The smallest doll shows the size of a baby 28 days after it is first conceived. 

So what exactly is a Neural Tube Defect?

It sounds very technical, but a Neural Tube Defect (or NTD for short) is basically a fault that develops when a baby’s brain and spine are forming in the first 28 days of pregnancy. This fault - or defect - occurs so early in an unborn baby’s development that most women haven’t even discovered they are pregnant when it happens. This is why it is SO important that you start taking folic acid tablets before you get pregnant.

The neural tube, which goes on to form the baby’s brain and spinal cord, starts to develop when a baby is smaller than a grain of rice. Not enough folic acid in the mother’s body at this stage can cause Neural Tube Defects such as spina bifida.   

The  latin words spina bifida mean ‘split spine’ (or backbone) . This description is used because a fault in the development of the baby’s spinal cord and the bones surrounding it leaves a gap or split in the spine.  Beth (pictured) was one baby who was affected in this way.

Here’s what happens in more detail

The beginnings of the baby’s brain and spinal cord - the neural tube - starts to form around the third week after conception. Only a very few women would actually realise they were expecting a baby at this stage – in fact it is not even called a baby, it is an embryo.

This tiny developing embryo, no bigger than a grain of rice, has no arms, legs  or major organs yet.

A layer of cells along the length of the embryo develops into a kind of crease from end to end. 

The crease gets deeper and its edges grow upwards and out. Next, the edges grow towards each other ready to form a tube – this is about to become the ‘neural tube’ we have been talking about.

Imagine a long boot unzipped ready for you to put on. As you pull the zip up your leg the boot forms into a kind of ‘tube’ shape around your leg. The final part of the development of the neural tube is a bit like that. The edges ‘zip up’, although not as one long ‘zip’, but as several short ‘zips’ starting at a few different points at the same time along the neural tube.  Each end of the neural tube should also close up. If this ‘zipping’ stage doesn’t happen completely, a gap will be left in the tube, which will become a Neural Tube Defect, such as spina bifida, or a more serious defect, anencephaly.

Once the neural tube has completely formed it begins to develop into the spinal cord and the brain.

Most pregnant women go on to have a healthy baby and the chances of a Neural Tube Defect happening in your pregnancy are very small. It’s very easy to think ‘it won’t happen to me’. 

Yet even though the risk is small it is real - every day in the UK at least two of the babies conceived will go on to develop Neural tube defects - there are around 900 affected pregnancies a year. If all women who might get pregnant took extra folic acid before they conceived up to 70% of Neural Tube Defects just wouldn’t happen.


"My daugher Beth has spina bifida. This photo was taken just one hour after she had spine closure surgery. Beth was one day old at the time."

Sam Copeland




"Beth is two years old in this photo. She had just got her first wheelchair and she learnt to wheel it herself within 24 hours. Some children with spina bifida have to use a wheelchair and continue to do so throughout their lives."

Sam Copeland
 is a new website. We aim to make it one of the best.

We welcome your ideas!

Go Folic! is led by:

Spina bifida • Hydrocephalus • Information • Networking • Equality - SHINE (Registered Charity No 249338), covering England, Northern Ireland and Wales. Scotland is covered by the Scottish Spina Bifida Association - SSBA (Scottish Charity No SC 013328).

Our special thanks go to the Go Folic! Women's Nutrition Project in San Francisco for their inspiration and support.