Ministers must act now to protect the health of women and their babies

At bpas, we see hundreds of women who are making the incredibly painful decision to end a much wanted pregnancy after a diagnosis of a neural tube defect such as spina bifida and anencephaly. There are an estimated 1,000 cases of these conditions diagnosed in the UK every year. Spina bifida causes lifelong disability while anencephaly, where the baby’s skull and brain do not form properly, is always fatal.

Sadly the UK has one of the highest rates of neural tube defects in the European Union, and it has remained largely unchanged since the early 1960s. Yet one simple measure could dramatically reduce the numbers of these cases – the fortification of flour with folic acid.

To avoid these conditions, women are advised to take folic acid supplements and up to 12 weeks in to their pregnancy. But in the UK nearly half of pregnancies are not planned, so many women are unable to take these supplements at the point when it will have an impact on the healthy development of their pregnancy.  The neural tube will have formed around the time a woman misses her first period. Mandatory fortification of flour with folic acid would mean the vitamin entered everyday foods widely consumed by women of childbearing age, like pasta and bread.

This is why we are calling on the UK’s health minister to implement the recommendations made seven years ago by the Scientific Advisory Committee on Nutrition that flour be fortified, recommendations that were approved by the UK’s chief medical officers.

This wouldn’t be a big change from current practice – the UK has been fortifying flour with calcium, thiamine, niacin and iron for over 50 years. The principle and the mechanics are already in place. And countries which have introduced mandatory fortification, such as the US and Canada, have seen a big drop in the numbers of cases of neural tube defects, with no evidence of adverse effects on the rest of the population. So why doesn't the UK follow suit?

Unplanned pregnancy is a fact of life, and it is often wonderful news for women and their partners. But it is completely unrealistic to expect all women to be regularly taking folic acid supplements on the basis that they might conceive.

The fortification of flour with folic acid is a simple measure with huge benefits. Our message to the UK’s health ministers is simple – act now to protect the health of women and their babies.