Women, Pregnancy, and Epilepsy
If you have epilepsy and are thinking about getting pregnant, you probably have some important questions. Is it safe for me to get pregnant? Will having epilepsy make it harder for me to conceive? If I do get pregnant, how will I manage my seizures while I'm expecting? Could my antiseizure drugs harm my baby?
Fortunately, most women with epilepsy give birth to normal, healthy babies, if you take precautions, your chance of having a healthy child is greater than 90%.
"There are increased risks, but these risks can be minimized by working carefully with your doctor. Don't let these risks keep you from having a family if that's what you really want," says epilepsy expert Mark Yerby, MD, MPH, associate clinical professor of neurology, public health, and preventive medicine, Oregon Health Sciences University in Portland.
Before you try to conceive, you should talk to your neurologist and your obstetrician. Most doctors recommend that women with epilepsy be cared for by a high-risk obstetrician during their pregnancy. Both will want to monitor you closely throughout.
Getting Pregnant With Epilepsy
It's possible that having epilepsy may make it more difficult for you to get pregnant. Women with epilepsy have fewer children than women in general. Their fertility rate is between 25% and 33% lower than average. Why is this? Here are some possible reasons:
- Women with epilepsy have higher rates of some conditions that can cause infertility. One of these is polycystic ovarian syndrome (PCOS).
- Women with epilepsy are more likely to have irregular menstrual cycles, which can make it more difficult to get pregnant.
- Women with epilepsy are also more likely to have menstrual cycles that do not produce an egg. These are called anovulatory cycles.
- Some antiseizure drugs may affect the hormone levels in your ovaries, which can affect reproductive functioning.
- Women with epilepsy are more likely to have abnormalities in hormones involved in pregnancy.
If your seizures are not under control, that may affect your fertility, as well. Experts say that if a woman is having seizures around the time her body is preparing to ovulate, they may disrupt the signals that make that process occur.
Once you become pregnant, it will be even more important to control your seizures. Having seizures during pregnancy can affect of the health of your baby. You might fall, or the baby may be deprived of oxygen during the seizure, which can injure the baby and increase your risk of miscarriage or stillbirth.
Unfortunately, some of the most common drugs for controlling seizures have been found to increase the risk of birth defects. In the general population there is a 2%-3% chance that a child will have a birth defect. In women with epilepsy, this risk goes up to 4%-8%.
To help decrease the chance of birth defects, especially neural tube defects that can affect the brain and spinal cord, women with epilepsy should take at least 0.4 milligrams per day of folic acidsupplements, before they try to conceive.