In preconception counseling for women planning pregnancy in 3 to 6 months, which information should the nurse provide?

• A. Discontinue contraception.
• B. Include adequate folic acid in the diet.
• C. Lose weight so more weight is gained during pregnancy.
• D. Continue to take any medications that are taken regularly.

Answer: (B)

Starting folic acid before conception is essential because neural tube development occurs very early in pregnancy, often before a woman knows she’s pregnant. A steady intake of folic acid helps prevent neural tube defects such as spina bifida and anencephaly. The standard recommendation is about 400 micrograms (0.4 mg) daily for women planning pregnancy, beginning at least one month before trying to conceive and continuing through the first trimester. Some individuals with higher risk factors may need a higher dose, but routine planning should aim for this baseline amount to ensure adequate protection during the critical early weeks. While dietary sources contribute, supplements are the reliable way to guarantee the needed amount given how early neural tube closure happens. Other suggested actions in the choices aren’t appropriate: stopping contraception isn’t the step for planning, weight changes should focus on achieving a healthy preconception weight rather than manipulating gain later, and medications during pregnancy may require review rather than automatic continuation. Emphasizing folic acid in the preconception period sets up safer early pregnancy outcomes.