Folic acid during pregnancy: help during the crucial months

For 20 years, FEMIBION® has been preventing neural deficiencies and supporting women by providing them needs-adjusted micronutrients such as folic acid, Metafolin®, and iodine from conception to birth.


During the Middle Ages, more than half of all children did not reach the age of 14, and as recently as 1870 one child in every four did not reach adulthood. By 1970, child mortality in Germany had decreased to about 25 out of every 1,000 children. The causes of this decline were the improved living conditions brought by prosperity, hygienic measures, and pediatrics. In recent decades, the further development of healthcare for pregnant women, obstetrics, and neonatal medicine have reduced child mortality in the Western countries to four in every 1,000 live births on average. 

But paradoxically, even though the conditions for pregnancy and childbirth are much better in the West than they were just 100 years ago, fewer children are being born in these countries. Only one or two children are being born per family, instead of the eight or ten that used to be the norm. Children are no longer a guarantee that their parents will be cared for in old age.

Today women want to have detailed information so that they can assess the risks.

christiane keil

Brand Manager for FEMIBION®

Merck KGaA, Darmstadt, Germany

Children are no longer being conceived simply because they are regarded as inevitable or because couples have no access to contraception. Having children is now a conscious choice. “Nowadays women are generally older — 29.4 years old on average — when they have their first child,” says Christiane Keil, Brand Manager for FEMIBION® at Merck KGaA, Darmstadt, Germany. “They plan ahead, and they want to have detailed information so that they can assess the risks and know what’s in store for them and for the child.”

Pregnant women receive comprehensive care, and the course of the unborn child’s development is routinely monitored using diagnostic methods ranging from 3D ultrasound examinations to genetic testing. 

Folic acid is necessary even before pregnancy

Nonetheless, the possibilities for preventing malformations of the embryo are generally limited. In the 1990s, researchers demonstrated that folate, better known as folic acid, plays a key role in embryonic development and can reduce the risk of neural tube defects. Neural tube defects can develop in an embryo between the 22nd and the 28th day of pregnancy. This is the period during which the primordial tissues of the various organ systems develop. In order for the central nervous system to evolve, the neural plate must develop into the neural tube, which will later form the brain and the spinal cord — the components of the central nervous system. 

If the neural plate fails to close and its seam remains open, the embryo develops with a cleft spine, also known as spina bifida. The mildest form of this defect, spina bifida occulta, produces mild to no symptoms, whereas the more severe forms, spina bifida aperta and spina bifida cystica, are generally associated with paraplegia, bladder or intestinal problems, and hydrocephaly. In some embryos this defect can even cause anencephaly, or failure to develop a brain. The frequency of neural tube defects varies greatly between countries. In the UK the frequency is 7.6 defects per 1,000 births, in Japan the ratio is only 0.9 per 1,000, and in Germany it is 1.0 per 1,000. It is thus estimated that 800 children with neural tube defects are born annually in Germany, however not all such cases are recorded. 

Inherited health issues

A folate deficiency is also believed to increase the likelihood of certain inherited heart defects. In addition, a study conducted in Norway has demonstrated a connection with autism spectrum disorders. Folic acid is needed for cell division and the formation of new cells. If the supply of folic acid is insufficient, cells with high rates of division – such as red and white blood cells – are the most likely to be damaged. Because the defective development of the neural tube occurs during the early stages of pregnancy, the German Federal Institute for Risk Assessment (BfR) and related professional organizations such as the German Nutrition Society (DGE) now recommend that women make sure they take in sufficient amounts of folic acid as soon as they decide they want to have children.

17 oranges a day

Vitamin B9, which is also known as folate, was discovered in the 1940s, but the key role it plays in embryonic development was not recognized until much later. In many Western countries, medical professionals have been recommending that pregnant women increase their intake of folic acid since the early 1990s. In Germany, this recommendation has been enforced since 1995. That was also the year of the market launch of FEMIBION®, a vitamin supplement that optimally covers the need for folic acid, starting with a woman’s desire to have a child and continuing through all the phases of her pregnancy. This would be practically impossible through diet alone, as it would require eating 17 oranges a day. 

Feminbion® 1 Pre-conception + Pregnancy is recommended until the end of the 12th week of pregnancy. After that, the mother should take Feminbion® 2 Pregnancy + Nursing Period. Feminbion® 1 Pre-conception + Pregnancy is recommended until the end of the 12th week of pregnancy. After that, the mother should take Feminbion® 2 Pregnancy + Nursing Period.

Feminbion® 1 Pre-conception + Pregnancy is recommended until the end of the 12th week of pregnancy. After that, Feminbion® 2 Pregnancy + Nursing Period should be taken until the end of the nursing period.

The folate that is naturally consumed in food is often not as thoroughly absorbed by the body as the synthetically produced variant, folic acid. However, after the synthetic folic acid is consumed it too must be converted into folate. But not every woman can completely convert folic acid. Merck KGaA, Darmstadt, Germany has therefore developed Metafolin®, a patented form of folate which can be used by the body directly and is helping to ensure that all women are sufficiently supplied with folates. FEMIBION® is the product that is most frequently recommended by gynecologists today. It systematically supports women from their initial desire to have a child all the way through pregnancy and the nursing phase. 

This needs-oriented two-phase product is adjusted to women’s changing nutritional requirements during pregnancy. FEMIBION® 1 contains 800 µg of folates as boosters that rapidly raise the body’s folate level, as well as other important B vitamins, vitamins C, E, and D3, and iodine. All of these supplements are recommended from the time a woman first desires to have a child until the end of the 12th week of pregnancy. As of the 13th week, FEMIBION® 2, which contains 400 µg of folates, maintains the established folate level. FEMIBION® 2 also contains all the other important micronutrients, as well as additional omega-3 fatty acids. These are important for the development of the embryo’s brain and eyes, which begins in the second trimester of the pregnancy. 

In its 20 years of promoting healthy pregnancies, FEMIBION® has become a trusted supplement for women. “We’ve also become very active as consultants for pregnant women,” says Brand Manager Christiane Keil. Women rely on the expertise associated with this product, which is available through the extensive array of services on the company’s website, a Facebook group, apps, and advice provided in portals for pregnant women. Through this interactive communication at many levels, the FEMIBION® brand is responding to the far-reaching change in the meaning of pregnancy in recent years. Women today want to enjoy their pregnancy and to know what to expect, so that they can prepare themselves in the best possible way. 

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