Epilepsy and pregnancy: What you need to know

If you have epilepsy becoming pregnant 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 raises special concerns. While most women who have epilepsy deliver healthy babies, you might need special care during your 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:

  • Slowing of the fetal heart rate
  • Decreased oxygen to the fetus
  • Fetal injury, premature separation of the placenta from the uterus (placental abruption) or miscarriage due to trauma, such as a fall, during a seizure
  • Preterm labor
  • Premature birth

Does epilepsy change during pregnancy?

All women's bodies react differently to pregnancy. 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?

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 a few potential side effects associated with anti-seizure medications. The risk seems to increase with higher doses and if you take more than one anti-seizure medication.

If you haven't had a seizure for nine months before you conceive, you're less likely to have a seizure during your pregnancy. If you haven't had a seizure for two to four years, you might be able to taper off medications before you conceive and see if you remain seizure-free. Talk to your health care provider before discontinuing your medications.

For most women, however, it's best to continue treatment during pregnancy. To minimize the risks for you and your baby, your doctor will prescribe the safest medication and dosage that's effective for your type of seizures and monitor your blood levels throughout your pregnancy.

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.

How should I 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 treatment changes you might need to make before pregnancy begins.

If you have frequent seizures before you conceive, you might be advised to wait to get pregnant until your epilepsy is better controlled.

Take your anti-seizure medication exactly as prescribed. Don't adjust the dose or stop taking the medication on your own. 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, illegal drugs and caffeine.
July 13, 2017 See more In-depth