Many women dream of someday having children and starting their own family. For some, however, their medical history can complicate their vision of what they think motherhood should look like. This can be especially true for women with epilepsy who want to have children. The good news is that most women with epilepsy are able to have successful pregnancies and deliver healthy babies. In fact, Web MD notes that the chances of an epileptic mother having a healthy baby are around 90%. With that being said, however, there are still some things that you will need to take into account if you have epilepsy and are considering becoming pregnant. Here are seven things to consider about epilepsy and pregnancy:
You may need to take certain steps before becoming pregnant.
Many women with epilepsy begin their pregnancy journey before they are actually pregnant. This is because you may need to make adjustments to your medication to ensure that you are using the safest medication and dosage for your baby. Certain anti-epileptic medications, such as topiramate (Topamax), valproic acid (Depakote), phenobarbital, and phenytoin, can slightly increase the risk of birth defects in some women, so you should discuss getting pregnant with your neurologist so that they can help you make the best decision for your health and the health of your baby. Your neurologist may also take a blood test before you get pregnant to determine how much medication is in your blood. This measurement is then used as a benchmark to keep your medication stable during your pregnancy.
You may need to take more folic acid than other pregnant women.
Folic acid is an essential vitamin used to prevent neural tube defects and abnormalities in the brain and spinal cord. Certain types of anti-seizure medications can affect how the body uses folic acid. Because of this, your doctor may recommend taking a high-dose folic acid supplement to decrease the risk of neural tube defects and abnormalities in the brain and spinal cord. In most cases, it is recommended that women trying to conceive should start taking folic acid about 3 months before conception since most women won’t know they are pregnant until after the neural tube has already developed.
It is rare to pass epilepsy to your child.
Although epilepsy can have a genetic component, it is actually quite rare for a parent to pass epilepsy down to their child. The general population has a 1% risk of having a child with epilepsy, while an epileptic mother has a 5% risk of having a child with epilepsy. Even if both the mother and father have epilepsy, it is still unlikely that you will have a child with epilepsy. With that being said, the chances of your child developing epilepsy can increase if your epilepsy was inherited. To know more about whether your epilepsy was inherited or not, you may need to speak with a genetic counselor.
The frequency of your seizures can change with pregnancy.
In most cases, you can expect to have about the same seizure frequency while pregnant and some women even experience less seizures while pregnant. Women who have been seizure-free for 9 months before their pregnancy are also more likely to remain seizure-free during pregnancy. On the other hand, however, the Epilepsy Foundation notes that around 15-30% of women have an increase in seizure frequency during pregnancy. When this happens, it is usually not due to your- epilepsy, but to other factors. Some reasons why you could have more seizures during pregnancy are: throwing up your medication before the body can absorb it, weight gain that changes the effectiveness of your medication, pregnancy stress can trigger seizures, and the physiological, hormonal, and psychological changes associated with pregnancy can trigger seizures or alter the way your body responds to your seizure medication.
You can have seizures during pregnancy and still deliver a healthy baby.
Some seizures can induce premature labor or cause a miscarriage, however most women who have seizures while pregnant are still able to deliver healthy babies. Currently, there is no research that suggests focal aware, focal impaired awareness, absence, or myoclonic seizures are harmful to an unborn baby. With that being said, seizures during pregnancy can still be dangerous, especially if they cause you to fall on your stomach. To minimize the risk of injuring the baby, you should discuss what to do during a seizure with your neurologist and OB/GYN. Overall, experts agree that the risk of uncontrollable seizures is more dangerous than the risks posed by seizure medications.
You may need to take vitamin K supplements.
In the case that you are taking your anti-seizure medications during pregnancy, your doctor may recommend that you take an oral vitamin K supplement during the last month of your pregnancy. Taking a vitamin K supplement helps to decrease the risk of bleeding problems in your baby after birth.
You can deliver any way you choose.
Just because you have epilepsy does not mean that you will automatically need to have a cesarean section. Like other women, you will have the option of delivering vaginally or through a cesarean section. In most cases, seizures do not often occur during labor and can usually be stopped with IV medications when they do occur. With that being said, you may still need to have a cesarean section if you are having constant and/or uncontrollable seizures while in labor or if there are other delivery complications that warrant a C-section. While you cannot always accurately predict whether or not you will have seizures during labor, women who have frequent seizures during the third trimester are more likely to have a seizure during delivery.
You can breastfeed.
Some new moms with epilepsy worry that they will be unable to breastfeed due to their medications. However since the baby has been exposed to these same drugs throughout the duration of your pregnancy, you can safely breastfeed them without having to worry. Still, many doctors recommend taking your seizure medications after feeding the baby in order to minimize the amount of mediation that is passed through the breastmilk.
Dr. Kashouty, a diplomate of the American Board of Psychiatry and Neurology (ABPN), practices general neurology with fellowship trained specialization in clinical neurophysiology. Dr. Kashouty finds the form and function of the nerves and muscles the most interesting part of neurology, which is what led him to specialize in neurophysiology with more emphasis on neuromuscular conditions. He treats all neurological diseases, but his main focus is to treat and manage headaches, movement disorders and neuromuscular diseases.
