Epilepsy and pregnancy: What you need to know

The combination of epilepsy and pregnancy might seem risky, but the odds are in your favor. Find out how to promote a healthy pregnancy.

By Mayo Clinic Staff

Epilepsy during pregnancy can pose some unique concerns. However, most women who have epilepsy deliver healthy babies. If you have epilepsy and are considering pregnancy, here's what you need to know.

Does epilepsy make it more difficult to conceive?

Some drugs used to treat seizures might contribute to infertility. However, certain anti-seizure medications can also reduce the effectiveness of hormonal birth control methods.

How does epilepsy affect pregnancy?

Seizures during pregnancy can cause:

  • Fetal heart rate deceleration
  • Fetal injury, premature separation of the placenta from the uterus (placental abruption) or miscarriage due to trauma experienced during a seizure
  • Preterm labor
  • Premature birth

Does epilepsy change during pregnancy?

Every woman reacts to pregnancy differently. For most pregnant women who have epilepsy, seizures remain the same. For a few, seizures become less frequent. For others, particularly women who are sleep deprived or don't take medication as prescribed, pregnancy increases the number of seizures.

What about medication?

Any medication you take during pregnancy can affect your baby. Birth defects — including cleft palate, neural tube defects, skeletal abnormalities, and congenital heart and urinary tract defects — are the primary concern with anti-seizure medications.

For babies whose mothers take anti-seizure medication, the risk of major birth defects is 4 to 6 percent — compared with 2 to 3 percent for all babies. The risk seems to be highest when more than one anti-seizure medication is taken and when a form of the anti-seizure medication valproate (Depacon, Depakote, Depakote ER, others) is used.

A few women can safely taper off their medication before pregnancy. For most women, however, it's best to continue treatment during pregnancy. To minimize the risks for you and your baby, your health care provider will prescribe the safest medication and dosage that's effective for your type of seizures.

What does my epilepsy mean for my baby?

Beyond the effects of medications, babies born to mothers who have epilepsy also have a slightly higher risk of developing seizures as they get older.

What should I do to prepare for pregnancy?

Before you try to conceive, schedule an appointment with the health care provider who'll be handling your pregnancy. Also meet with other members of your health care team, such as your family doctor or neurologist. They'll evaluate how well you're managing your epilepsy and consider any treatment changes you might need to make before pregnancy begins.

Take your anti-seizure medication exactly as prescribed. Don't adjust the dose or stop taking the medication on your own. Remember, uncontrolled seizures likely pose a greater risk to your baby than does any medication.

It's also important to make healthy lifestyle choices. For example:

  • Eat a healthy diet
  • Take prenatal vitamins
  • Get enough sleep
  • Avoid smoking, alcohol and illegal drugs
Jul. 19, 2014 See more In-depth