDs which may be developed from a lack of folic acid intake can include spina bifida, and anencephaly. Spina bifida is translated to ‘split spine’, and this happens when the separate bones called vertebrae in the spine do not fully form. This condition can cause some children to be confined to a wheelchair. If you would like more information on this condition, click here.

Anencephaly is when a baby’s brain, skull and scalp does not fully form, and these babies often die in the womb, or shortly after birth. If you would like more information on this condition, click here.

When should I be taking folic acid?

It has been previously recommended that a person who can get pregnant should take folic acid for a full year before they becomes pregnant to give their baby the best chance of developing healthily to full-term (from conception to birth). The issue with this is that in the cases of unplanned pregnancies or the decision to get pregnant within a year of actually getting pregnant, there is no chance for a solid year of folic acid intake.

It is now recommended that folic acid should be taken by any person who has a possibility of becoming pregnant. This means that (even if you are not planning on getting pregnant anytime soon) you should still take folic acid from the time of your first period until your last (i.e menopause). Regardless of if you are currently sexually active, taking folic acid daily means that if you have sex and become pregnant unexpectedly you will be able to provide the levels of folic acid that you and your baby need to stay healthy.

Dr. Sinead Howley's recommendations on folic acid

Dr. Sinead Howley, a Dublin GP, believes that there is not enough discussions about the importance of taking folic acid. She argues that it is very important that all people of childbearing age are recommended to take daily folic acid alongside their pill prescription. “Any women on contraception should still be advised in their doctors visits that they should be regularly taking folic acid. This is because no contraception is 100% effective, and it is better to be prepared. There needs to be more awareness raised that folic acid should be taken every day, in the case of an unplanned pregnancy.” If you would like to read Dr. Howley’s full article, please click here.

Where can I get folic acid?

Folic acid tablets can be bought in pharmacies and health shops, and some supermarkets without a prescription from a doctor. These tablets cost from half a cent per tablet to 18 cent per tablet depending on the brand you choose. 

Folic acid tablets are also technically available free of charge for medical card holders with a doctor’s prescription. However, the prescription charge of €1.50 per month paid at the pharmacy means that each tablet in the months prescription for 28 x 400mcg folic acid tablets is costing 5 cent each, which is more expensive than buying some brands of folic acid without a medical card prescription. 

If you are unsure of which tablets to buy, you should ask the pharmacist which ones they would recommend – they are there to help. It is also always a good idea to consult your GP before taking any medication or help supplements.

For further information on folic acid, click here.

Foods high in folic acid

The levels of folic acid needed to prevent birth defects are not possibl to achieve through diet alone –  a daily folic acid tablet is required.

However, there is no harm in ensuring you are also eating healthy foods that contain folic acid.

These include:

  • Legumes, asparagus, broccoli, leafy greens and brussel sprouts
  • Eggs
  • Beets
  • Citrus fruits, papaya
  • Nuts and seeds
  • Beef liver
  • Wheat germ, fortified grains
  • Bananas, avocado

If you would like further information on the levels of folate in these foods and how much you should be eating in a balanced diet, click here.

What is the correct amount of folic acid I should be taking?

400 micrograms (mcg) of folic acid should be taken daily to be sure that the correct level of folic acid is in your system.

The benefits of folic acid

Taking folic acid can help prevent certain birth defects of the brain and spinal cord, known as neural tube defects (NTDs). Spina bifida is one of the most common NTDs. NTD’S can bring about nerve damage or incomplete brain development in severe cases, causing disabilities. Many of these (up to 70%) could be prevented by taking folic acid.

If you are already pregnant, start taking folic acid straight away and continue each day up to 3 months into your pregnancy.

Why take folic acid every day, even if I'm not pregnant?

About half of pregnancies are unplanned. That means, that by the time you might realise you're pregnant it may be too late to help support a baby’s spine and brain development by taking folic acid.

A baby’s spine develops fully in the first 28 days of pregnancy. That’s why taking folic acid is essential for at least 3 months before and during the first three months of pregnancy. Taking folic acid every day can help a baby to develop without a neural tube defect (NTD).

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