Epilepsy And Pregnancy: What To Expect

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For women with epilepsy, the challenges of pregnancy and caring for a newborn go far beyond worrying about morning sickness, labor pains, late-night feedings and other typical concerns:

“Will my epilepsy medication affect my pregnancy?”

“Will my epilepsy cause complications during the birth?”

“Will my baby be at risk for birth defects?”

“Despite these very real concerns, the vast majority of women with epilepsy can expect to have a normal pregnancy and labor and give birth to healthy babies,” says Marianna V. Spanaki-Varelas, M.D., Ph.D., MBA, a Henry Ford neurologist who specializes in epilepsy treatment.

Pregnancy and seizures

“Only one-third of women with epilepsy experience an increase in seizure frequency,” Dr. Spanaki-Varelas says.

Fluctuations in reproductive hormones can magnify the effects of epilepsy. Although this link is not clearly understood, it appears that estrogen and progesterone may act on some of the same areas of the brain where seizures can begin.

Increased seizure activity may also be attributed to common side effects of pregnancy such as sleep deprivation, which is a known seizure trigger, and morning sickness, which may remove your anti-seizure drugs from your body before the medication has had a chance to work properly.

Epilepsy and pregnancy: Make a plan

As with other chronic conditions such as diabetes and high blood pressure, it is best to consult with your doctor before, during and after your pregnancy. Together, you can create a plan that takes into account your medical history and specific reproductive needs.

“Women with epilepsy can take several steps in consultation with their doctor to help create the best possible pregnancy experience,” Dr. Spanaki-Varelas says.

These include:

  • Manage your epilepsy. Follow these 10 life hacks to help control your epilepsy.
  • Have regular follow-ups with your neurologist before you become pregnant and during pregnancy. Certain anti-seizure drugs can affect the birth control pill, increasing the risk for an unplanned pregnancy. You may need a higher dose of anti-seizure medication during pregnancy and frequent monitoring of the drug levels is recommended.
  • Take supplements. Your doctor should recommend that you start taking folic acid months before conception or other supplements to help reduce the risk of your baby developing certain birth defects due to anti-seizure medication.
  • Communicate. Be sure to inform your doctor if you experience any changes in your seizure activity during pregnancy.
  • Stay healthy. It is important for women with epilepsy to be in good general health before pregnancy by having good nutrition, getting enough sleep and exercise, and minimizing stress.
  • Remain positive. Your pregnancy should be a source of excitement, so remind yourself of this throughout your planning and pregnancy, to help keep your stress levels in check.
  • Be prepared for seizures. Most seizures are not harmful to your unborn baby. However, falling or injuring yourself during a seizure could increase the risk to both of you. Make sure that your loved ones know how to administer seizure first aid.

How does epilepsy affect labor?

In some cases, there might be an increased risk of seizure during the stress of labor, and drugs can be safely administered to help control this. You may also have an increased risk for experiencing certain conditions such as premature labor, postpartum hemorrhage and eclampsia. Epilepsy and anti-seizure medication use are not reasons for a cesarean delivery. Prior communication of your OB/GYN team with your neurologist is important.

Is breastfeeding ok for moms with epilepsy?

With most anti-seizure medications, breastfeeding is encouraged. Again, talk to your doctor about your specific medications and if there are any concerns you need to know about.

Postnatal safety – Protecting your newborn

If your seizures come on quickly or without any recognizable triggers, follow these steps when caring for your baby:

  • Get down on the floor. Change your baby’s diapers and clothes on the floor. This will help prevent your baby falling off changing tables or beds if you have a seizure.
  • Feed your baby there, too. Whether you breastfeed or use formula, you should feed your baby while you sit on the floor to keep your baby safer.
  • Stick to sponge baths. Avoid the tub and wash your baby on a foam mat on the floor.
  • Use a baby sling. Carrying your baby in a sling rather than in your arms may provide some protection if you have a seizure and fall.
  • Tether yourself to your baby’s stroller. Attach a wrist strap to your baby’s stroller to keep it from rolling away if you let it go during a seizure.

Marianna V. Spanaki-Varelas, M.D., Ph.D., MBA, is a neurologist who sees patients at Henry Ford Hospital in Detroit and Henry Ford West Bloomfield Hospital.

For an appointment, visit henryford.com or call 1-800-HENRYFORD (436-7936). Learn more about epilepsy treatment at Henry Ford.

Categories: FeelWell