Folic Acid in Pregnancy - Why It’s Essential, When to Take It, and What Happens If You Don’t

When you're pregnant, there’s a lot of advice to take on board—what to eat, how to stay active, and what to avoid. One thing that should be at the top of your list is taking folic acid. But why is it so important? And when should you start taking it?

Let’s dive into the details, based on the latest NHS guidance, to help you understand everything you need to know about folic acid during pregnancy.

What is Folic Acid and Why is It Important?

Folic acid is the synthetic form of folate, a type of B vitamin (B9). It’s essential for the development of a healthy baby, particularly during the early stages of pregnancy.

Folic acid plays a key role in the formation of the neural tube, which becomes your baby’s brain and spinal cord. Taking the right amount of folic acid before and during early pregnancy helps prevent serious birth defects of the brain and spine, such as spina bifida. It’s vital for the baby’s growth and development in those early weeks when the spinal cord is forming.

When Should I Start Taking Folic Acid?

The NHS recommends that you start taking folic acid before you become pregnant and continue until you’re at least 12 weeks pregnant. In an ideal world, you’d begin taking folic acid at least one month before trying to conceive, but it’s never too late to start—even if you’re already pregnant, taking it can still be beneficial.

How Much Folic Acid Should I Take?

The NHS advises that most women need to take 400 micrograms (mcg) of folic acid every day. This is the standard recommended dose for women trying to conceive or who are already pregnant.

However, if you’re at higher risk of having a baby with neural tube defects, your doctor or midwife may recommend a higher dose (5 mg). You may be at higher risk if you:

• Have previously had a baby with a neural tube defect
• Have a family history of neural tube defects
• Are diabetic (type 1 or type 2)
• Are obese (with a BMI of 30 or more)
• Are taking medication that affects folic acid metabolism, such as anti-epileptic drugs

If any of these apply to you, make sure to discuss the appropriate dose with your healthcare provider.

Where Can I Get Folic Acid From?

The best way to ensure you’re getting the right amount of folic acid is through a daily supplement. You can buy folic acid supplements over-the-counter at pharmacies or online. These are available as standalone supplements or as part of a pregnancy multivitamin.

In addition to supplements, you can get folate from foods, although it’s hard to get enough through diet alone. Foods rich in folate include:

• Leafy green vegetables (spinach, kale)
• Fortified breakfast cereals
• Beans and lentils
• Citrus fruits
• Eggs

What Happens If I Don’t Take Folic Acid?

Not taking folic acid during early pregnancy can increase the risk of your baby developing neural tube defects, such as spina bifida. This is a serious condition where the spinal cord doesn’t form properly and can lead to lifelong disabilities. Taking folic acid reduces this risk by up to 70%.

If you’re not sure if you’ve been taking folic acid consistently, it’s still worth starting as soon as you find out you’re pregnant. The earlier in pregnancy that folic acid is taken, the better.

If you forget to take your folic acid supplement for a day or two, don’t panic. Just continue taking it daily and try to stick to a routine.

Can I Take Too Much Folic Acid?

While folic acid is essential during pregnancy, it’s also important to stick to the recommended dosage. Taking too much folic acid (above 1,000 mcg per day) can mask signs of vitamin B12 deficiency, which could affect your health and your baby’s health.

If you’re considering taking higher doses of folic acid (for example, 5 mg), always consult with your GP or midwife first to make sure it’s necessary for you.

What If I Didn’t Take Folic Acid Before I Got Pregnant?

If you didn’t take folic acid before conceiving, it’s still important to start taking it as soon as you find out you’re pregnant. The risk of neural tube defects is greatest in the first few weeks of pregnancy, but folic acid can still provide benefits after this time, so don’t worry if you didn’t start early.

If you’re concerned that you might have missed the window for folic acid to have its full effect, it’s best to speak to your midwife or GP. They can provide reassurance and advice on next steps.

Can I Rely on My Diet for Folate?

Although it’s great to include folate-rich foods in your diet, it can be difficult to get enough through food alone. The NHS strongly recommends taking a folic acid supplement because it ensures you’re getting the right amount. Fortified foods (such as some cereals and bread) can help, but supplements are the most reliable way to ensure you're getting the 400 mcg you need.

Folic acid is a small but mighty part of your pregnancy journey. Taking it every day can reduce the risk of serious birth defects and support your baby’s growth in the crucial early weeks. The key takeaway: start taking folic acid before you conceive and continue for the first 12 weeks of pregnancy. If you’ve missed the mark, don’t worry—just start as soon as you can and talk to your healthcare provider if you have any concerns.

Taking care of yourself with folic acid is one of the simplest and most important steps you can take to give your baby the best start in life.

Be Prepared with Bloom Club

As you start off your pregnancy, it’s normal to have lots of questions and even some anxieties about the process and what to expect. The good news is that you don’t have to navigate this stage alone! Bloom Club offers an amazing range of resources to support you through your pregnancy and birth journey, including expert advice and helpful videos on the signs of labour, breathing techniques, and what to expect during your birth.

For just £9.99 a month, you’ll get access to exclusive videos, in-depth educational content, and expert guidance from experienced midwives. Whether you want to understand the stages of labour better or get tips on how to manage contractions, Bloom Club is here to provide you with everything you need to feel confident and supported as you approach your big day.

Join Bloom Club today and start your journey towards a positive birth experience.
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