ften overlooked among the many vitamins essential for human health, folate—also known as vitamin B9—plays a remarkably powerful role in maintaining life and supporting healthy development. Though it is required in small amounts, its impact is enormous, particularly during pregnancy, when a woman’s body undergoes profound physiological changes to nurture and develop a baby. Adequate folate intake before and during pregnancy can mean the difference between healthy growth and serious, lifelong complications.

Folate is fundamental to the body’s ability to create and repair DNA, the genetic blueprint of all life. It is also essential for the production of red blood cells and for normal cell division and growth. Because pregnancy is a time of rapid cell multiplication—both in the mother and the foetus—the demand for folate increases substantially. Without sufficient levels, these processes cannot function optimally, placing both mother and child at risk.

One of folate’s most critical roles during pregnancy is its involvement in the early development of the fetal nervous system. Within the first month after conception, the neural tube forms. It and later develops into the baby’s brain and spinal cord. If this structure fails to close properly, serious birth defects known as neural tube defects can occur. These include conditions such as spinal bifida and encephaly, which can lead to paralysis, lifelong disability or infant death.

What makes folate deficiency particularly dangerous is the timing of these developmental events. The neural tube closes very early in pregnancy—often before a woman realises she is pregnant. As a result, waiting to improve nutrition after pregnancy confirmation may be too late. This is why medical experts stress the importance of adequate folate intake during the reproductive years, even before conception occurs.

For mothers, insufficient folate can lead to a range of health problems. One of the most common forms of megaloblastic anemia, a condition in which red blood cells become abnormally large and inefficient at carrying oxygen. This can cause fatigue, weakness, shortness of breath and dizziness—symptoms that can complicate pregnancy and reduce overall well-being. In severe cases, folate deficiency may also contribute to nerve-related symptoms, such as tingling, memory difficulties and mood disturbances.

Recognising the importance of this nutrient, international health organisations have established clear guidelines for folate intake. The US National Institutes of Health and the Institute of Medicine recommend that pregnant women consume 600 micrograms of folate—its synthetic form—each day. During breast feeding, when the mother continues to support the child’s growth and development, the recommended daily intake remains high at 500 micrograms.

Ensuring adequate intake before, during and after pregnancy is not merely a personal health choice but a public health priority. By raising awareness and encouraging proper nutrition and supplementation, countless lives can be improved and many preventable birth defects avoided.

Beyond pregnancy and childbirth, folate plays a vital role in maintaining a strong and responsive immune system. Research has shown that individuals with folate deficiency often experience impaired immune responses, making them more susceptible to infections. Folate is required for the production and proper functioning of white blood cells, which serve as the body’s primary defense against harmful bacteria and viruses. Inadequate levels can weaken this defence system and increase inflammation within the body.

Emerging studies suggest that sufficient folate intake may have broad long-term health benefits. It has been associated with improved cardiovascular health by helping regulate homocysteine levels in the blood. The compound is linked to an increased risk of heart disease. Additionally, folate may play a role in supporting mental health by contributing to the production of neurotransmitters involved in mood regulation.

Naturally occurring folate is found in a variety of foods, particularly leafy green vegetables such as spinach, kale and lettuce. Legumes, including lentils and beans, citrus fruits, nuts and whole grains, are also good dietary sources. Many countries have adopted food fortification programmes, adding folic acid to staples like flour and cereal to help reduce population-wide deficiency rates.

Despite these measures, many women of childbearing age still fail to meet the recommended folate requirement through diet alone. Factors such as limited access to nutritious foods, increased nutritional needs and poor absorption can all contribute to deficiency. For this reason, folic acid supplementation is widely recommended as a simple, affordable and effective public health strategy.

Health professionals emphasise that taking a daily folic acid supplement before conception and throughout pregnancy is one of the easiest and most powerful steps a woman can take to protect her baby’s health. This small preventive measure has been shown to dramatically reduce the risk of neural tube defects and improve pregnancy outcomes worldwide.

Folate is far more than just another vitamin—it is a cornerstone of maternal health, foetal developmen, and immune strength. Ensuring adequate intake before, during and after pregnancy is not merely a personal health choice but a public health priority. By raising awareness and encouraging proper nutrition and supplementation, countless lives can be improved and many preventable birth defects avoided.

A simple vitamin, taken at the right time, truly has the power to shape a healthier future for mothers, for children and for generations to come.

The writer is a student of medicine