Neurology

Pregnancy and Epilepsy

If you are thinking about getting pregnant, please ask your doctor for a referral to the Strong Epilepsy Center to discuss the issues that may affect you while you are pregnant. If you are already pregnant, it would be wise for you to be followed at our Center.

Can I have children if I have epilepsy?

Yes. However, there is an interaction between hormones and epilepsy medications. It is important that you are followed closely by a neurologist/epileptologist during your pregnancy.

What will being pregnant do to my seizures?

The majority of women do not have any change in their seizure frequency during pregnancy. It is extremely important that you continue to take your medication. It probably will be necessary to adjust your medication as your pregnancy progresses.

What happens if I have a seizure while I am pregnant?

Grand Mal (Tonic/Clonic) seizures are the greatest concern because of the possible injury to both mother and unborn baby. Therefore, it is important to avoid situations which could bring on seizures. Please get plenty of rest, eat healthy foods, and continue to take your antiseizure medications.

How will my antiseizure medications affect my baby?

More than 90% of women with epilepsy have normal, healthy babies. However, any medication can cause birth defects. In the general population, the risk of birth defects is about 2-3%. For women with epilepsy who are taking antiseizure medication, the risk is about 4-6%.Remember that the risk of injury to the unborn baby is much greater if the mother has a seizure than the risks associated with the use of antiseizure medication. If you are considering becoming pregnant, please take folic acid to decrease the risks of birth defects.

Will my baby have seizures?

The risk of seizures in an baby depends on your family history and your seizure type. Overall, there is about a 10% risk of your baby having a seizure.

How often do I need to be seen during my pregnancy?

Please see your obstetrician at the recommended intervals. We would like to see you about once a month to check your drug levels. Hormones and antiseizure medications interact and the dosages will probably have to be adjusted during your pregnancy.

What can I do to reduce the risk of complications during pregnancy?

Be sure to use birth control so that you can carefully plan your pregnancy. Birth control pills are not as effective if you are taking antiseizure medication, so the chances of an unplanned pregnancy may be higher. Discuss this issue with your doctor.

Maintain a healthy life style. This includes a good diet, exercise and rest. Take a multivitamin with folic acid.

Discuss with your doctor the need to take Vitamin K during the last month of your pregnancy. This may assure adequate blood clotting for the baby after delivery.

What happens if I have a seizure during labor?

The risk of having a seizure during labor or delivery is only 1%. If this happens, the seizure can be medically managed by medication.

Will I have a C-section?

No. Most women with epilepsy have normal vaginal deliveries without difficulty.

Can I breast feed my baby if I am taking antiseizure medications?

Yes. Medications do appear in the breast milk, but it is best for women to breast feed their babies for a least a few weeks. This will naturally wean the baby from the medication exposure he or she received during the pregnancy.

If you are taking Phenobarbital or Primidone, they will probably make the baby sleepy. The benefits outweigh the risks, but it is best if the pediatrician and our neurologist work together so that you can continue to breast feed your baby.

Is there anything special I need to do after I have the baby?

It is important to see our neurologist about 4 weeks after delivery to check your drug levels. Continue to take care of yourself, avoid stress and get adequate rest. Develop a child care plan with the help of your family or a home health care agency. Consider using a small stroller in the house rather than carrying your baby. Think about putting the baby's mattress on the floor. There may be other adjustments you will need to make to keep your baby safe.