The Royal College of Midwives (RCM) has said that folic acid policy should be improved, following research by the British Medical Journal (BMJ) that neural tube defects haven’t substantially declined in the last 20 years across Europe.
‘Long term trends in prevalence of neural tube defects in Europe’ research figures raise concerns that long-standing recommendations for women to take folic acid supplements when planning a pregnancy need to be improved.
Responding to the recent research, Professional Policy Advisor at RCM Janet Fyle said: “There is strong evidence about the benefits of folic acid in reducing the risk of neural tube defects such as spina bifida. The fundamental problem is that the supplements – when taken – are not being taken early enough, before the woman becomes pregnant or very early in pregnancy, as this is when it will deliver the greatest benefits.
“This is particularly an issue for vulnerable groups of pregnant women, such as younger women, ethnic minorities and some women from low socio-economic groups who cannot afford to buy folic acid supplements. The challenge is to improve pre-conception care so that more women are taking the supplements before they become pregnant.”
An additional study, published on BMJ Open and carried out in Spain, found that a “high proportion of women” did not reach the recommended doses of FAS (folic acid supplement). 
“We need a rethink of policy priorities to ensure that all childbearing women can access folic acid supplementation in a timely manner. This could include awareness raising campaigns which the RCM has always advocated,” Janet Fyle added.
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