In the U.K., a lack of folic acid in foods is a problem. Nearly 2,000 babies have been born with serious side effects such as spina bifida since 1998 due to the government’s failure to add the B vitamin to flour, according to researchers.
About 150 yearly birth defects could have been avoided had the government added it to flour like 78 other countries, including the United States. 
The World Health Organization (WHO) recommends daily oral iron and folic acid supplementation as it is a facet of vital prenatal care to lower the risk of low birth weight, maternal anemia, and iron deficiency. In the U.S., the Centers for Disease Control and Prevention (CDC) urges women to take 400 mcg of folic acid per day even a month before getting pregnant.
Yet, nearly 70% of women don’t take folic acid regularly before and during the early stages of pregnancy.
Even without supplementation, researchers say in the study that adding folic acid to flour would have cut the rate of birth defects in the U.K. by 21%.
“Given the evidence from the Medical Research Council Vitamin Study regarding the efficacy of folic acid in preventing neural tube defects, the failure of Britain to fortify flour with folic acid has had significant consequences,” researchers from Oxford University, Public Health England (PHE) and Queen Mary University London say.
“The recent evidence that only 28% of pregnant women in England in 2012 took folic acid supplements at the correct time indicates that, in practice, recommending folic acid supplementation is largely ineffective,” they said.
Recently, U.K. government advisers wrote to ministers asking them to add folic acid to flour, as the Food Standards Agency recommended in 1998…then again in 2000, 2006, and 2009. 
Members of the Scientific Advisory Committee on Nutrition (SACN) referred to an ever-increasing number of abortions in England and Wales for neural tube defects, with 420 in 2013, up from 390 in 2012 and 299 in 2009.
“It is a public health failure that Britain has not implemented the fortification of flour with folic acid for the prevention of spina bifida and other neural tube defects. This failure has caused, and continues to cause, avoidable terminations of pregnancy, stillbirths, neonatal deaths and permanent serious disability in surviving children,” researchers concluded. 
Dr. Alison Tedstone, chief nutritionist at Public Health England, said:
“Implementing the Scientific Advisory Committee on Nutrition’s advice to add folic acid to flour would reduce the risk of birth defects, such as spina bifida, in pregnancy.
PHE’s analysis shows that 85% of 16 to 49-year-old women have folic acid levels below the new World Health Organization recommendation for women entering pregnancy.
This highlights the importance for pregnant women, and those trying or likely to get pregnant, of taking a daily folic acid supplement of 400 micrograms – before and up to the 12th week of pregnancy.”
Professor Alan Cameron, vice president of clinical quality for the Royal College of Obstetricians and Gynaecologists (RCOG), added that if the government fortifies food with folic acid, it will help women of low socioeconomic status and women with unplanned pregnancies get some of the B vitamin they need to have healthy babies.
In addition to preventing birth defects, a study published in 2013 in the Journal of the American Medical Association (JAMA) found that mothers who take folic acid were 40% less likely to have a child with autism.
Caveat: While increasing folic acid intake (appropriately) may have beneficial effects, it’s worth noting that folic acid is actually not naturally-occurring. Folic acid refers to the oxidized synthetic compound used in supplements and food fortification, as in the case with the U.K. Folate, on the other hand, is a general term for a group of water soluble b-vitamins, and refers to the various tetrahydrofolate derivatives naturally found in food.
So if you want the natural version, go for folate!
 The Independent
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