Why is folic acid important.

The U.S. Public Health Service recommends that all women of childbearing age consume 400 micrograms (0.4 mg) of folic acid each day. Folic acid, a nutrient found in some green leafy vegetables, most berries, nuts, beans, citrus fruits, fortified breakfast cereals, and some vitamin supplements can help reduce the risk for birth defects of the brain and spinal cord (called neural tube defects). The most common neural tube defect is spina bifida, in which the vertebrae do not fuse together properly, causing the spinal cord to be exposed. This can lead to varying degrees of paralysis, incontinence, and sometimes mental retardation.

Folic acid is most beneficial during the first 28 days after conception, when most neural tube defects occur. Unfortunately, many women do not realize they are pregnant before 28 days. Therefore, folic acid intake should begin prior to conception and continue through pregnancy. Your healthcare provider or midwife will recommend the appropriate amount of folic acid to meet your individual needs.

Most healthcare providers or midwives will prescribe a prenatal supplement before conception, or shortly afterward, to ensure all of the woman's nutritional needs are met. However, a prenatal supplement does not replace a healthy diet.

Exercise during Pregnancy

Regular exercise, with the approval of your physician or midwife, can often help to minimize the physical discomforts of pregnancy and help with the recovery after the baby is born. There is evidence that physical activity may be especially beneficial for women with gestational diabetes.

According to the American College of Obstetricians and Gynecologists, women who exercised and were physically fit before pregnancy can safely continue exercising throughout pregnancy. Women who were inactive before pregnancy or who have medical or pregnancy complications should consult with their physician or midwife before beginning any exercise during pregnancy.

All women should be evaluated by their physician or midwife before beginning or continuing an exercise program during pregnancy.

Exercise may not be safe if the pregnant woman has any of the following conditions:

• Preterm labor in current or past pregnancies
• Vaginal bleeding
• Cervical problems
• Leaking of amniotic fluid
• Shortness of breath
• Dizziness and/or fainting
• Decreased fetal activity or other complications
• Increased heart rate (tachycardia)
• Certain health problems, such as high blood pressure or heart disease

Types of exercise and strenuous activities to avoid during pregnancy include:

• Horseback riding
• Water skiing
• Scuba diving
• High altitude skiing
• Contact sports
• Any exercise that can cause a serious fall
• Exercising on your back after the first trimester (because of reduced blood flow to the uterus)
• Vigorous exercise in hot, humid weather, as pregnant women are less efficient at exchanging heat
• Exercise involving the Valsalva maneuver (holding one's breath during exertion), which can cause an increased intra-abdominal pressure