At What Month Can a Pregnant Woman Stop Taking Folic Acid?

November 29, 2025 •

4 min read

According to the Centers for Disease Control and Prevention (CDC), getting 400 micrograms of folic acid daily before and during early pregnancy can help prevent neural tube defects. Knowing at what month can a pregnant woman stop taking folic acid is a common and important question for expectant mothers to ensure proper fetal development. The standard recommendation is to take a supplement through the first 12 weeks of pregnancy, but the decision to continue should involve a discussion with a healthcare provider.

Quick Summary

Most women should take folic acid until the 12th week of pregnancy, a period crucial for preventing neural tube defects. Continuing supplementation thereafter is generally safe and offers additional benefits, like preventing maternal anemia. High-risk pregnancies may require different doses and durations, so professional medical guidance is essential.

Key Points

End of First Trimester: Most pregnant women can stop taking a dedicated folic acid supplement after 12 weeks, as the neural tube has already formed and closed.
Continued Benefits: Continuing folic acid throughout pregnancy is safe and helps prevent maternal anemia and supports overall fetal development.
High-Risk Pregnancies: Women with risk factors like a personal history of neural tube defects require a higher dose (4-5 mg) and must follow their doctor's specialized advice.
Consult a Doctor: Always discuss changes to your supplementation plan with a healthcare provider to ensure you are meeting your and your baby's needs.
Supplements vs. Food: While food sources of folate are good, supplements are necessary in early pregnancy because folic acid is more bioavailable and reliably provides the necessary amount to prevent NTDs.
Avoid Excess Folic Acid: Taking excessively high doses without medical supervision may carry risks, potentially masking a vitamin B12 deficiency.

Why Folic Acid is Essential in Early Pregnancy

Folic acid, the synthetic form of folate (vitamin B9), plays a critical role in early fetal development. During the first month of pregnancy, the baby's brain and spinal cord begin to form, a process that relies heavily on proper cell division and growth. Without sufficient folic acid during this period, the neural tube, which eventually becomes the brain and spinal cord, may not close completely. This can lead to serious birth defects known as Neural Tube Defects (NTDs), such as spina bifida and anencephaly.

The closure of the neural tube is typically complete by the end of the 12th week of pregnancy, which is why supplementation is universally recommended for this critical window. Because many pregnancies are unplanned, health organizations advise that all women of childbearing age take folic acid daily to ensure their bodies are prepared for a potential pregnancy.

The 12-Week Guideline: A Crucial Milestone

The 12-week mark serves as the standard endpoint for mandatory folic acid supplementation for NTD prevention. By this time, the neural tube has fully formed and closed, meaning the risk window for these specific birth defects has passed. For a low-risk pregnancy, a healthcare provider may advise that it is no longer necessary to take a dedicated folic acid supplement after this point. However, it is a personal decision and can depend on the woman's diet and general health.

Reasons to Consider Continuing Folic Acid

While the primary purpose of taking a high-dose folic acid supplement is fulfilled by the end of the first trimester, there are several reasons why some women may choose to continue, or are advised by a doctor to continue, taking it throughout their pregnancy.

Preventing Maternal Anemia: Folic acid is vital for the production of red blood cells. Pregnancy significantly increases the demand for blood, and continued supplementation can help prevent megaloblastic anemia, a condition that can lead to fatigue, weakness, and other health issues for the mother.
Supporting Fetal Growth: Even after the first trimester, a growing fetus requires a constant supply of nutrients. Folate supports cell growth and division throughout the entire pregnancy, benefiting the baby's ongoing development.
Lowering Homocysteine Levels: High levels of homocysteine in the blood have been linked to pregnancy complications like preeclampsia. Studies show that continued folic acid supplementation can prevent the rise in homocysteine levels that often occurs later in pregnancy.
Potential Cognitive Benefits: Some research suggests that continued folic acid intake beyond the first trimester may have beneficial effects on a child's cognitive development, though more research is needed in this area.

