When Emily gave birth to her second child with spina bifida, her partner, Jake, found himself retreating to the garage, unsure of how to cope. Emily was overwhelmed with emotion, crying as she faced the reality of their situation.
Their first child, Noah, was born in 1989 after a smooth pregnancy filled with excitement. They prepared the nursery, packed their bags, and discussed their birthing preferences. However, Emily’s plans were turned upside down with a preterm delivery via c-section, resulting in the birth of Sarah, who had a serious birth defect.
As Emily recalled the details of that night, she remembered the panic of her amniotic sac rupturing and the realization that she was going into labor earlier than expected. Despite Jake’s reassuring words, their world changed when Sarah was diagnosed with myelomeningocele—a type of neural tube defect (NTD) where part of the spinal cord protrudes through an opening in the back, leading to nerve damage.
Initially, they hesitated to have another child due to the care Sarah required. But two years later, they decided to try for a sibling. They opted for a maternal serum AFP blood test to screen for neural tube defects, avoiding amniocentesis despite the increased risk, believing history wouldn’t repeat itself. However, their second daughter, Emma, was born with a less severe form of spina bifida.
In the early ’90s, awareness around preventing neural tube defects grew significantly. For women with a history of NTD-affected pregnancies, the risk of recurrence was notably higher. In 1991, the U.S. Public Health Service recommended that these women take 4 mg of folic acid daily starting one month before conception and continuing through the first trimester.
Folic acid, a vital B vitamin, is naturally found in foods like leafy greens, fruits, beans, and meats. However, most women find it challenging to get enough through diet alone. Thus, in 1992, the recommendation expanded to include all women of childbearing age to consume 400 micrograms of folic acid daily to help reduce the risk of NTDs.
Since then, folic acid has been added to various staple foods such as cereals and bread, which has led to significant declines in NTD occurrences worldwide. It is estimated that fortification has prevented around 22,000 severe birth defects annually.
With about half of U.S. pregnancies being unplanned, the CDC emphasizes the importance of folic acid for all women capable of becoming pregnant. While Emily and Jake can’t change their family’s past, they hope their story raises awareness about the benefits of folic acid.
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In summary, understanding the importance of folic acid can make a significant difference in preventing neural tube defects. Ensuring adequate intake before and during early pregnancy is crucial for all women, especially those with previous affected pregnancies.