Trying to conceive: Do birth control pills affect folic acid stores?

Does taking birth control pills affect the folic acid stores of the user? If so, how long before conceiving should a person wait after going off the pill to get pregnant?


Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

A highly respected text, "Contraceptive Technology," by Robert Hatcher gives no mention to oral contraceptive's effect on folic acid. Research is cloudy on this matter.

Nutritionists generally believe that birth control pills interfere with Vitamin B synthesis and utilization by the body. They feel that women should take a B-complex vitamin while on the pill.

Folic acid is such an important vitamin in the prevention of neural tube defects in pregnancy, that it is best to begin a supplement as soon as a couple decides to try and conceive. Because so many pregnancies are unplanned and because the pill is so widely used, it makes sense to me to assure one has a diet high in B vitamins or use a supplement if you are of childbearing age.

There is no hard and fast rule about pregnancy and birth control pills. I suggest to my clients that they go off the pill six months to a year before attempting a pregnancy. This gives ample opportunity to return to normal cycling, which makes it easier to date a pregnancy.

Preconception counseling would involve assisting the woman to achieve a level of fitness, start on a vitamin supplement, get checked for sexually transmitted disease, begin to educate herself on essential nutrients and begin to eat a good diet and stop smoking (both of them) if necessary. She and her mate can even begin to chart her cycles and to observe for cervical mucus changes which make achieving a pregnancy much easier.

Birth control pills do not interfere with fertility. In fact they can improve fertility by preventing ectopic pregnancies, pelvic infections, fibroids, ovarian cysts, enometrial cancer and possibly endometriosis. The low dose pills (1/35, 1/20) are the standard today and it rarely takes any extra time to return to normal cycles after discontinuing.

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