By Abul Wara
Karachi: An increasing number of children in Pakistan are being born with Spina Bifida—a severe, lifelong birth defect that can cause paralysis—due to widespread unplanned pregnancies and lack of awareness about a simple, affordable preventive measure: folic acid supplementation before conception.
Doctors warn that most women in Pakistan miss the critical window for prevention because they begin prenatal care only weeks after conceiving, by which time the spinal cord of the fetus has already developed. Spina Bifida, a type of neural tube defect, occurs when the baby’s spinal cord fails to close properly in the earliest weeks of pregnancy, often resulting in a fluid-filled sac on the back and loss of function in the lower body.
“The key to prevention is folic acid, but it must be taken before conception,” explained Dr. Saqib Bakhshi, neurosurgeon at Aga Khan University Hospital in Karachi. “Most women come to a gynecologist three to four weeks after pregnancy begins—by then, the damage is already done.”
In a country where most pregnancies are unplanned, countless women miss the opportunity to take folic acid during the critical early period. Daily intake of this vitamin by women of childbearing age can dramatically reduce the risk of Spina Bifida and other neural tube defects. “It’s completely safe and widely available. Just one small pill can make a huge difference,” Dr. Bakhshi emphasized.
Dr. Farukh Javed, neurosurgeon at Jinnah Postgraduate Medical Centre (JPMC), said his hospital sees 10 to 12 neural tube defect cases every month. “Among all birth defects we receive, these are the most common,” he noted, stressing that folic acid also helps in blood formation and early brain and spinal development of the fetus.
Despite the condition’s severity, there is no national registry in Pakistan. Experts estimate around 8 out of every 1,000 live births are affected—far exceeding the global average of 0.5 to 1 per 1,000.
Spina Bifida requires life-long care and multidisciplinary treatment involving neurologists, pediatricians, urologists, surgeons, and rehabilitation specialists. Early signs of the defect include a bulge or swelling on the baby’s lower back, which parents should not ignore.
The message from healthcare professionals is clear: planned pregnancies and timely folic acid intake are vital. Raising awareness and encouraging women to start supplementation before pregnancy could prevent hundreds of children each year from a life of disability.
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