Most women with epilepsy do not experience any problems becoming pregnant and have healthy babies. Although seizure medications carry a small risk of causing birth defects, choosing the right medication and having regular checkups during pregnancy can keep that risk to a minimum.
Also, since having seizures during pregnancy can affect the baby, it’s important for women with epilepsy to keep seizures controlled during pregnancy by taking the correct dose of their medication.
Before you become pregnant
Before you become pregnant, talk with your doctor about your epilepsy treatment.
In general, the recommendation is to only use one medicine for epilepsy and to use it at the lowest possible dose needed to prevent seizures. Having seizures during pregnancy can carry much higher risk to the baby than the seizure medicines themselves.
If you are not yet pregnant but are planning to become pregnant, stopping medicine might be an option if you have been seizure-free for several years. Your doctor may suggest a trial run without the medicine before you become pregnant. Experts recommend that this trial run take place at least 6 months before the pregnancy so that you and your doctor can see the results of stopping your treatment. If you begin having seizures, you may need to go back on medicine.
While you are pregnant
If you need to stay on medicine during your pregnancy, your doctor may make recommendations to reduce the risk of birth defects and make sure your seizures are well controlled throughout your pregnancy. These may include:
- Having monthly blood tests to make sure you have the right levels of seizure medicine in your body
- Taking folic acidwhich has been shown to reduce the risk of some birth defects
You may put yourself and your baby at greater risk if you change, reduce or stop taking your medicine while you are pregnant. Talk with your doctor first.
During your pregnancy, you may need more frequent checkups to monitor the baby’s condition and blood tests to monitor your drug levels.
After your baby is born, he or she may need to take extra vitamin K for a short period of time. (Some antiepileptic medicines can cause a temporary blood disorder in newborns that makes it difficult for their blood to clot normally. Vitamin K can help reverse this problem.) Your doctor may recommend that you take vitamin K during your pregnancy.
Breastfeeding while you are taking antiepileptic medicine is usually safe. But talk to your doctor about any concerns you have. If you are taking a barbiturate (such as phenobarbital) to control your seizures, breastfeeding may make the baby drowsy or irritable, because the drug may get into your breast milk. However, for most seizure medications, only a fraction of the medication enters breast milk and the benefits of breastfeeding far outweigh any potential risk.
If you have epilepsy and find out that you are pregnant, consult your doctor immediately. Do not stop taking your medicine without first talking to your doctor.
Epilepsy is a stressful condition that can lead to anxiety, stress and depression in those who have it. If you know someone with the disorder, offer your support. “There’s so much stigma attached to epilepsy, but it doesn’t have to be that way,” said Suzette LaRoche, MD. “With the right treatment, those who have it can live happy, healthy lives.”
Reviewed by Suzette LaRoche, MD, a neurologist and epileptologist at Mission Health Neurology. This information is based on guidelines from the American Academy of Neurology.