Epilepsy is a relatively common condition. Most women who have epilepsy remain free of seizures throughout pregnancy and they have straightforward pregnancies and healthy babies. It is important to continue taking your medication because having frequent seizures during pregnancy can be harmful for you and your baby. Therefore, planning your pregnancy and having extra care during your pregnancy can reduce the risks to you and your baby.
With any pregnancy there is a small chance that your baby may not develop normally in the womb. The risk of this happening may be slightly higher with some of the anti-seizure medications. The risk of harm to your baby is higher with sodium valproate than other medications (for more information on risk- please click here). The most commonly used drugs for epilepsy (lamotrigine and carbemazapine) have lower risks than sodium valproate- if you take these medications there will be similar risks to not taking medication at all for epilepsy. The most common problems for your baby linked to these medications include spina bifida, facial cleft or heart abnormalities.
If you are planning a pregnancy, it is important to discuss the safety of your antiseizure medication with your GP or epilepsy specialist. Your GP or epilepsy specialist can help you decide which medication will be best for you, dependent on the type and severity of your seizures. We would advise you not to stop any medication without medical advice from your GP/ epilepsy specialist or obstetrician (a doctor who specialises in pregnancy and birth).
If you're taking antiseizure medication, you will need to take 5 milligrams (5mg) of folic acid once a day as soon as you start trying for a baby and for the first three months of pregnancy. This is to help your baby's brain, skull and spinal cord develop normally and help avoid development problems such as spina bifida. This will need to be prescribed for you, usually by your GP, as it is a higher dose than normal. Over the counter pregnancy supplements do not contain enough folic acid so it’s important to get the correct dose prescribed, ideally before you to try to conceive.
A specific epilepsy in pregnancy tool kit has been designed to provide a summary of your epilepsy, treatment, management and recommendations. Please download, print, complete and we can scan this into your badger notes. The link for this toolkit and further advice for women with epilepsy can be found by clicking here.
Your midwife will discuss your medical history with you at your booking appointment. They will then discuss with you whether you require care that is shared between you, your midwife and the obstetric team (Doctors who specialise in care during pregnancy and birth).
It's difficult to predict how pregnancy will affect epilepsy. For some women their epilepsy symptoms stay the same, while others may see an improvement in their condition. For some women their epilepsy can become less controlled leading to more frequent or more severe seizures. This can be due to the effect of hormones on antiseizure medication levels, or triggers such as missed doses of medicines, not getting enough sleep or being physically or emotionally stressed.
If you have a complex disease you will be taken care of by a team of specialist doctors that may include specialist midwives, obstetricians, anaesthetists and disease specific clinicians (this will include the team who care for you out of pregnancy). The suite of doctors will provide tailored and specialist care throughout your pregnancy to discuss with you how pregnancy may be affected by your medical condition.
If there is a change in your seizure control, it is essential that you let your doctor, midwife or epilepsy specialist know, urgently.
After pregnancy and birth you care will return to your GP and/or Specialist for management of your condition. Please confirm with your GP/ Specialist before starting or stopping any medication post pregnancy.
For more information on what to expect during pregnancy, labour and postnatal period. Epilepsy in pregnancy | RCOG
You can also use the EpSMon app to self-monitor any seizure activity. For further information Epilepsy safety - SUDEP Action
Both Epilepsy Action Home - Epilepsy Action and the Epilepsy Society Epilepsy Society | Transforming lives through advocacy, research and care detail information on pregnancy and epilepsy as well as links to support groups and forums for those living with epilepsy.
For the NHS choices website information on epilepsy Epilepsy and pregnancy - NHS (www.nhs.uk)
