Patient education: Epilepsy and pregnancy (The Basics)

What is epilepsy? — Epilepsy is a condition that causes people to have repeated seizures. Seizures are waves of abnormal electrical activity in the brain. Seizures can make you have convulsions, pass out, or move or behave strangely.

If I have epilepsy, can I have a normal pregnancy? — Yes, most people with epilepsy can have a healthy pregnancy. But there is a higher risk of certain problems. For example, you might have worse seizures during pregnancy. Also, some anti-seizure medicines could harm an unborn baby.

If you have epilepsy and want to have a baby, you will need to work closely with your doctors. They will make sure that you are doing the right things to control your epilepsy and protect your baby.

More than 1 doctor will take care of you during pregnancy. Your obstetrician will take care of your pregnancy. Your epilepsy doctor will take care of your epilepsy. They will often work closely together.

What should I do before trying to get pregnant? — It is very important to talk with your doctors before you try to get pregnant. That way, they have enough time to check your anti-seizure medicine and change it, if needed. That's because certain anti-seizure medicines and doses can harm an unborn baby.

Your doctor might:

●Keep you on your anti-seizure medicine

●Change your dose of anti-seizure medicine

●Reduce the number of anti-seizure medicines you take (if you take more than 1)

●Change your anti-seizure medicine – They will make sure that your anti-seizure medicine is adjusted to be as safe as possible during pregnancy.

You should never stop your anti-seizure medicine on your own. But your doctor might talk with you about this option if:

●You have not had any seizures for many years.

●You have a type of epilepsy that can go away over time.

●Your tests, including EEG (which measures electrical activity in your brain) and imaging tests, suggest that you are not likely to have more seizures.

In addition to checking your medicine, your doctor will prescribe a vitamin called "folic acid." All people who could get pregnant should take folic acid, whether or not they are actively trying to get pregnant. Folic acid helps prevent problems that babies can be born with. For people with epilepsy, taking it before and during pregnancy also appears to lower the risk of developmental delays and autism in the child.

There are other steps that everyone should take before trying to get pregnant, too. Your doctor or nurse can talk to you about general planning for pregnancy.

How might my epilepsy affect my baby? — Having seizures while you are pregnant might harm your baby. If you fall down, you could hurt yourself and your baby. When you have a convulsive seizure (the kind that causes shaking and might make you pass out), your baby might not get enough oxygen.

Does pregnancy affect epilepsy? — Not usually. But some people do have more seizures during pregnancy and for a while after delivery. You could have more seizures if you don't take your anti-seizure medicine as directed (if you need medicine), or if you don't get enough sleep.

How can I lower my chances of having a seizure? — To lower your chances of having a seizure, you can:

●Take your anti-seizure medicine exactly as directed. Do not stop or change your medicine without talking to your doctor. You might worry that your anti-seizure medicine will harm your baby. Ask your doctor about this. There is some chance that certain types of medicine could do harm, but having a seizure can also harm your baby.

●Let your doctors know if you vomit soon after taking your anti-seizure medicines, especially in early pregnancy. They might have you take another dose. If you are vomiting often, they might also give you another medicine to help prevent this.

●Let your doctor know if you start any new prescription or non-prescription medicines, or herbal drugs.

●Get enough sleep – Not getting enough sleep raises your chances of having a seizure. If possible, have your partner and family members help take care of your baby at night so you can get regular sleep.

Will I have tests during pregnancy? — Yes. You will have tests to check your baby's health. These can include blood tests and an imaging test called an ultrasound. An ultrasound creates pictures of your baby inside your body.

You will also have regular blood tests to check the amount of anti-seizure medicine in your body. Pregnancy can lower the amount of medicine in your blood. Your doctor might increase your dose to prevent the level from getting too low. If it does get too low, your seizures might get worse.

Can I have a normal vaginal delivery? — Most people with epilepsy have a normal vaginal delivery. Having epilepsy is not a reason on its own to have a C-section (surgery to get the baby out). It is uncommon to have a seizure during delivery. Even so, your doctor will watch you closely during your delivery and adjust your medicine, if needed.

Will my baby be healthy? — If you were healthy and your epilepsy was under control during your pregnancy, chances are very good that your baby will be healthy.

Will I be able to breastfeed? — Yes. Most people are able to breastfeed even when taking anti-seizure medicine. But it's also important to try to get enough sleep, since not sleeping enough raises your chances of having a seizure. If you are breastfeeding, you should make a plan to regularly have another adult help if possible. They can care for your baby during the night and feed them with a bottle while you sleep. This way, you can sleep for a longer stretch of time, ideally getting your regular sleep each night. Also, try to take extra naps each day whenever possible.

You can use a breast pump so your baby can get breast milk from a bottle, or you can use formula for the bottle feedings. If you want to breastfeed or pump, talk with your doctor.

What else can I do to protect my baby? — If you have frequent seizures, there are things you can do to help keep your baby safe after they are born. You can:

●Change your baby's diaper on the floor – That way, if you have a seizure, your baby won't fall off of a changing table.

●Have someone else with you when you bathe your baby – Then your baby won't be alone in the bathtub if you have a seizure.

●Tell your baby's doctor that you have epilepsy so they understand your situation.

More on this topic

Patient education: Epilepsy in adults (The Basics)
Patient education: EEG (The Basics)
Patient education: Seizures (The Basics)
Patient education: How to plan and prepare for a healthy pregnancy (The Basics)
Patient education: Deciding to breastfeed (The Basics)
Patient education: Coping with high drug prices (The Basics)

Patient education: Seizures in adults (Beyond the Basics)