Many women begin folic-acid supplements only after a positive pregnancy test, but by then, the baby’s brain and spine have already started forming. Health experts say folate (Vitamin B9) should be built up in the body at least three months before conception to protect against serious birth defects and anaemia.
Why folate before pregnancy is essential for every woman
Folate, also known as Vitamin B9, is one of the most crucial nutrients for women of child-bearing age — yet many start too late. Neural-tube defects such as spina bifida develop within the first 28 days of pregnancy, often before a woman even realises she’s expecting.That’s why the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) recommend beginning folic-acid supplements at least one to three months before conception, not after a positive test.
Key benefits of folate for women’s health and pregnancy
According to the National Institutes of Health (NIH), folate is needed to:
- Support the development of a baby’s brain and spinal cord
- Prevent neural-tube defects (NTDs) such as spina bifida and anencephaly
- Help form healthy red blood cells and prevent anaemia
- Aid the production of DNA and neurotransmitters that regulate mood
Deficiency in early pregnancy can cause lifelong disability or miscarriage — but it is easily preventable with timely intake.
Folate vs folic acid: What’s the difference?
- Folate is the natural form found in food.
- Folic acid is the synthetic form used in supplements and fortified foods.
The body absorbs folic acid more efficiently, which is why supplements are essential even for women who eat plenty of greens and pulses.The ICMR-NIN 2020 guidelines recommend 200 µg daily for adults and 400–600 µg for pregnant women.
Best folate-rich foods to add before and during pregnancy
Leafy greens, pulses, citrus fruits, and fortified cereals are excellent sources, but diet alone rarely meets the higher requirements of early pregnancy — supplements fill that gap.
When to start folic-acid supplements
The CDC advises 400 µg of folic acid daily for all women of reproductive age, starting at least three months before conception and continuing throughout pregnancy and breastfeeding.Because nearly half of pregnancies are unplanned, public-health experts recommend that all women aged 15–45 years take a daily supplement, even if not actively trying.Women with a previous NTD-affected pregnancy or taking anti-epileptic medicines may need higher doses, under medical supervision.
Signs of folate deficiency
Mild deficiency can cause:
- Fatigue or weakness
- Pale skin
- Mouth sores or a swollen tongue
- Poor focus or irritability
Severe deficiency leads to megaloblastic anaemia, where red blood cells enlarge and carry less oxygen, causing breathlessness and exhaustion.
How to improve folate absorption naturally
- Avoid over-boiling vegetables — folate is heat-sensitive.
- Eat fresh greens and citrus daily.
- Pair folate-rich foods with Vitamin C sources (amla, orange, tomato) to improve absorption.
- Limit alcohol, which blocks folate absorption and increases excretion.
Folate is one of the few vitamins proven to prevent life-threatening birth defects; however, timing is crucial.If you’re planning a pregnancy or could become pregnant, start folic-acid supplementation three months in advance while maintaining a diet rich in greens, pulses, and fruits.This small, proactive step can protect your baby’s brain and spine, prevent anaemia, and ensure a healthier pregnancy for both mother and child.