By Jennifer Vickery
Preconception Health Education Coordinator
Congratulations! You are getting married! You and your partner are starting a new and exciting adventure together, and for some of you this new adventure may include having children some point along the way.
Whether you or your partner are planning to become pregnant in the coming months or years, did you know all women of childbearing age, which are roughly ages 14 through 44, are encouraged to take a daily multivitamin? Women of childbearing age should take a multivitamin with 400 micrograms (mcg) of folic acid every day. This daily consumption of folic acid can greatly reduce your chances of having a baby born with a neural tube defect.
If taken before pregnancy, folic acid can prevent up to 70 percent of neural tube defects (NTDs), a group of serious birth defects including spina bifida and anencephaly. NTDs happen when the neural tube, which forms the brain and spine, fails to close properly around the fourth week of pregnancy. Often before some women are even aware they are pregnant. This can result in physical abnormalities, with varying degrees of disability, and can even be fatal. NTDs are common birth defects that occur in about 200 pregnancies each year in North Carolina.
Research suggests that folic acid may also decrease risks for birth defects of the heart, urinary tract and cleft lip/palate. Additional studies have found that folic acid may have other health benefits, including reducing the risk of cardiovascular disease, stroke, Alzheimer’s, cervical and colon cancer, and depression. Folic acid, along with many of the other vitamins in a daily multivitamin, is essential for a healthy body on the inside and out. Because folic acid is responsible for cell growth, for many people multivitamins can make a big difference in the health of your hair, nails and skin.
A multivitamin with folic acid helps women maintain good health, whether or not they are planning a pregnancy. Two-thirds of women in the United States don’t consume enough folic acid and/or folate. Folate and folic acid are forms of a B9 vitamin. Folate occurs naturally in food, and folic acid is the synthetic form of this vitamin. Since 1998, folic acid has been added to cold cereals, flour, breads, pasta, bakery items, cookies, crackers and nutrition bars, as required by federal law. Foods naturally high in folate include leafy green vegetables (spinach, broccoli and lettuce), orange juice, beans (especially black eyed peas), avocado, kiwi, cantaloupe, paprika, tahini and arugula.
However, even if you eat healthy every day, it’s almost impossible to obtain the recommended amount of folic acid or folate from food alone. In addition, folate absorption depends on the food itself, how it is cooked and the individual’s ability to metabolize it. For example, in order to obtain your daily amount of folate from food alone you would need to eat 14 cups of broccoli or one loaf of bread or drink an entire container of orange juice to get the proper amount of folate daily. Obviously consuming this much broccoli, bread or orange juice would be unhealthy and counterproductive to achieving your overall health goals. Therefore, the easy solution is to take a daily multivitamin to achieve the recommended folic acid dosage.
Because our bodies can only absorb about half of the folate we consume, a multivitamin is the best way to get folic acid into your body. A daily multivitamin makes up for what women lack in daily nutrition. Check the bottle label to make sure the multivitamin has 400 mcg of folic acid. Generic multivitamins work just as well as brand names – but cost half the price!
The North Carolina Preconception Health Campaign offers free multivitamins for nonpregnant women who are in need through various safety net agencies including the Buncombe County Health Department, Minnie Jones Health Center and the Family Medicine Clinic at MAHEC. Additional information and free resources are available at EveryWomanNC.org 
Jennifer Vickery is the Western Regional Coordinator for the NC Preconception Health Campaign and a Preconception Health Education Coordinator at Mission Health Fullerton Genetics Center.