Women, Pregnancy, and Epilepsy
Prepare in Advance for Pregnancy With Epilepsy
Depending on what your doctor says about your epilepsy, you may want to change medications before you get pregnant, or it might be fine to stay with the one you are taking now. If you are taking more than one antiseizure drug, your doctor may recommend that you taper down to just one. That's because combinations of drugs to treat epilepsy have a higher risk of causing birth defects than just one drug alone.
If you are making any changes in your antiseizure medications at all, you should do that at least a year before getting pregnant. Switching medications has risks, too. You may not respond well to the new drug and have breakthrough seizures, which could be harmful to a pregnancy. When changing medications, doctors will usually add the new drug before stopping the old one. If you become pregnant during this time, the baby could be exposed to both drugs instead of just one.
Whether you change seizure drugs or not, be sure to add folic acid to your daily schedule. Starting before you get pregnant, take prenatal vitamins with 0.4 milligrams of folic acid every day, and keep taking them throughout the pregnancy. Folic acid has been shown to reduce the risk of some birth defects by 60% to 70%. Because there are some extra risks associated with pregnancy when you have epilepsy, it's important to do everything you can to minimize those risks.
Epilepsy and Labor
Many women with epilepsy worry that they will have a seizure during labor. This is an understandable fear. As your pregnancy progresses, your metabolism changes. By the time you are nine months pregnant, the blood volume in your body is 50% greater than it was before you got pregnant. This means that the antiseizure medications in your body will be more diluted. That's why your doctor will be monitoring the levels of medication in your blood throughout your pregnancy, and might increase the dosage if it's getting too low.
So when labor starts, you may already be a little more vulnerable to a seizure. Then, you may miss a dose, because things don't always go exactly according to plan when a woman goes into labor. You will also be in pain and breathing hard, which can increase the chance of a seizure. This doesn't mean that seizures are common during labor and delivery, but they are a possibility.