• Counsel your patients about folic acid. Studies conducted by the Gallup Organization and commissioned by the March of Dimes have consistently shown that women are more likely to consume folic acid if a health care provider advises them to do so.
  
  Your patients listen to what you tell them and are often waiting for you to make the first move. They realize the length of their visit with you is limited and very often do not get the chance to get answers to all of their questions. Regardless of whether or not your patients initiate the conversation or are planning a pregnancy, discuss the importance of folic acid with all women of childbearing age.
  
  In addition to helping prevent neural tube defects, folic acid may have a wide range of other beneficial health effects. Some studies suggest that it also may help protect children from birth defects of the heart, limbs and face. Other studies suggest that folic acid may protect against cardiovascular disease, cervical and colon cancer and possibly breast cancer.
• Encourage your medical staff to routinely ask women about folic acid and multivitamin intake when taking a patient’s history.
• Persuade your colleagues to present the folic acid message during grand rounds.
• Order educational materials from the March of Dimes for display in your waiting room, hospital or clinic. Give these materials to patients when you or your staff are taking the medical history or scheduling the next appointment. To learn more about what is available, go to the March of Dimes product catalog.

Helping Patients Overcome Barriers
Barrier #1: Multivitamin supplements are costly.
Recommendation: Advise the patient to take less expensive folic acid tablets or generic multivitamins containing standard amounts and contents.

Barrier #2: The patient is averse to taking or swallowing pills.
Recommendation: Advise the patient to take chewable vitamins or folic acid in liquid or powder form. You may also want to refer the patient to a nutritionist for information on how to get sufficient amounts of folic acid daily in the diet (for example, through enriched grain products such as fortified breakfast cereals and through other foods containing folic acid, such as orange juice, legumes and leafy green vegetables).

Barrier #3: The patient believes that she doesn’t need to take folic acid because she’s using contraception (for example, she’s using a diaphragm).
Recommendation: Explain that folic acid is for her. Half of all pregnancies in the United States are unplanned or incorrectly timed. Folic acid may benefit the woman’s health, too; some studies suggest that it may reduce her risk of heart disease, cervical and colon cancer and possibly breast cancer.