Navigating Pregnancy With Epilepsy: What You Need To Know

Planning for a baby can be an exciting yet daunting journey for anyone, but for people with epilepsy, there may be additional risks involved. Understanding those potential risks and challenges is crucial for ensuring a safe and healthy pregnancy. With careful planning and support from medical professionals, most women with epilepsy successfully navigate pregnancy and deliver healthy babies. If you have epilepsy and are planning on having a baby in the future, or you are already pregnant, here is what you need to know.

Planning for Pregnancy

Managing your epilepsy while pregnant requires careful planning, with the help and support of a healthcare professional. In advance of your pregnancy, you can request preconception counselling with your GP or the healthcare professional who handles your epilepsy treatment. During this visit, your GP or doctor should discuss all the possible risks involved in pregnancy, as well as any needed changes to your epilepsy medication and its dosage.

Some types of anti-seizure medication carry a high risk of harm to your baby. These include valproic acid, carbamazepine, phenobarbital, phenytoin and sodium valproate.

Doctors recommend having your ASM levels checked as soon as you find out you are pregnant and then every four weeks throughout the pregnancy.

Sodium Valproate

Sodium valproate is widely used as an effective way to treat and control all types of seizures in people with epilepsy. However, studies show that women who take valproate while pregnant face a higher chance of their child being born with birth defects, such as spina bifida, facial and skull malformations and malformations of the limbs and certain organs. The use of sodium valproate during pregnancy is also associated with developmental disorders in children.

As a result, any use of valproate in women and girls must adhere to the Pregnancy Prevention Programme, as mandated in 2018. The intention behind this is to ensure that patients are well-informed about the risks involved and the importance of preventing pregnancy under the use of Sodium valproate.

If you are currently using Sodium valproate, your GP or doctor may recommend switching to a safer alternative such as lamotrigine or levetiracetam. It can take several months to adjust to new medication, so you should speak to your healthcare provider about this well in advance of pregnancy.

If you are pregnant and currently taking Sodium valproate, do not stop taking your medication. Seek immediate advice from your doctor before making any changes to your medication. Stopping your treatment could lead to a seizure, which may affect your health or the health of your baby.

Epilepsy and Fertility

Research indicates that there is no correlation between epilepsy and fertility. People with epilepsy have the same likelihood of getting pregnant as people without epilepsy.

However, some types of epilepsy medications affect the breakdown of hormones in the body. Depending on the medication, this could either make it difficult to get pregnant or lower the contraceptive efficacy. If you’re worried about your medication affecting either of these areas, talk to your doctor or GP about making changes to your medication.

The Effect of Pregnancy on Epilepsy

Epilepsy differs from person to person, and so the effects of epilepsy during pregnancy can vary from one woman to another. For many, their epilepsy does not change during pregnancy. Others, though, have reported a change in the frequency of their seizures. Seizure activity rises for about one-third of women with epilepsy during pregnancy. Common seizure triggers include stress, tiredness and hormonal changes, all of which are more likely when pregnant.

Leading up to your pregnancy, try to keep track of your seizures and anything that might trigger them. Share this information with your doctor, they can give you advice on dealing with your triggers or help you find ways to avoid them altogether.

If your seizures become more heightened during your pregnancy, contact your GP or doctor to discuss further treatment options.

Other Ways to Encourage a Healthy Pregnancy

You can prepare for a safe and healthy pregnancy by making simple lifestyle changes.

• Start taking folic acid supplements.** Folic acid helps prevent birth defects and plays a role in developing red blood cells. For the best results, it is suggested that you start taking folic acid as soon as you start trying for a baby, and continue for the first 12 weeks of pregnancy.
• You can also increase your chances of a safe pregnancy by maintaining a healthy diet.** Eating well can reduce many of the risks involved during pregnancy, such as high blood pressure and gestational diabetes. A good diet has also been linked to a lower likelihood of birth defects and contributes to the long-term health of a baby.**Consult your GP or doctor before making any major changes to your diet or taking new supplements.
• Aim to get enough sleep during your pregnancy. Adequate sleep is vital in ensuring our bodies and brains function smoothly. This is even more important during pregnancy when the body undergoes many physical and hormonal changes. Adjusting your sleeping position and going to bed at the same time each night can help relieve sleep problems during pregnancy.

Navigating pregnancy while managing epilepsy can be challenging, but by understanding the risks involved and taking proactive steps to manage your condition, you can have a safe and healthy pregnancy. It is also important to communicate openly with your doctor or GP, as they can provide personalised guidance tailored to your specific needs.

We’ve gathered some links to resources where you can get more help and information on this topic:

• Epilepsy and pregnancy (NHS)
• Pregnancy & Seizures (Epilepsy Foundation)
• Pregnancy and epilepsy (Epilepsy Society)