Not taking folic acid while pregnant increases the risk of neural tube defects (NTDs) like spina bifida, affects fetal brain development, and may result in low birth weight or preterm birth.
What Happens if You Don’t Take Folic Acid While Pregnant? | Critical Health Insights
Folic acid isn’t just another supplement on the checklist—it’s crucial for your baby’s brain and spine development. But what exactly happens if you skip folic acid during pregnancy? In this guide, we’ll explore why folic acid is vital, the risks of deficiency, and how you can make sure you’re getting enough of it throughout your pregnancy journey.
Why Is Folic Acid So Important During Pregnancy?
Folic acid, a synthetic form of folate (vitamin B9), plays a central role in cell division and DNA formation, both of which are crucial during pregnancy when your baby is developing rapidly. It is especially important during the early stages—often before many women know they are pregnant.
| Function of Folic Acid | Impact on Pregnancy |
| DNA synthesis and cell growth | Supports fetal growth and tissue formation |
| Neural tube formation | Prevents neural tube defects like spina bifida |
| Red blood cell production | Reduces the risk of maternal anemia |
| Brain and spinal cord development | Ensures proper fetal nervous system development |
Most doctors recommend starting folic acid supplements before conception to ensure the baby receives adequate levels during the earliest weeks of development.
What Are Neural Tube Defects (NTDs)?
One of the most significant risks of not taking folic acid during pregnancy is the increased chance of neural tube defects (NTDs). The neural tube forms the baby’s brain, spinal cord, and spine, and without enough folic acid, this development can go wrong.
Common Neural Tube Defects (NTDs):
- Spina bifida: The spine does not close properly, which can cause mobility issues and nerve damage.
- Anencephaly: The brain and skull do not develop fully, leading to severe disability or death.
- Encephalocele: Brain tissue protrudes through openings in the skull.
NTDs occur very early—usually within the first 28 days of pregnancy—making it critical to have sufficient folic acid levels before and during early pregnancy.
When Should You Start Taking Folic Acid?
The most critical time for folic acid intake is during the first trimester, but ideally, you should begin taking it at least one month before conception. This ensures that your body has enough folate during the initial weeks of pregnancy, when the neural tube forms.
| Pregnancy Stage | Recommended Folic Acid Intake |
| Preconception | 400 mcg per day |
| First trimester (0-12 weeks) | 600 mcg per day |
| Second and third trimesters | 400-600 mcg per day |
Doctors often recommend continuing folic acid throughout pregnancy and into breastfeeding to support the baby’s development and maternal health.
Risks of Not Taking Folic Acid During Pregnancy
Skipping folic acid can increase the chances of several complications, not just for the baby but also for the mother. Let’s take a closer look at the potential risks.
1. Neural Tube Defects (NTDs)
As mentioned earlier, the absence of sufficient folic acid can lead to defects like spina bifida or anencephaly. These conditions can have lifelong consequences for the baby and, in severe cases, may result in miscarriage or stillbirth.
2. Preterm Birth or Low Birth Weight
Studies have shown that folic acid deficiency is linked to higher rates of preterm birth and low birth weight. Babies born too early or underweight are at greater risk of developmental delays and health issues.
3. Maternal Anemia
Folic acid helps in the production of red blood cells. A deficiency may lead to anemia, leaving the mother fatigued and more susceptible to infections. Anemia during pregnancy can also affect the oxygen supply to the baby.
| Potential Risk | Impact on Baby or Mother |
| Neural tube defects | Birth defects in the spine or brain |
| Preterm birth | Increased risk of health complications |
| Maternal anemia | Fatigue and decreased immunity in the mother |
| Developmental delays | Cognitive or motor issues for the baby |
How to Get Enough Folic Acid During Pregnancy
Fortunately, ensuring you get enough folic acid isn’t difficult. A combination of prenatal vitamins and folate-rich foods can meet your body’s needs.
1. Folic Acid Supplements
Most prenatal vitamins contain at least 400-600 mcg of folic acid, which covers the daily requirement for pregnant women. These supplements are available over-the-counter, but your doctor may prescribe higher doses if you are at higher risk for NTDs.
