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.

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