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Prevention of Birth Defects

Birth defects are a leading cause of infant death and childhood disability in North Carolina and across the United States. Unfortunately, not all birth defects can be prevented and there is never a guarantee for a healthy baby. However, there are many things a woman can do to increase her chance of having a healthy baby.

Three Important Steps

There are many things a woman can do to increase her chances of having a healthy baby. A healthy pregnancy starts with these three important steps:


By the time most women know they are pregnant, their baby is already growing, and some birth defects may have already happened. This is because most birth defects happen in the very early weeks of pregnancy, before a woman misses her first menstrual period.

Ideally, a woman should start planning for her baby’s health before she becomes pregnant. She can then start to make healthy choices that will help increase the chances of having a healthy baby. These choices include taking a daily multivitamin containing folic acid, eating a healthy diet and avoiding risky behaviors such as smoking, drinking alcohol and taking drugs before getting pregnant.

The American Academy of Family Physicians  External link recommends that a woman act like she is already pregnant before she tries to get pregnant to be sure that she is making healthy choices for herself and her future baby. A woman should talk to her health care provider about any health issues, family history and medications before trying to conceive. Some health issues and medications are known to increase the risk of birth defects. At this preconception visit, she and her health care provider may also discuss updating vaccinations; managing chronic diseases like diabetes, high blood pressure and epilepsy during pregnancy; taking medications; and reducing risk factors for birth defects and other potential health problems.

For more information about planning a healthy pregnancy, visit the March of Dimes’ Preconception Health Education Center. External link


All women who could become pregnant should take a daily multivitamin or "prenatal vitamin" with 400 micrograms (mcg) (0.4 milligrams or mg) of the B-vitamin folic acid. Taking this amount of folic acid every day is especially important for women who are trying to become pregnant. Women should start taking folic acid at least 3 months before getting pregnant if possible. Several studies have shown that women who take a daily multivitamin with 400 mcg of folic acid before and during pregnancy decrease the risk that their baby will be born with a neural tube defect ("NTD") by up to 70 percent. Consuming folic acid may also prevent other birth defects, such as clefts and heart defects.

Folic acid is also found in green leafy vegetables, dried beans and fortified foods such as cereal, bread and orange juice. One way to get enough folic acid from food is to eat one serving of breakfast cereal every day that has been enriched with folic acid. Check the label on the side of the box and choose a cereal that has at least 100% of the daily value (%DV) of folic acid.

Women who have already had a baby with a neural tube defect should take more folic acid (about 4000 mcg or 4.0 mg) to reduce the risk of having another baby with an NTD. These women should talk with their health care provider about taking higher amounts of folic acid.

To learn more and test your knowledge about folic acid, visit the CDC’s folic acid quiz and website. External link


The best time to start healthy habits that will increase the chance of having a healthy baby is before a woman gets pregnant. Having a healthy lifestyle during pregnancy is also very important. Be sure to talk with your health care provider about making healthy decisions that are right for you and your baby.

DO exercise regularly in moderate amounts. Try walking briskly for 30 minutes every day. Being overweight or obese before and during early pregnancy may increase the risk for certain birth defects. Talk with your health care provider before starting a new exercise routine.

DO eat a balanced, nutritious diet. Try adding foods rich in folic acid to your diet. Most women only need 300 extra calories a day to support their baby’s growth and development. Talk with your health care provider about how to eat well during pregnancy.

DO plan your pregnancy and talk with your health care provider before getting pregnant. It is very important to talk with your health care provider about any existing medical issues that you have. Some medications can increase the risk of birth defects when taken during pregnancy.

DON’T smoke. And avoid being near other people who are smoking. Smoking during pregnancy increases the risk of certain birth defects. Smoking can also cause miscarriage, problems with the placenta, preterm birth, low birth weight and Sudden Infant Death Syndrome ("SIDS"). Women who smoke also have a harder time getting pregnant. The best time to quit smoking is before getting pregnant, but it never too late to stop smoking! For free support and information, call 1-800-QUIT-NOW (1-800-784-8669) or visit the QUIT NOW  External link website.

DON’T drink alcohol. No amount of alcohol during pregnancy is known to be safe. Alcohol affects the developing brain and can cause birth defects, low birth weight, prematurity, abnormal facial features, behavior and learning problems, and difficulties with memory, attention and judgment. Do not drink alcohol if you are pregnant or may become pregnant.

DON’T use drugs. Cocaine, crack, heroin, amphetamines, marijuana and other street drugs can hurt you and your baby and cause lifelong health and developmental problems for your baby. The best time to stop using is before getting pregnant, but it never too late to stop using drugs! For free information and help finding substance abuse resources near you, call 1-800-662-HELP (1-800-662-4357) or visit the Substance Abuse and Mental Health Services Administration  External link website.