The health of the expectant mother is absolutely essential to ensure the health of the baby.

“Two keys to a healthy pregnancy are Folic Acid, and B12,” says S. Suresh, director, Mediscan. With decades of experience in screening pregnant women for birth defects in the foetus, he brings a lot of authority into his advocacy for Folic Acid and B12.

Deficiency in both these components leads to elevation in homocysteine levels in the blood, which in turn causes defects in the neural tube.

The neural tube, in plain terms, is what develops into the brain and spinal cord of the baby with maturation. “The tube will have to close between the 42nd and 46th day after conception. If it does not, then the baby will develop with various defects,” Dr. Suresh adds.

A more recent study has shown that in Indian women, B12 deficiency also leads to the same cause and effect. “While neural tube defects have multi-factoral causes, about 50-60 per cent of them occur due to nutritional factors,” he explains.

“Even today we see a significant number of babies with neural tube defects. Even if you can deliver the baby safely, the long-term quality of life can be very bad. The child will have a number of disabilities,” Deepa Hariharan, neonatologist, adds.

It is absolutely essential for women to have folic acid supplements, as it drastically reduces the chances of neural tube defects, she stresses.

While doctors put women on folic acid immediately after pregnancy is confirmed, Dr. Suresh says that is not soon enough. “The neural tube should seal by the 46th day. Unless you start folic acid a month before conception, the effects of it will not be valid.”

K. Saraswathy, former director, Institute of Obsterics and Gynaecology, says, it has helped that the State government is providing iron and folic acid tablets to adolescent girls.

“With this supplementation, the health of the mother too is vastly improved, and in a multiple pregnancy, the greater the need for it,” she adds.

Fortification of food

The ideal thing would be, as in the West, fortification of foods with these components, Dr. Suresh adds. For instance, cereals, which are an essential part of the Western diet, can be fortified.

However, it is not part of the diet or lifestyle of the majority of Indians.

Tablets ideal

Therefore, tablets would be ideal, given the culture settings and constraints. Mothers must also take as much greens as possible, a natural source.

With all the tablets, what is essential is the need for the mother to eat healthy, avoid junk and fatty foot, gain weight in a regulated manner, and a good walking schedule, says Dr. Saraswathy.

Breathing and relaxation exercises are also recommended for pregnant women, she adds.