title: Uptake of folic acid supplements before and during pregnancy: focus group analysis of women's views and experiences.
abstract: BACKGROUND
  To reduce risk of neural tube defects, current guidance recommends that all women who could become pregnant should take a daily 400 μg folic acid supplement before conception and until the 12th week of pregnancy. It is recognised that compliance with this guidance is sub-optimal, although little is known about the reasons why. The present study aims to explore the rationale behind women's decision-making on folic acid supplement use to inform health communications.
  
  
  METHODS
  Women attending routine health visitor led baby clinics completed a questionnaire to establish their folic acid use in their most recent pregnancy. Participants were then invited to join focus group discussions to explore motivators and barriers to folic acid supplement use before and during pregnancy.
  
  
  RESULTS
  Of 292 women approached, 211 (70%) provided information on supplement use. Of these, 67 (31%) reported having taken folic acid supplements as recommended; 118 (56%) only during pregnancy [22 (18%) only intermittently]; and 26 (12%) had not taken folic acid at all. Eight focus group discussions were held comprising 24 participants. Discussions indicated the rationale behind current recommendations was known. Participants often linked folic acid use with morning sickness, and invoked busy lives, competing priorities for concern, and poor memory in accounting for intermittent use. Building a 'lay evidence base' from their own experiences, many cited healthy pregnancy outcomes without supplement use and expressed scepticism about its preventive action.
  
  
  CONCLUSIONS
  The findings of the present study highlight the importance of guidance on the importance of daily folic acid supplement use, the severity of neural tube defects and the provision of evidence on risk reduction.
authors: The Open University, Milton Keynes, Bucks, UK.
authors: R S
authors: RS
authors: Barbour
authors: M
authors: M
authors: Macleod
authors: G
authors: G
authors: Mires
authors: A S
authors: AS
authors: Anderson
mesh_terms: D000328:Adult; D019587:Dietary Supplements / Q000706:statistics & numerical data; D005260:Female; D017144:Focus Groups; D005492:Folic Acid / Q000008:administration & dosage*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D039382:Maternal Nutritional Physiological Phenomena; D009436:Neural Tube Defects / Q000517:prevention & control*; D010349:Patient Compliance; D016742:Preconception Care; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D039401:Prenatal Nutritional Physiological Phenomena; D014803:Vitamin B Complex / Q000008:administration & dosage*; D016387:Women's Health
chemical_list: D014803:Vitamin B Complex; D005492:Folic Acid