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Epilepsy and Pregnancy

Last Updated September 2022 | This article was created by familydoctor.org editorial staff and reviewed by Leisa Bailey, MD

Epilepsy is a central nervous system (neurological) disorder. It causes abnormal brain activity and can lead to seizures, unusual behaviors, and loss of awareness. It can usually be managed with medicine. Women who have epilepsy are at higher risk for complications during pregnancy. Regular medical care before, during, and after your pregnancy is important for monitoring these risks.

Path to improved health

Talk to your doctor if you have epilepsy and are planning to get pregnant. They may want to make sure that your symptoms have been well controlled for at least six months before you get pregnant.

It’s very important that you take your antiseizure medicine just as your doctor tells you. If you haven’t had any seizures for 2 years or more, your doctor may want to slowly stop your seizure medicine before you become pregnant or while you are pregnant. However, you should not stop taking this medicine on your own. Your doctor can help you find the right medicine that will have the fewest potential effects on your baby.

As with all pregnant women, it’s also very important for you to take prenatal vitamin supplements and folic acid. It can help prevent certain kinds of birth defects. Start taking these vitamins before you get pregnant to get the most benefit. Your antiseizure medicine may change how your body absorbs folic acid. Your doctor may recommend a type of prenatal vitamin with a higher dose of folic acid.

It is also very important to get adequate sleep to decrease the chances for seizures during pregnancy.

Pregnancy affects each woman who has epilepsy differently. Some women actually experience fewer seizures than normal while pregnant.

However, women who have epilepsy and become pregnant have a higher risk for pregnancy-related complications than pregnant women who don’t have epilepsy. These complications include:

  • Vaginal bleeding
  • The possibility that your seizures may occur more often
  • Preeclampsia (a condition during pregnancy that is a combination of high blood pressure and the presence of protein in the urine after 20 weeks of pregnancy)
  • Separation of the placenta (the organ that provides nourishment for the baby during pregnancy) from the uterus (womb) that can occur with a seizure

The majority of women who have epilepsy deliver normal, healthy babies. But there are some risks. Babies of mothers who have epilepsy have a higher risk of the following:

  • Developing seizure disorders as they get older
  • Developmental and growth delays
  • Bleeding problems after birth (related to the mother’s seizure medicines)
  • Being born prematurely or stillborn
  • Birth defects caused by the medicine you take
    • It is important that you follow your doctor’s directions for taking your medicine. The risks of not taking your medicine are much higher for you and your baby. These include physical injury, developmental delay, and even death from your seizures.

Tell your doctor about any family history of brain or spinal defects. Eating a healthy diet, getting enough sleep, and exercising regularly are other things you can do to have a safe and healthy pregnancy.

Things to consider

During your pregnancy, you will see your doctor often. Your doctor will perform frequent blood tests to be sure that you’re getting enough antiseizure medicine. It’s very common for your doctor to change the dose of your medicine during your pregnancy.

They may also want you to have several ultrasound exams during your pregnancy. Your doctor may even want you to have an amniocentesis. In this procedure, a small amount of fluid is removed from your uterus. This fluid gives your doctor some information about the health of your unborn baby. These extra precautions are a way for your doctor to monitor your pregnancy and your unborn baby’s development.

Questions to ask your doctor

  • What happens if I have a seizure during pregnancy?
  • How do I know when vaginal bleeding could be a sign of something serious?
  • Will my medicines affect my baby?
  • What are the chances that my baby could be born with epilepsy?
  • Are there foods that I can eat to help my body better absorb folic acid?

Resources

U.S. National Library of Medicine, Medline Plus: Epilepsy

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