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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.
Seizure triggers such as stress, tiredness, and hormonal changes are naturally more common during pregnancy, making specialised care more important than ever.
In light of this, the NHS have announced new clinical standards for maternity services in England, which will be of great benefit to women with epilepsy. By March 2027, women with epilepsy will gain access to local specialist teams offering expert guidance on managing epilepsy safely during pregnancy.
Beyond expert advice, these specialist teams will also assist women with epilepsy by offering tailored care plans and providing timely medication during their pregnancy.
These new standards are part of a larger plan to reduce maternal mortality. A report published by MBRRACE-UK revealed that epilepsy is associated with higher rates of maternal death. Epilepsy was highlighted alongside other important concerns, such as mental health, venous thromboembolism, pre-hospital and acute care, and obstetric haemorrhage.
The new clinical standards aim to address each of these areas through enhanced care. For example, as venous thromboembolism (blood clots) is the leading cause of maternal death, pregnant women will now be offered early risk assessments, even before their first antenatal appointment.
These improved standards are a huge step in the right direction, but your own involvement in working closely with your doctor remains essential in ensuring a healthy pregnancy.
If you have epilepsy and are planning a pregnancy, try to keep a detailed log of your seizures and potential triggers during the lead-up to your pregnancy. Such information can prove invaluable to your doctor, helping them provide accurate advice on minimising seizures and avoiding risks.
If you notice that your seizures become more frequent during pregnancy, reach out to your GP or doctor to explore further treatment options. By embracing these new clinical standards and maintaining open communication with your doctor, you can better protect both your health and your baby’s health.
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:
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