If you have epilepsy, you’re probably wondering if it may complicate your pregnancy. The good news is that an overwhelming majority of women with epilepsy have healthy pregnancies and give birth to healthy babies.
Here's how to ensure a good outcome for you and your baby.
What is epilepsy?
Epilepsy is a brain disorder characterized by recurrent seizures and involuntary behaviors such as loss of consciousness, muscle spasms and confusion. These seizures happen when electrical impulses in the brain misfire, sending out abnormal signals to nerve cells.
Epilepsy is a chronic condition affecting more than 1.1 million women of childbearing age in the United States. Treatment with medication and possibly surgery can help manage it.
How does epilepsy affect pregnancy?
Having seizures during pregnancy can cause injury or problems for you and your baby, including trauma from falls or burns, increased risk of premature labor, miscarriages and a decrease in fetal heart rate. Discuss how to reduce your risk of these issues with your neurologist and the doctor you’ve chosen for your prenatal care.
While it’s true that there seems to be a slight increase in the incidence of certain birth defects in the babies of epileptic mothers, these appear to be often caused by the use of certain anticonvulsant medications during pregnancy rather than by the epilepsy itself.
Working with your doctor to choose the right drug to manage your symptoms or weaning yourself off your medication under your practitioner’s guidance can help reduce this risk. Another way to safeguard your and your baby’s health is by taking adequate amounts of folic acid (400-600 mcg from your prenatal vitamin and food sources) before and early in your pregnancy.[1]
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While epilepsy isn't likely to complicate your labor and delivery (you’re just as likely to have a vaginal delivery as any other pregnant mom), it is important that you continue to take anticonvulsant medication during labor to minimize your risk of a seizure during delivery. As with women who don’t have epilepsy, an epidural anesthesia can be used to manage any labor and delivery pain.
How might my epilepsy affect my baby and me after birth?
Caring for your baby postpartum can be a concern for moms with epilepsy. Consider changing or dressing her on the floor to reduce the risk of falls. You might even try bathing her with other adults around or giving her sponge baths rather than bathing her in the tub when you're alone to ensure her safety.
Breastfeeding your baby shouldn’t be a problem — epilepsy medications pass into the breast milk in such low doses that they are unlikely to affect a nursing baby.
How does pregnancy affect epilepsy?
Many women find that their epilepsy doesn't worsen during pregnancy. In fact half of all moms-to-be experience no change in their condition, and an even smaller percentage find that their seizures actually become both milder and less frequent. However, as many as a third discover that their seizures become more frequent and severe. That’s why it’s so important to seek out a supportive doctor and the help of friends and family.
Here's some reassuring news: Women who have been seizure-free for at least nine months before becoming pregnant have an excellent chance of remaining seizure-free throughout their pregnancies. Discuss this and any other questions you may have with your doctor.[2]
How do you treat epilepsy during pregnancy?
A great first step toward a healthy pregnancy with epilepsy is to get your condition under the best possible control you can — preferably before you conceive, and with the help of your neurologist and prenatal practitioner. If you’re already pregnant, it's important to get that help as soon as you can.
For the best possible results, your doctors will want to closely supervise your condition and possibly adjust your medication levels. (Close communication between your doctors is a must.) Getting plenty of sleep and following a healthy, nutritious diet are also important.
Can you take epilepsy medication during pregnancy?
Ask your doctor about whether you should be weaned from your medications prior to conception, or, if possible, during pregnancy. This may be doable if you’ve been seizure-free for a period of time.
If you have been having seizures, it’s important to try to get them under control ASAP. You'll need medication to do this, but it may be possible to switch to a less risky drug than the one you’ve been taking. Preferably, you'll start taking only one drug, which appears to cause fewer problems during pregnancy than a multi-drug therapy.
Still, it’s important not to stop taking a necessary medication for fear of hurting your baby — most medical experts agree that the risks to baby from seizures during pregnancy are greater than the risks from seizure medications.
Along with folic acid, you may also want to discuss taking a vitamin D supplement with your doctor, since some epilepsy medications can interfere with how the vitamin is metabolized. Selenium and zinc are also important, so make sure your prenatal vitamin includes these minerals.
During the last four weeks of pregnancy, you might also be prescribed a vitamin K supplement to reduce the risk of hemorrhage, another condition that babies of women taking seizure medications have a slightly higher risk of.
For more information on epilepsy and pregnancy, visit the Epilepsy Foundation; to help yourself in the future or help other moms with epilepsy, consider registering with the Antiepileptic Drug Pregnancy Registry. Their goal is to determine which therapies are associated with an increased risk to pregnant moms.
As long as you stay in close contact with all your doctors while you're expecting (and you follow these tips and the advice of your practitioners on how best to manage your condition), your chances of having a healthy pregnancy and baby are great.
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