A Crucial Nutrient In Pregnancy
Pop quiz time…
Which nutrient goes by the name B9?
A) Biotin
B) Niacin
C) Riboflavin
D) Folate
If you guessed Folate, you're RIGHT!
Folate, also known as vitamin B9, is one of the eight micronutrients that makes up the B-complex family of vitamins. It is involved in vital bodily processes, which also hold true for life cycle events such as pregnancy. Sadly, there still surrounds a lot of unawareness of the importance folate holds in this critical stage of the life cycle. Folate is involved in the very early stages of embryonic development, i.e. it helps in the development of the neural plate. This plate fuses in the sixth week of gestation (Mayoclinic.org).
A deficiency of this vitamin leads to a very preventable condition in pregnancy known as spina bifida (a type of neural tube defect), where the neural tube does not close completely.
Illustration showing Spina Bifida (image taken from Shuttershock)
Consequences of Spina Bifida
Spina Bifida can lead to some debilitating consequences as the child grows and develops into an adult.
According to the National Health Service (NHS), U.K., Spina Bifida can lead to the following consequences:
- Hydrocephalus (excess fluid in the brain) in babies (risk of brain damage)
- Weakness of the legs
- Paralysis of the legs
- Bowel or urinary incontinence
- Loss of temperature regulation or sensation in the lower limbs
Prevention of Spina Bifida
It is very important for woman who are planning to conceive to start preconception folate as soon as possible.
The National Institutes of Health (NIH) states that pregnant women need at least 600 micrograms of folate a day to meet the requirements of the growing baby.
It is advised to take a folate supplement each day up till the 12th week of pregnancy to prevent any kind of neural tube defects.
In addition to a daily folic acid supplement, pregnant women are advised to take a diet rich in folate.
Food high in folate include:
- Spinach
- Asparagus
- Brussel Sprouts
- Broccoli
- Edamame
- Avocados
- Oranges
- Beets
- Eggs
- Lentils
- Black beans
- Nuts and seeds
Folate not only helps in prevention of neural tube defects but also aids in the promotion of adequate red blood cells to compensate for the growing needs of the fetus and reduce anemia in the mother.
As a clinician, here are a few simple ways you can bring folate into the conversation with patients who are pregnant or planning to be:
✅ Start early:
“Have you started taking a prenatal or folic acid supplement yet? We recommend starting even before pregnancy to reduce the risk of birth defects.”
✅ Explain the why in plain language:
“Folate helps the baby’s brain and spine develop properly. A deficiency can lead to serious but preventable conditions like spina bifida.”
✅ Talk food, not just supplements:
“Along with a supplement, let’s talk about foods that are naturally rich in folate—like spinach, lentils, and oranges. Want me to provide you with a list?”
✅ Connect folate to energy and iron:
“Getting enough folate also supports healthy red blood cells, which can help reduce fatigue and lower the risk of anemia during pregnancy.”
Bottom line:
Conversations about folate don’t need to be long or complicated.
They just need to happen early—and in a way that makes patients feel supported, not scolded.
A 30-second chat can go a long way in preventing something truly life-altering.
Interested in pregnancy nutrition beyond folate?
You might also like Episode 22 on supporting patients with type 1 diabetes during pregnancy—including tips on nutrition, glucose control, and how to navigate those critical early weeks. Click here to listen.
This article was written by Aleena Khawar, Nutritionist (Singapore Nutrition and Dietetics Association)
Reviewed by Colleen Sloan, PA-C, RDN
