Neural tube defects (NTD) like spina bifida and anencephaly are one of the most common birth defects today. Affecting the brain and spinal cord of a fetus, this can occur before a woman even realizes she is pregnant.

The health of a fetus and the mother are always the top priorities during pregnancy and although maintaining good health habits statistically reduces the risk of birth defects, the possibility of birth defects cannot be completely eliminated.

When an opening in the brain or spinal cord occurs early in the embryo’s development, it is known as NTD. The cord of the embryo begins to develop and roll into a tube approximately 28 days after the baby is conceived and with normal development, the cord will close. When the neural tube does not close completely, an open NTD occurs.

According to a published report by Duke University, NTD are one of the most common birth defects in America and occur in approximately one in one-thousand live births.

One of the best ways a woman can combat this risk is by taking a prenatal vitamin with folic acid before she is pregnant.

The FDA has recognized the serious nature of NTD and taken action by requiring many foods like breads, grains and cereals to be fortified with folic acid in an effort to battle this defect.

Folic acid, a synthetic form of folate and from one of the Vitamin B categories, is considered by many the most important supplement a woman can take during pregnancy.

It has become common knowledge that folic acid is essential in the development of a healthy baby.

Studies have shown that by taking folic acid in the recommended dose, usually 800 mcg to 1000 mcg, a woman can decrease her risk of a neural tube defect by up to 70%.

Depending upon family history of NTD, the dosage may vary.

Folic acid may also play a role in decreasing the risks for other serious birth defects such as cleft palate, congenital heart defects and chronic disease conditions such as heart disease, several cancers and Alzheimer’s disease.

The elimination of caffeine, alcohol and nicotine during pregnancy is of course an obvious choice by women who are pregnant or trying to get pregnant, but the addition of folic acid must be integrated into a daily routine immediately to help stave off neural tube defects.

Prenatal vitamins are an essential part of the equation for pregnant women and those attempting to conceive. Maintaining proper levels of folic acid, calcium and iron as well as many other nutrients while carrying a fetus will provide the best possible health results for a baby and mother prior to delivery.

Studies indicate that low folic acid levels can cause severe birth defects of the brain and spinal cord called neural tube defects. Low folic acid levels may even reduce the chance of a woman carrying to term.

Many women who are trying to get pregnant and not taking a prenatal vitamin find their levels well below the suggested safe levels recommended by the FDA.

They spend the first several weeks of pregnancy with unsafe levels of these nutrients in their systems increasing their risks of having a baby born with birth defects.

With this in mind, anyone even considering pregnancy should be taking a prenatal vitamin with at least 800 mcg of folic acid each day. For women with low folate levels, of advanced age or who are experiencing fertility issues, doctors may recommend a prescription prenatal vitamin that contains 1000 mcg for a more aggressive approach.

The most important nutrient in a prenatal vitamin is folic acid. Folate can also be found in green leafy vegetables, nuts, beans and citrus fruits. The FDA requires that many flour products such as breads, buns and bagels be fortified with extra folic acid. Breakfast cereals and fortified enriched grain products offer the nutrient as well.

Calcium is another important nutrient in a prenatal vitamin. A growing fetus consumes much of the mother’s calcium during pregnancy; thus creating a low level in the mother’s system that may result in bone density loss and increase the chance of osteoporosis later in life. Calcium can also be found in dairy products such as milk, cheese and yogurt. Many juices are now fortified with calcium as well.

Iron is also an essential nutrient for maintaining a healthy pregnancy. The mother’s body creates additional amounts of blood during pregnancy to support a growing baby. With a higher volume of blood present in her system she needs supplemental iron to maintain a healthy level throughout her blood supply. Keeping a healthy level of iron lowers the risk in pregnant women of developing iron-deficiency anemia. Natural sources of iron include meat, fish and poultry. Other sources of iron may include beans, dried fruits, whole grains, fortified cereals and enriched breads.

Vitamins A, B, C, D, E, niacin and zinc are also found in a prenatal vitamin tablet. Although most experts agree that proper levels of folic acid, calcium and iron are most essential in carrying a healthy baby to term, these other vitamins are important as well.

Some women taking prenatal vitamins have experienced mild side effects like constipation and nausea. The constipation may be caused by the iron supplement. Drinking more water than usual may ease the constipation. Nausea can be reduced by taking the prenatal vitamin with food later in the day.

My husband’s AARP application arrived in the mail recently along with his firefighter retirement check – he just turned 50. He barely looks 40. I tell him it’s genetics, he jokes it’s from not having to raise a few kids.

I know how psyched my 20-year-old son is about having a sibling. He has no idea how psyched I am about having a free 20-year-old babysitter!

After years of mulling it over, hours of discussion, passionately over-analyzing the subject with no definitive resolution, questions arise; the brain goes on overload.

Do I really want to start the whole process again? Will we still be able to travel and work?

And what about raising the kid? Public or private school? Minivan or SUV?

Or as my husband says, Lions or Bears fan? Red Wings or Black Hawks? And how much is college going to be in the year 2026? Will we be cashing in the house for two semesters of college?

And who’s the designated babysitter when the free twenty-year-old gets tired of smelly diapers?

Our cat sitter is only $17 a day and that includes two feedings and one litter box clean-up; wonder if she’ll be available! Some other friends recently turned their loving dog-sitter Paula into their Nanny for their two babies.

Grandma Nancy’s out of service. She’s in Michigan helping with 17 grandkids at the over-ripe age of 82.

What if the little one is allergic to the cats? Who goes, the kid or the cats? What if we have multiples? Won’t even go there!

Here’s a horror story. Last time I had a baby my shoe size went up ½ size. If it happens again; so much for my Donald Pliner Snake-skin sandals.

Then there’s the boob issue; will they sag after nursing and droop like half-filled water balloons. I can always get a boob-job after breast-feeding and finance the kid’s college.

What about baby-proofing the house and sleep . . . ah sleep . . . I really enjoy my sleep . . . do I really want to give up the peace and quiet I’ve come to know and love for so many years since my twenty-year-old son last woke me to his final bout of middle of the night tears so many moons ago.

“Yes.” Absolutely. Bring in the troops. I have like 48 eggs left (okay, truth is, research indicates women over 35 have 25,000-90,000 eggs)… so let’s get the show on the road, remember, I’m 43 and counting! Send in the troops at least every other day. Let’s bravely forge ahead, (divide properly) and conquer!