Folic acid: Here is why women of childbearing age must take it

In 2001, a British gynecologist didn’t tell a woman who was trying to conceive about the importance of taking folic acid during this critical period. He will now pay her daughter millions of pounds as compensation for the health problems she suffers as a result of his negligence.

Evie Toombes, a 20-year-old British woman, is a well-known athlete who rides horses and does show jumping, but also suffers from a cleft spine, known as spina bifida, a condition that may occur in fetuses in the first month of pregnancy and causes one or more vertebrae to widely separate in the spine..Although Evie manages to lead a relatively routine life, she sometimes needs to use a wheelchair and sometimes has to spend 24 hours in the hospital connected to an IV. This understandable frustration led her to make a decision that others would hardly even think of, to sue her mother's gynecologist, Dr. Philip Mitchell, who she claims bears full responsibility for the fact that she was born with this defect and has suffered from it all her life.

This claim may seem puzzling at first reading, but when you delve deeper into this story, you can certainly see that it’s logical. Evie claims that the doctor didn’t tell her mother Carolyn to take folic acid before she became pregnant. This supplement could have reduced the risk of fetal spinal defects. This, in retrospect, could have led to Evie never being born. This is because if Carolyn had known about the possible shortage of folic acid in her body, she might have chosen to postpone attempting to conceive until her condition was balanced.

Such a claim raises many objections, and it’s doubtful that many people thought that Evie’s claim would be accepted. However, last week, the London Supreme Court ruled in her favor and the amount of compensation she’ll receive is high and unprecedented. Her lawyers say that the total amount hasn’t been decided, but Evie will receive compensation for all the treatments and mental anguish she’s endured, an amount that will amount to millions of pounds.

"He told me to go home and have a lot of sex"

In February 2001, Carolyn, Evie’s mother, went to Mitchell for counseling before she began trying to conceive. She stated that she and her husband agreed not to have sex at all until they decided to have a child. In her testimony, she said that the doctor didn’t talk to her at all about the importance of taking folic acid to prevent this syndrome, adding that the doctor told her to go home and "have a lot of sex” - advice she said was very blunt.

"He told me that taking a folic acid supplement wasn’t necessary," she said. Carolyn added that Mitchell said that if she had a good diet that supplements weren’t necessary. The lawsuit states that if Carolyn had received better medical advice she would have continued to avoid having sex with her husband.

For Evie, the significance of the decision is of course extremely dramatic. Aside from the fact that she wouldn’t exist if things had been run differently, today she deals with limitations and medical problems that will worsen in the future. Evie will need a wheelchair more and more and she’ll always suffer from intestinal and bladder problems. Mitchell, for his part, claimed that he did explain to Caroline the importance of taking folic acid in a meeting. He also tried to argue that she may have already become pregnant before her first appointment, but this claim was refuted in court.

The judge, Rosalind Coe, ruled that "in these circumstances, it can be concluded that Mrs. Toombes wasn’t pregnant when she first saw Mitchell. She didn’t receive adequate advice on the importance of taking folic acid before getting pregnant and for the first 12 weeks of pregnancy. She also didn’t receive information about the connection between taking folic acid and preventing a cleft spine and neural tube defects.” The court hearings will continue to determine the exact amount of compensation Evie will receive.

And if you’re a woman who is thinking of getting pregnant for the first time, or a gynecologist who wants to avoid paying millions in compensation in a few decades, we emphasize that to avoid the chance of defects, it’s recommended to take 400 micrograms every day of folic acid before getting pregnant and for the first 12 weeks. This mineral is sometimes difficult to obtain from diet alone so it’s recommended to take a supplement with the recommended dosage. 

For this reason and since sometimes even wanted pregnancies may be unpredictable or planned, health care organizations overwhelmingly recommend that women of childbearing age take folic acid daily.