2. Folate-Rich Foods
In addition to supplements, it’s important to eat foods rich in folate. Here are some excellent dietary sources of folate:
| Food | Folate Content (per serving) |
| Leafy greens (spinach) | 58 mcg per half cup (cooked) |
| Citrus fruits (oranges) | 29 mcg per medium orange |
| Lentils | 180 mcg per half cup (cooked) |
| Fortified cereals | 100-400 mcg per serving |
| Avocado | 59 mcg per half avocado |
These foods can complement your supplement intake and ensure you’re getting folate from natural sources.
Who Is at Higher Risk for Folic Acid Deficiency?
Some women may require higher doses of folic acid due to certain medical conditions or lifestyle factors. If you fall into any of these categories, consult your doctor about your folic acid needs.
| High-Risk Group | Reason |
| Women with a previous NTD pregnancy | Increased likelihood of another NTD |
| Diabetics or women with epilepsy | Medications may interfere with folate absorption |
| Women with gastrointestinal disorders | Conditions like celiac disease impair nutrient absorption |
| Obese women | Higher nutrient demands |
These women are often prescribed 4,000 mcg (4 mg) of folic acid daily to reduce the risk of complications.
Can You Get Too Much Folic Acid?
While folic acid is essential, taking too much—usually over 1,000 mcg per day without medical supervision—can mask symptoms of a vitamin B12 deficiency, leading to neurological issues. Stick to your doctor’s recommended dose to avoid any risks associated with excessive intake.
10 FAQs About Folic Acid During Pregnancy
What happens if I miss a few days of folic acid during pregnancy?
Missing a few days is usually not a cause for concern if you resume taking it promptly. However, try to stay consistent, especially during the first trimester when the baby’s neural tube is developing.
Can I start taking folic acid after discovering I’m pregnant?
Yes, it’s still beneficial to start folic acid even after confirming your pregnancy. Although the neural tube forms early, folic acid continues to support fetal development throughout pregnancy.
How much folic acid should I take if I’m trying to conceive?
Experts recommend 400 mcg of folic acid daily at least one month before conception to reduce the risk of NTDs and support early pregnancy development.
Is it safe to take prenatal vitamins with folic acid throughout the entire pregnancy?
Yes, it’s safe and recommended to continue taking prenatal vitamins with folic acid throughout pregnancy to maintain optimal fetal growth and maternal health.
Can I get enough folic acid from food alone?
It’s possible to get some folate from food, but most healthcare providers recommend supplements to ensure you meet the daily requirements, especially during pregnancy.
Are there side effects of taking folic acid?
Folic acid is generally well-tolerated, but some people may experience mild side effects like nausea or bloating. These can often be managed by taking the supplement with food.
What should I do if I took no folic acid during the first trimester?
If you missed taking folic acid early on, speak with your doctor. They may recommend starting supplements immediately and possibly increasing your intake.
Can folic acid prevent miscarriage?
Folic acid reduces the risk of NTDs, which can lead to miscarriage in severe cases. However, it is not a guaranteed way to prevent miscarriage from other causes.
Is folic acid important during breastfeeding?
Yes, folic acid supports your recovery postpartum and ensures your baby receives essential nutrients through breast milk. Continue taking your prenatal vitamins while breastfeeding.
Can I take folic acid along with other vitamins?
Yes, folic acid is often combined with other vitamins in prenatal supplements. Just ensure you don’t exceed the recommended daily dose without consulting your doctor.
Conclusion: Don’t Skip Folic Acid for a Healthy Pregnancy
Folic acid plays a critical role in preventing neural tube defects and supporting your baby’s development, especially during the first trimester. Skipping folic acid can increase the risks of serious birth defects, preterm birth, and low birth weight. With prenatal vitamins and a diet rich in folate, you can meet your body’s needs and give your baby the best possible start. Prioritize consistent intake for a healthy, worry-free pregnancy.