Folic acid and pre-natal vitamins does one need to take folic acid in addition to pre-natal vitamins, or should pre-natal vitamins suffice since it already includes folic acid?

You : You should be taking a prenatal vitamin with at least 800 mcg (micrograms) of Folic Acid if you are planning to conceive. This prevents many cases of spina bifida and other neural tube defects, which are serious birth defects. They may also reduce the chance of cleft lip or palate. The minimum amount recommended for women trying to conceive is 400 mcg. In pregnancy it is recommended that you get at least 600 mcg a day (the recommended dietary allowance). Over the counter (otc) prenatals containing 800 mcg of Folic Acid should be fine. Only about 30% of women who might get pregnant are taking Folic Acid supplements. Folate is the 'natural' form of folic acid, found in the diet, but is not as useful as a supplement compared with folic acid, which is more available for your body to use. Prescription prenatals contain 1000 mcg or 1 milligram (mg) of folic acid, a slightly higher dose. They may be covered by your insurance, if not they can be more expensive. While i think that an otc prenatal is fine, and much better than taking nothing, as a fertility md i prescribe prenatals for my patients. There is no scientific evidence to support otc or prescription. Some prescription prenatals contain stool softeners to reduce constipation from the iron content, or 'gentler versions' of the iron. If you have side effects with prenatals (feeling sick, bowel problems) try different brands or talk to your ob/gyn. Four situations where you should take more Folic Acid in addition to (not instead of) a prenatal vitamin: 1. You had a previous pregnancy or child with a neural tube defect or cleft lip or palate (4 milligrams or 5 milligrams total Folic Acid a day) 2. You are taking anti-seizure medications (anti-epileptics) such as lamotrigine, even if not for a seizure disorder (4 milligrams or 5 milligrams total Folic Acid a day). Review all these meds with your prescribing md if you are planning to conceive. 3. Previous pregnancy with pre-eclampsia - take at least 1 milligram of Folic Acid a day, 4-5 milligrams is ok too. 4. (controversial) two or more miscarriages, especially if you have a known mthfr mutation or high homocysteine levels. Mthfr mutations are very common and are only weakly associated with miscarriage risk. Best wishes getting pregnant.