Tomorrow is D-Day - The two year anniversary of Diagnosis Day, when I first learned about anencephaly, the fatal neural tube defect (NTD) that effects 1 in 1000 pregnancies in the United States every year - and even more in other parts of the world.
To think, a tiny tablet could have made all of the difference. Well, several tiny tablets.
A minimum of 1,000 micrograms (mcg) a day, the equivalent of 1 Milligram (mg), is recommended during pregnancy for development of the neural tube, a flat piece of matter that folds to become the tube that forms our spines, skull, and brain. This all occurs in the earliest stages of pregnancy, between three and four weeks - before many women even know they are pregnant.
Women with a history of neural tube defects anywhere in their family should take a higher daily dose of folic acid during, and prior to pregnancy. Women who have had a child with a neural tube defect should take between 4 mgs and 5 mgs of folic acid every day, or 4,000 mcgs to 5,000 mcgs. Women whose husbands have a history of neural tube defects should do the same. Women whose boyfriends, with whom they are sexually active, have a history of neural tube defects should also take this increased dose. Although anencephaly and other NTDs such as spina bifida have been determined to be the result of both environmental and genetic factors, the development of your child's brain is not something you want to take a chance on.
I cannot encourage this enough: Women of child-bearing age who may become pregnant should seriously consider taking the minimal recommended daily dose of folic acid. Women who are sexually active, women who are not sexually active. Women who are on the pill, start popping these vitamins right along with them. Women who are not on the pill, get on this one. Women who like to get drunk and make bad decisions, take folic acid - In fact, take extra, because when we drink our bodies have more difficulty absorbing the vitamin. Ladies, take your fucking folic acid. It is estimated that 70 percent of NTDs could have been avoided if the baby's mother had had sufficient folic acid intake. You never, never, NEVER want to to receive the news that I did two years ago and wonder to yourself what you could have done differently, only to learn how simply you could have made a difference in your child's life.
Folic acid can be found in food. Leafy vegetables, citrus fruit, and legumes and whole grains are a great natural source. Today many breakfast cereals are enriched with folic acid as well. But don't rely on food to get your recommended daily allowance. Your body can more easily absorb folic acid in its tablet form; the table also allows you to know how much folic acid you have ingested.
Not all prenatal vitamins are made equal. Your average over-the-counter prenatal vitamin has only 800 mcgs; pregnant women, you should really have at least 1,000, remember? I currently take one of the more popular brands (just in case the Holy Spirit visits me, or something, I guess, or I use a public restroom without a seat liner), One A Day, which has only 800 mcgs. If I were smarter and more diligent, and if I were sexually active, I would be taking that prenatal and at least four of the 800 mcg folic acid tablets pictured here a day, for at least 4,000 mcgs, or 4 mgs. I'd also be takig a B-complex supplement, to help my body metabolize the folic acid. Although there is some evidence that too much folic acid in certain forms can be bad for us, folic acid is water soluble, and much of the "excess" you might intake will be tinkled out throughout the day - one more reason why it's important that we intake sufficient amounts.
You can't really build up a "surplus" of folic acid in your body in anticipation of pregnancy. As stated above, it's water soluble and is going to leave your body if it's not processed. Folic acid prior to pregnancy is recommended A) To develop the habit of taking the vitamin daily, and B) Because most pregnancies are still unplanned, and the crucial period for taking folic acid is when many women are unaware that they've conceived.
I'm a bit of a hypocrite. I vowed to take 4 to 5 mgs of folic acid for the rest of my child-bearing years, but lately it seems I can't be bothered by it. I also believe that anencephaly was simply God's will for Gabriel; after all, I had added a folic acid supplement to the prenatal vitamins I had already been taking for months leading up to Gabriel's conception - I just added the supplement too late. Besides, I make no guarantees that taking your vitamins will fix everything.
Maybe Gabriel was just meant to be what Gabriel was, what Gabriel is. Gabriel has been God's instrument for many messages. Today, I'm feeling compelled to use the lessons I learned from Gabriel to encourage women to consider this information for the health of their future children. I can promise you that the regret is much more inconvenient than the hassle.
For more information on folic acid, please visit the following websites:
http://www.chg.duke.edu/diseases/ntd.html
http://www.cdc.gov/ncbddd/folicacid/index.html
http://womenshealth.gov/publications/our-publications/fact-sheet/folic-acid.cfm#f
http://www.metametrixinstitute.org/post/2012/03/27/Folate-Too-Little-Too-Much-or-Just-Right.aspx
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