Epilepsy and Pregnancy: Should I Get Pregnant if I Have Seizures?
Even in what we consider normal circumstances, pregnancy can be difficult, both physically and emotionally. For those with epilepsy, pregnancy can be especially hard on the body, which means that even the idea of pregnancy can be extremely frightening. It’s a decision that affects the whole family.
You may be wondering, is pregnancy really a risk to someone who has seizures? It’s important to remember that everyone’s body is different, so it’s difficult to predict how pregnancy will affect your epilepsy. It may be completely unaffected, it could increase seizure frequency, or you could even see an improvement with seizure control. But either way, there will be challenges.
What are the challenges?
Pregnancy can cause physical tiredness and emotional stress, both of which are common seizure triggers. If you notice an increase in seizure frequency, please speak to your neurologist. The aim is to stay as seizure free as possible. If you were to injure yourself due to a seizure you could also put your baby at risk, there is a possibility of placental abruption or physical injury to the baby.
During pregnancy your body may need more of your anti-seizure medication than usual, especially if you are on Lamotrigine. We interviewed Wanda who explained how her doctors had to increase her medication while pregnant. You can listen to her experience here.
When a seizure occurs there is also a risk that it could cause the fetal heart rate to slow, that oxygen to the fetus could decrease and that it could induce preterm labor or a premature birth. Is the risk high? Well, that depends on the type of seizures you have, remember to talk to your healthcare provider to determine your own level of risk.
When should you speak to your doctor?
Research has shown that if you are taking anti-seizure medication there is an increased risk of your child not developing normally. So it’s important to reduce those risks by talking to your doctor about your medication, if possible before you get pregnant, or as soon as possible afterwards. Remember, unless you have spoken to your doctor about it, don’t stop taking your medication. They may wish to switch you to an alternative after looking into your individual needs but, coming off your medication prematurely could cause an increase in seizures, which could lead to an injury that affects your baby.
What are some things that you can do to reduce the risks?
If you are taking medication for seizures your doctor will likely prescribe you a high dose of folic acid, to be taken once a day, while you are trying to get pregnant. If you become pregnant unexpectedly make an appointment with your doctor to get your folic acid prescription as soon as possible. Folic acid has been shown to prevent serious problems with the brain and spinal cord known as neural tube defects. Statistically, women with epilepsy do have a higher risk of having children with congenital malformations due to antiepileptic drugs.
Your health care provider may advise that your baby be given Vitamin K when born or advise you to take it in your last month of pregnancy. This can help prevent bleeding problems, which are a rare occurrence but have been found in some infants born to people with epilepsy.
Extra appointments and scans to monitor your baby’s development, as well as blood tests to monitor your anti-seizure medication level, are advisable. Again, don’t stop taking medication or adjust the dose without talking to your doctor first. Uncontrolled seizures could be a higher risk than your medication.
Make healthy lifestyle choices, such as getting enough sleep, avoiding caffeine and alcohol, taking prenatal vitamins and avoiding known seizure triggers.
The most important thing to do is talk to your neurologist and make sure you have accurate information about your specific medical circumstances prior to and during pregnancy.
At the end of the day there are lots of women who have epilepsy who give birth to healthy, happy babies. Wanda, who we mentioned earlier, suffers from focal seizures and gave birth to a beautiful little girl. She talked to us about her experience, you can listen here: Wanda’s Story
If you are worried about pregnancy with epilepsy you can find support and answers to questions on this subject and many more in our Facebook Support Group. We encourage you to join.
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