7. Folic-Acid Use
Folic acid, also referred to as folate, folacin or vitamin B9, is very important during pregnancy. Folate is the form of folic acid found in food. Folic acid
is the synthetic version of this B vitamin. It’s important to take
folic acid before trying to get pregnant and during early pregnancy
because this is when it is most helpful.
Taking folic acid is good for you and
baby. We know diabetic women may benefit from taking in higher levels
of folic acid. Other benefits of taking folic acid include reducing your risks of developing asthma and allergies.
Folic acid may help prevent problems in a
baby. Neural-tube defects can occur in a baby during early pregnancy,
often before you even suspect you might be pregnant. There are various
types of neural-tube defects—the most common is spina bifida, when the
base of the spine remains open, exposing the spinal cord and nerves.
Studies show taking folic acid before
pregnancy and in early pregnancy may help prevent or decrease the
incidence of neural-tube defects. Once pregnancy is confirmed, it may be too late to prevent neural-tube problems.
Your Folic-Acid Intake.
A pregnant woman’s body excretes four or five times the normal amount
of folic acid. Folic acid isn’t stored in the body for long, so you need
to replace it every day. A prenatal vitamin contains 0.8mg to 1mg of
folic acid. This is usually enough for a woman with a normal pregnancy.
Researchers believe you can help prevent spina bifida if you take 400mcg
(0.4mg) of folic acid a day, beginning before pregnancy and continuing
through the first 13 weeks. This is suggested for all pregnant women.
A folic-acid deficiency can result in
anemia in you. Extra folic acid may be needed with multiple fetuses or
if you suffer from Crohn’s disease.
Some researchers suggest a woman take
400mcg of folic acid before pregnancy and increase that amount to 600mcg
when pregnancy is confirmed. Others recommend a dose of 1mg a day of
folic acid, perhaps more, is necessary. Still others believe if a woman
is at risk for having a baby with neural-tube defects (she had a baby
before with the problem or she has epilepsy, diabetes or certain types
of thrombophilia), she should take 4mg a day. Talk to your healthcare
provider about it.
We know some medications interfere with
folic-acid metabolism. These medicines include aminopterin,
carbamazepine, methotrexate, phenytoin, phenobarbital, diphenylhydantoin
and trimethoprim-sulfa (Septra, Bactrim).
Smoking cigarettes removes folic acid from
the body. Second-hand smoke can also reduce folic-acid levels. In
addition, drinking green tea can keep your body from absorbing folic
acid, so avoid it.
Foods Supplemented with Folic Acid.
Beginning in 1998, the U.S. government ordered that some grain
products, including flour, breakfast cereals and pasta, be fortified
with folic acid. It’s made a difference! The number of babies born with
neural-tube defects has decreased by nearly 20% since the program began.
But many babies of Hispanic women are still at risk. Studies show
nearly twice as many are born with neural-tube defects. One reason may be that many Hispanic grain foods are not fortified with folic acid.
Eating 1 cup of fortified breakfast
cereal, with milk, and drinking a glass of orange juice supplies about
half of your folic-acid requirement for one day. Folate is found
naturally in many foods, such as fruits, legumes, brewer’s yeast,
soybeans, whole-grain products and dark, leafy vegetables. A
well-balanced diet can help you reach your folic-acid-intake goal. Also
see the list of foods that are good folate sources in Preparing for
Pregnancy.
8. You Should Also Know
Bleeding and Spotting during Pregnancy
Bleeding and spotting during pregnancy cause concern. Bleeding is vaginal bleeding that is usually as heavy as, or heavier than, a menstrual period. Spotting is vaginal bleeding that is usually lighter than a regular menstrual period.
In the first trimester, bleeding or
spotting can make you worry about the well-being of your baby and the
possibility of miscarriage. As your uterus grows, the placenta forms and
vascular connections are made, and bleeding may occur then. During the
second trimester, bleeding may happen with sexual intercourse or a
vaginal exam. Bleeding during the third trimester can be a sign of
placenta previa or the onset of labor.
If you experience any type of bleeding during pregnancy, it is not
unusual. Some researchers estimate 20% of all pregnant women bleed
during the first trimester. But not all women who bleed have a
miscarriage.
Call your healthcare provider if you
experience any bleeding. If bleeding causes your healthcare provider
concern, he or she may order an ultrasound exam. Sometimes ultrasound
can show a reason for bleeding, but during early pregnancy, there may be
no detectable reason for it.
Strenuous exercise or intercourse may
cause some bleeding. If this occurs, stop your activities and check with
your healthcare provider.
Most healthcare
providers suggest resting, decreasing activity and avoiding intercourse
if bleeding occurs. Surgery or medication are not helpful and probably
won’t make much difference.
Benefits of Pregnancy
• Allergy and asthma sufferers
may feel better during pregnancy because the natural steroids produced
during pregnancy help reduce symptoms.
• Pregnancy may help protect
against ovarian cancer. The younger a woman is when she starts having
babies, and the more pregnancies she has, the greater the benefit.
• Migraine headaches often disappear during the second and third trimesters.
• Menstrual cramps are a thing of the past during pregnancy. An added benefit—they may not return after baby is born!
• Endometriosis (when endometrial
tissue attaches to parts of the ovaries and other sites outside the
uterus) causes pelvic pain, heavy bleeding and other problems during
menstruation for some women. Pregnancy can stop the growth of
endometriosis.
• Having
a baby may protect you against breast cancer. Researchers believe the
high levels of protein secreted by the growing baby may be associated
with a lower risk for younger moms. The protein may interfere with
estrogen’s role in causing breast cancer.