During your counseling discussion, Monica reveals that she would like to have a child, but that she is anxious about becoming pregnant again because she delivered a stillborn child with anencephaly 3 years ago.  With this new information, how much would your folic acid recommendation for Monica be?

a.) 400 mcg

b.) 500 mcg

c.) 600 mcg

d.) 4000 mcg

The next sections will help you to determine barriers to folic acid intake, absorption and metabolism.  When counseling individuals, look through patient histories for mention of these barriers or ask the individual directly.  A model chart insert for periconceptional counseling is available in the Resources section.