When someone with epilepsy is doing some family planning, one of the first questions they usually ask is whether or not pregnancy is possible. The simplest answer is that while it is entirely possible, and that (as Dr. Ahmed Sadek writes) “most women with epilepsy go on to have healthy babies,” there are some unique challenges.
Planning is Key
As Dr. Sadek continued, one of the most essential steps to a healthy and successful pregnancy is to be sure that you do a lot of planning long before becoming pregnant. There are few things to consider as you make your plans:
- Medications – Most women with epilepsy cannot simply halt their usage in order to become pregnant and protect the fetus from risks associated with medications. Though the risks of fetal malformation are very small (between 4 and 6 percent), they exist. And if a woman is taking several medications to control seizure activity the risks may increase.
- Supplementation – In addition to considering how to address the use of anti-seizure medications, most women will want to consider the right supplements to help offset risks due to medication. Folic acid is always supplied to pregnant women as it helps eliminate or reduce risks of birth defects. Other prenatal supplements along with folic acid are essential considerations for the pregnant woman living with epilepsy.
- Specialization – There are epilepsy specialists capable of helping with the planning process and with pregnancy. They are able to evaluate the medication regimen the woman uses and then help to maintain the ideal regimen to improve chances for conception and a healthy pregnancy. Dr. Sadek also suggests consulting with a “high-risk obstetrician” throughout pregnancy in order to keep a sharp eye on the baby’s health.
- Seizure control – It is very tempting for some women to just set aside their medication regimens, but this is unsafe. As Dr. Sadek explains, “it could result in an increased risk of seizure and injury during pregnancy. Most women continue to have the same level of seizure control throughout the pregnancy as they did before pregnancy. However, sometimes medication levels will drop during pregnancy because of changes in hormone levels. This is why it is very important to see your epilepsy specialist often during your pregnancy and get your medication levels checked regularly.”
Post-pregnancy, there are still some issues to consider. Breastfeeding is another of them, and the benefits that a newborn gains from being breastfed are considered higher than any concerns about the use of anti-seizure medications while breastfeeding. As Dr. Sadek explains, a “baby may receive some medication through breastmilk, this is typically a much smaller amount the baby received inside the womb. In general, it is felt that the great benefits of breast milk outweigh any potential risks.”
Breastfeeding is another issue to discuss with the epilepsy specialist and high-risk obstetrician as you make plans for becoming pregnant, make your way through a pregnancy, and even after the child is born.
The key, though, is planning. Chances for becoming pregnant and maintaining a healthy pregnancy and delivering a child free of birth defect all increase when a mother with epilepsy plans her entire pregnancy with the support of medical experts.
Epilepsy can make it a bit more difficult to become pregnant, and yet others may actually reduce hormonal birth control methods like “the pill.” Epilepsy may have some impacts on the pregnant mother and fetus. For example, it can cause a slow fetal heart rate and reduced oxygen. A seizure can cause fetal injury, which is why medication must be maintained. There are also risks of premature birth and labor.
The good news is that planning and working alongside experts can guarantee the best results.