As a physician, you are a critical component in the folic acid education process.  By counseling your patients about the benefits of folic acid, you can affect health behavior and decrease the incidence of birth defects each year. 

In 2002, the March of Dimes worked with the Gallup Organization and sampled women, ages 18-45, with a random-digit-dialed telephone survey.  Eighty percent of the respondents reported that they had heard of folic acid, but only 33% take folic acid daily and just 20% knew that folic acid may help prevent birth defects [43].  It is clear that women of childbearing age do not completely grasp the importance of folic acid.

The same survey also revealed that half of the women aware of folic acid learned about it from a magazine/newspaper article or a radio/television broadcast. 

This finding is troubling given that studies have shown that women value the advice of their health care professionals, and that discussing folic acid greatly increases awareness about the need for supplementation.  According to a recent MotherRisk study, folic acid counseling for women who were planning to become pregnant provided great results, with 71% of those counseled taking folic acid, compared with only 17% of those who were not counseled [66].  

Consider a multisite observational study that found that failure to provide adequate preconception care may have a significant impact on pregnancy outcomes.  This study suggested that racial disparities that exist in the incidence of very-low-birthweight infants could in part be explained by disparities in maternal conditions, such as chronic hypertension, that require comprehensive interventions initiated long before the onset of pregnancy.  In fact, programs that have expanded health care services for underserved women limited only to care provided during pregnancy have reported only a minimal impact on preventing adverse pregnancy outcomes, such as low birthweight and preterm delivery. [113]