Comparing Different Supplementation Approaches


Feature	Standard Supplementation (First Trimester Only)	Continued Supplementation (Throughout Pregnancy)
Primary Goal	Prevent Neural Tube Defects (NTDs)	Prevent NTDs, avert maternal anemia, support fetal growth
Recommended Dose	400 mcg daily before conception, 400-600 mcg through 12 weeks	Often maintained at 400-600 mcg as part of a prenatal vitamin
Key Benefit	Ensures proper closure of the neural tube	Supports overall maternal and fetal health beyond the first trimester
When to Stop	Generally after 12 weeks, with doctor's approval	Can be continued until birth or throughout breastfeeding
Typical User	Women with low-risk pregnancies following standard advice	Women seeking extended benefits or at higher risk for anemia

What About High-Risk Pregnancies?

For women with specific risk factors, the standard recommendations for folic acid are different. High-risk factors include a personal or family history of NTDs, diabetes, or taking certain anti-epilepsy medications. In these cases, a healthcare provider will likely prescribe a much higher dose of folic acid, typically 4-5 mg (4,000-5,000 mcg) daily. This higher dose is usually started at least one month before conception and continued through the first 12 weeks. Women with these risk factors should follow their doctor's specific advice regarding both dosage and duration.

The Importance of Doctor's Advice

Self-diagnosing or arbitrarily stopping a supplement during pregnancy is not recommended. It is vital to discuss your specific health needs and risks with a healthcare provider. They can provide personalized advice based on your medical history, dietary intake, and the specific brand of prenatal vitamin you are taking. Some prenatal vitamins contain a higher dose of folic acid than a standard supplement, and a doctor can help you understand the appropriate amount for your situation. Moreover, they can test for underlying conditions, such as vitamin B12 deficiency, which can be masked by high folic acid intake.

Folic Acid from Food vs. Supplements

It is important to understand the difference between folic acid from supplements and folate found naturally in food. While a healthy, balanced diet rich in folate-containing foods (such as leafy greens, legumes, and fortified grains) is beneficial, it is difficult to get the recommended amount of folate from diet alone to prevent NTDs. This is why supplementation is so crucial during the periconceptional period. Folic acid from supplements is more easily absorbed by the body than natural folate.

Conclusion

For most women, taking folic acid until the 12th week marks the end of the most critical period for preventing neural tube defects. However, continuing to take it throughout the entire pregnancy is safe and provides additional benefits, such as preventing anemia and supporting ongoing fetal growth. It is essential to consult with a healthcare provider to determine the best course of action based on your individual health profile and to ensure you are receiving the optimal dosage. Never make changes to your pregnancy supplementation regimen without professional medical guidance.

An excellent resource for learning more about folic acid and pregnancy is the March of Dimes website, which offers detailed information on recommendations and benefits. March of Dimes website

Frequently Asked Questions

Yes, stopping folic acid before the end of the first trimester (12 weeks) can be dangerous. The neural tube, which forms the brain and spinal cord, develops during the first month of pregnancy. An adequate folic acid supply is critical during this period to prevent neural tube defects.

Missing a single dose or two is unlikely to cause significant harm. However, consistency is key, especially in the early stages of pregnancy. If you miss a dose, just resume taking it as soon as you remember. If you consistently forget, set a reminder or discuss your options with your doctor.

While it's important to eat folate-rich foods like leafy greens and fortified cereals, it is extremely difficult to get the recommended 400-600 mcg per day from diet alone. For this reason, supplementation is strongly recommended for all women trying to conceive and those in early pregnancy.

Yes, if you have a high-risk pregnancy due to a previous NTD-affected pregnancy or other factors, your doctor will likely prescribe a higher dose, typically 4-5 mg (4,000-5,000 mcg) per day. Never take a higher dose without explicit medical advice.

Continuing to take folic acid after the first trimester helps prevent maternal anemia, supports overall fetal growth, and maintains lower homocysteine levels, which is associated with a lower risk of certain pregnancy complications.

Yes, it is possible to take too much folic acid, though this typically only happens with excessive doses from supplements, not from food. High intake can potentially mask a vitamin B12 deficiency, which could have serious health consequences if left untreated.

The CDC recommends that women continue to take folic acid while breastfeeding, with a slightly lower daily recommendation of 500 mcg. Folic acid is a normal part of breast milk and supports your baby's ongoing development.