Do I need more folic acid than other pregnant women do?
Folic acid helps prevent neural tube defects, serious abnormalities of the brain and spinal cord. Because some seizure drugs affect the way the body uses folic acid, your health care provider might recommend a high-dose folic acid supplement — ideally starting three months before conception.
What can I expect during prenatal visits?
During pregnancy, you'll see your health care provider often. Your weight and blood pressure will be checked at every visit, and you might need frequent blood tests to monitor your medication levels. If you're taking anti-seizure medications, your health care provider might recommend oral vitamin K supplements during the last month of pregnancy to help prevent bleeding problems in the baby after birth.
What if I have a seizure when I'm pregnant?
Seizures can be dangerous, but many mothers who have seizures during pregnancy deliver healthy babies. Report the seizure promptly to your health care provider. He or she might adjust your medication to help prevent other seizures. If you have a seizure in the last few months of your pregnancy, your health care provider might monitor your baby at the hospital or clinic.
How can I make sure my baby is OK?
Your health care provider will closely monitor your baby's health throughout the pregnancy. Frequent ultrasounds might be used to track your baby's growth and development. Your health care provider might recommend other prenatal tests, depending on the circumstances. What you find out might help you understand the odds and make important decisions about your pregnancy.
What about labor and delivery?
Most pregnant women who have epilepsy deliver their babies without complications. Women who have epilepsy might use the same methods of pain relief during labor and delivery as other pregnant women.
Seizures don't commonly occur during labor. If you do have a seizure during labor, it might be stopped with intravenous medication. If the seizure is prolonged, your health care provider might deliver the baby by C-section. If you have frequent seizures during your third trimester, your health care provider might recommend an elective C-section to avoid the risk of a seizure during labor.
If your anti-seizure medication dosage is altered for pregnancy, talk to your health care provider about returning to your pre-pregnancy levels shortly after delivery to continue keeping your seizures under control and your medication at safe levels.
Will I be able to breast-feed my baby?
Breast-feeding is encouraged for most women who have epilepsy, even those who take anti-seizure medication. Discuss any adjustments you'll need to make with your health care provider ahead of time. Sometimes a change in medication is recommended.
July 19, 2014
See more In-depth
- Risks during pregnancy. Epilepsy Foundation. http://www.epilepsy.com/learn/impact/reproductive-risks/risks-during-pregnancy. Accessed May 20, 2014.
- Frequently asked questions. Pregnancy FAQ129. Seizure disorders in pregnancy. American College of Obstetricians and Gynecologists. http://www.acog.org/~/media/For%20Patients/faq129.pdf?dmc=1&ts=20140521T1342401418. Accessed May 21, 2014.
- Kuczkowski KM. Labor analgesia for the parturient with neurological disease: What does an obstetrician need to know? Archives of Gynecology and Obstetrics. 2006;274:41.
- Schachter SC. Management of epilepsy and pregnancy. http://www.uptodate.com/home. Accessed May 21, 2014.
- Schachter SC. Risks associated with epilepsy and pregnancy. http://www.uptodate.com/home. Accessed May 21, 2014.
- Sukumaran SC, et al. Polytherapy increases the risk of infertility in women with epilepsy. Neurology. 2010;75:1351.
- Sethi NK, et al. Pregnancy and epilepsy — When you're managing both. The Journal of Family Practice. 2010;59:675.
- Meador KJ, et al. Effects of breastfeeding in women taking antiepileptic drugs. Neurology. 2010;75:1954.
- Harden CL, et al. Management issues for women with epilepsy — Focus on pregnancy (an evidence-based review): III. Vitamin K, folic acid, blood levels, and breast-feeding: Report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Epilepsia. 2009;50:1247.
- Harden CL, et al. Management issues for women with epilepsy — Focus on pregnancy (an evidence-based review): II. Teratogenesis and perinatal outcomes: Report of the Quality Standards Subcommittee and Therapeutics and Technology Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Epilepsia. 2009;50:1237.
- Harden CL, et al. Management issues for women with epilepsy — Focus on pregnancy (an evidence-based review): I. Obstetrical complications and change in seizure frequency: Report of the Quality Standards Subcommittee and Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology and the American Epilepsy Society. Epilepsia. 2009;50:1229.
- Nadebaum C, et al. Language skills of school-aged children prenatally exposed to antiepileptic drugs. Neurology. 2011;76:719.
- Borthen I, et al. Delivery outcome of women with epilepsy: A population-based cohort study. BJOG: An International Journal of Obstetrics and Gynaecology. 2010;117:1537.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. May 28, 2014.