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Fortification will spare women painful decision to end wanted pregnancies

Fortify flour with folic acid to spare women painful decision to end wanted pregnancies, bpas urges

• Private Member’s Bill to fortify flour to be debated in the House of Lords on Friday
• The UK has a high rate of Neural Tube Defects (NTDs) like spina bifida
• Folic acid reduces these defects significantly, but needs to be taken before conception as the neural tube closes in very early pregnancy
• Many pregnancies are not planned, so fortification of flour with folic acid would be most effective way of helping women and their babies
• 2015 National Diet and Nutrition Survey showed blood folate levels in UK women of reproductive age well below those recommended by WHO for NTD reduction

The British Pregnancy Advisory Service (bpas) today backs a bill calling for flour to be fortified with folic acid in order to reduce the number of pregnancies that are affected by neural tube defects (NTD) like spina bifida and anencephaly, the majority of which end in abortion.

bpas believes the failure to spare so many pregnant women from a diagnosis of an NTD through this simple and safe initiative is profoundly disappointing. At a time when women themselves are under pressure to make significant lifestyle changes in order to support a healthy pregnancy – even when the evidence base is unclear – this straightforward public health measure that is proven to protect a developing pregnancy should be supported.

Fortification of flour with folic acid has been introduced in more than 70 countries around the world, including the US, Canada and Australia, leading to a reduction in NTDs as a result. The UK has been adding calcium, thiamin, niacin and iron to wheat flour for more than 50 years so both the principles and the mechanics of fortification are already in place.

It is now a decade since the UK’s Scientific Advisory Committee on Nutrition (SACN) first recommended flour be fortified, and the UK’s chief medical officers considered and approved that recommendation. UK health ministers have the authority to enact this and Scotland is keen to do so, but has been waiting for a decision in Westminster so a UK-wide approach can be taken.

The UK has one of the highest rates of neural tube defects like spina bifida and anencephaly in Europe, with around 1,000 pregnancies affected each year. Spina bifida causes lifelong disability, while anencephaly is a condition in which where the baby’s skull and brain do not form properly and the baby dies shortly after birth. The majority of women (80%) make the painful decision to end what is often a much wanted pregnancy after such a diagnosis.

The most effective way to reduce NTDs is to take folic acid supplements prior to conceiving, however around half of pregnancies are not formally planned. If flour was fortified with folic acid, the vitamin would already be present in foods consumed everyday – meaning that many more women would have sufficient levels of the vitamin in their blood when they became pregnant even if they had not taken supplements.

Clare Murphy, Director of External Affairs at the British Pregnancy Advisory Service, said:

“The fortification of flour with folic acid is a straightforward public health intervention which could spare many women every year from the painful decision to end a wanted pregnancy after a diagnosis of a neural tube defect. These are some of the saddest cases we see in our centres. It is bizarre that when public health messages routinely instruct pregnant women not to touch a drop of alcohol, even when then is no evidence of harm, we would shy away from this simple initiative that can genuinely protect pregnancies.

“A small number of parliamentarians are currently campaigning to restrict women’s access to abortion on grounds of disability. We urge them to unite with those who defend women’s choice over this effective measure that can prevent disabilities in the first place.”


For further information please contact the bpas press office on 0207 061 3377 or 07788 725 185 or press@bpas.org

About bpas
bpas is a charity which cares for more than 70,000 women a year and provides reproductive healthcare services including pregnancy counselling, abortion care, miscarriage management and contraception, at clinics across the UK. It supports and advocates for reproductive choice. More information can be found at bpas.org.

The World Health Organisation recommends red blood cell folate levels should be above 906 nmol/L in women of reproductive age to achieve the greatest reduction in NTDs

Analysis of blood samples from the National Diet and Nutrition Survey published in 2015 found among UK women of reproductive age the median level was 535 nmol/L and the mean 614 nmol/L (Scotland mean 563, Northern Ireland mean 512, Wales mean 611)