Becoming pregnant can be very exciting, but it can also be a challenging time. There are lots of things to plan, tests to have and decisions to make. And if you have epilepsy in pregnancy, there may be some extra things to think about too. There can be some risks, so it’s vital to talk to your doctor so you can prepare as safely as possible.
In this article, you’ll learn more about epilepsy and pregnancy. If you are planning to get pregnant - or are already - it’s important to speak with a doctor about your specific situation. This article is intended to provide general information, and is not medical advice.
Epilepsy and pregnancy: is it safe?
It can be - organizations like the American Academy of Neurology describe pregnancy as “relatively safe” for women and their babies. The majority of women with epilepsy have safe and healthy pregnancies. The Epilepsy Pregnancy website, a resource for women with epilepsy, points out that there’s no difference in pregnancy rates, time to get pregnant, or pregnancy outcomes for women with epilepsy, compared to those who don’t have epilepsy.
That said, there are certain risks and challenges you should be aware of and discuss with your doctor. See below for more detail.
Planning for epilepsy in pregnancy
Ideally, women with epilepsy who would like to get pregnant would plan in advance with the support of medical professionals. But life isn’t always like that!
Here are some considerations around pregnancy if you have epilepsy.
Epilepsy and pregnancy planning
If you’ve decided that you want to get pregnant and you have epilepsy, then advanced planning may increase your chances of a healthy, safe pregnancy.
If possible, speak with your doctor up to 12 months before you plan to get pregnant [2]. For women who take certain anti-seizure medication, it may sometimes be best to change their medication before they become pregnant. Certain seizure medicines may harm your baby, so your doctor might want to change your prescription. And it can take between three and 12 months to safely switch to a new seizure medicine.
Your doctor may also recommend that you take folic acid supplements while you’re trying to get pregnant, and throughout the pregnancy. Folic acid can help with the healthy development of your baby and is recommended by the CDC for all women in pregnancy.
Read more: Folic acid and epilepsy during pregnancy
Epilepsy in a pregnancy that wasn’t planned
If you have epilepsy and you’ve just found out you’re unexpectedly pregnant, try to:
- Book an appointment with your doctor and an epilepsy specialist as soon as possible.
- Keep taking your epilepsy medication, but make an appointment with your doctor for advice on safety as soon as possible.
- Begin taking folic acid per your doctor’s recommendations.
Are there risks with epilepsy in pregnancy?
If you have epilepsy, there are a few potential risks related to pregnancy that you should be aware of. Speak with your doctor about these and any other potential risks.
Anti-seizure medication and pregnancy
Certain kinds of seizure medication are known to increase the risk of developmental problems for babies who were exposed to them in the womb. They may cause physical or neurodevelopmental disorders.
Whatever anti-seizure medicine you take, you should speak with your treatment team to work out a plan.
According to an article published by the International League Against Epilepsy, a study of eight ASMs found that the most high risk medication for epilepsy in pregnancy appears to be valproic acid (also known as sodium valproate). However, only a small number of ASMs were tested, so it’s possible that there may be other medications with risks that are not yet known about.
Learn more: Risks of sodium valproate and pregnancy
At present, the risk of developmental issues with many newer anti-seizure medications is not well studied.
Can pregnancy cause seizures?
Many women with epilepsy do not experience an increase in seizures in pregnancy - most have[7] their usual number of seizures. But every pregnancy, and every woman, is different.
Severe seizures during pregnancy
There is relatively little evidence about the effects of seizures during pregnancy on the health of the fetus or the mother. Focal seizures, depending on the type, are generally believed to be less dangerous than generalized seizures (although some focal seizures can become generalized seizures).
If you have generalized tonic-clonic seizures, some research has found that they may pose a health risk to the baby, particularly due to hypoxia (not getting enough oxygen) during this kind of seizure. Speak with your doctor to plan your medication and practical changes you can make around the home and routine to reduce the risks.
Epilepsy and pregnancy: you’re in control
Most women with epilepsy have healthy, safe pregnancies. Although there are certain risks - particularly from some kinds of seizure medication - these can often be managed. By working closely with your treatment team, you can feel more in control of your pregnancy.
