Quick answer
New Zealand guidance recommends a folic acid-only tablet daily, starting at least four weeks before conception and continuing until 12 weeks of pregnancy, to reduce neural tube defect risk. There's a standard dose for low risk and a higher dose for higher-risk pregnancies. Since about half of NZ pregnancies are unplanned, confirm your dose with a GP, midwife or pharmacist.
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Folic acid-only tablets — not general multivitamins — are the specifically recommended supplement for reducing neural tube defect risk in New Zealand.
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Guidance recommends starting at least four weeks before conception and continuing until 12 weeks of pregnancy.
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New Zealand guidance describes a standard dose for people at low risk and a separate, higher dose for people at higher risk of neural tube defects; a GP or midwife can confirm which applies to you.
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If a pregnancy is unplanned and folic acid has not been started, guidance is to begin as soon as possible rather than skip it.
Why does folic acid matter so early in pregnancy?
Folate is a B vitamin needed for cell growth and division; folic acid is the synthetic form used in supplements and added to some foods. It plays a role in the development of the neural tube, which goes on to form the brain and spinal cord in the earliest weeks of pregnancy — often before many people know they are pregnant.
This is why New Zealand guidance emphasises starting folic acid before conception rather than waiting for a positive pregnancy test: by the time pregnancy is confirmed, the neural tube may have already begun developing.
What does New Zealand guidance actually recommend?
Health New Zealand and Healthify describe folic acid-only tablets as the routinely recommended supplement for this purpose in Aotearoa, available in two strengths. Guidance is generally split by risk level: people at low risk of having a pregnancy affected by a neural tube defect are advised one strength daily, while people at higher risk — for example due to a personal or family history of neural tube defects, certain health conditions, or some medications — are advised a different, higher daily strength.
In both cases, the recommended window is the same: starting at least four weeks before conception and continuing until 12 weeks into pregnancy. Because determining which risk category applies to you requires a conversation about personal and family history, this is genuinely best confirmed with a GP, midwife or pharmacist rather than self-selected from a product shelf.
Folic acid tablets or a pregnancy multivitamin — which is right?
New Zealand guidance specifically points to folic acid-only tablets rather than general pregnancy multivitamins for this purpose, noting that some multivitamins do not contain enough folic acid to meet the recommended amount. If you are already taking a pregnancy multivitamin, check with a pharmacist whether it provides an adequate folic acid dose or whether a separate folic acid-only tablet is still needed.
Folic acid-only tablets are available on prescription (often the lowest-cost option) or over the counter from a pharmacy in New Zealand.
What if you find out you are pregnant and have not started folic acid?
Health New Zealand notes that just over half of pregnancies in Aotearoa are unplanned, meaning many people miss the ideal pre-conception window. Guidance in this situation is to start a folic acid tablet as soon as possible and continue until 12 weeks of pregnancy, rather than deciding it is "too late" to bother.
People also ask
Frequently asked questions
Can I take a pregnancy multivitamin instead of a folic acid tablet?
Check with a pharmacist first. New Zealand guidance notes some multivitamins do not contain enough folic acid for this specific purpose, so a dedicated folic acid-only tablet may still be needed alongside or instead of a multivitamin.
What should I do if I've just found out I'm pregnant and haven't been taking folic acid?
Guidance is to start taking a folic acid tablet as soon as possible and continue until 12 weeks of pregnancy. Speak with your GP or midwife to confirm the right dose and next steps for your situation.
How do I know if I need the higher folic acid dose?
This depends on personal and family history and certain health conditions or medications. A GP or midwife is best placed to assess your individual risk and recommend the appropriate strength.
Evidence and further reading
This guide provides general education, not diagnosis or individual medical advice. Follow product labels and speak with an appropriately qualified health professional when you are pregnant, nursing, taking medication or managing a health condition.
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