Epilepsy and Pregnancy: Labor and Delivery In Females With Epilepsy

Epilepsy is a chronic disease characterized by recurrent, unpredictable seizures. A seizure is a temporary dysfunction of the brain, which occurs due to excessive electrical discharge from the neurons.

If suffering from epilepsy, then becoming pregnant is risky. It raises special concerns. Most pregnant females who have epilepsy deliver healthy babies while some might need special care.

How Does Epilepsy Affect The Baby?

The type of seizures causes different degrees of complications. Partial or absence seizures cause minimal risk.

Tonic and grand mall seizure increases the risk to the mother and the baby. During this seizure, there is a temporary interruption of breathing which can deprive the oxygen to the baby. This slows down the heart rate for about 30 minutes. This type of seizure also increases the risk of trauma to the baby. The greatest risk of these seizures is during the last trimester of pregnancy when the baby’s brain is larger and needs more oxygen.

Seizures during pregnancy can lead to the following effects:

  • Slowing of the fetal heart rate
  • A decrease in oxygen to the fetus
  • Preterm labor
  • Premature birth
  • Fetal injury
  • Premature separation of the placenta from the uterus
  • Miscarriage

Babies born to mothers who have epilepsy have a higher chance of developing seizures as they get older.

Does Epilepsy Change During Pregnancy?

Bodies of different females react differently during pregnancy. Some who had epilepsy the seizures remain the same while in some they might become less frequent. Also, it is seen, if some females do not take the medications regularly, pregnancy increases the number of seizures.

There can be an increase in seizures during pregnancy in some, which can be due to anticonvulsant medications. Anticonvulsant medicines tend to work differently during pregnancy because of which the doctor needs to change the medication in pregnant females.

Also sometimes due to nausea the medicine is thrown up, before being properly absorbed by the body.

Effect of Anticonvulsant Medicines During Pregnancy

A major concern of using anticonvulsant medicines in expecting mothers suffering from epilepsy is that the baby can be born with a birth defect (1)

A female suffering from epilepsy has a 4-6% chance of having a baby born with a birth defect because of taking anticonvulsant drugs (2)

The birth defects can be mild such as small fingers and toenails or can be major defects such as spina bifida, cleft lip, neural tube defects, and heart abnormalities.

It is important to get a doctor’s advice on anticonvulsant medicine when trying to get pregnant. He might adjust the dosage or prescribe a safer drug. Never stop taking the medicine without the doctor’s advice.

For most females with epilepsy, it is best to continue to the treatment during pregnancy to minimize the risk to the baby and herself.

How to Prepare For Pregnancy If Suffering From Epilepsy?

Those suffering from epilepsy before trying to conceive should schedule an appointment with the healthcare professional. They can evaluate epilepsy and consider treatment changes that might be needed.

Some drugs which are used for the treatment of epilepsy often contribute to infertility and some might reduce the effectiveness of hormonal birth control methods.

If suffering from frequent epilepsy, wait until epilepsy gets better or controlled.

Taking the epilepsy medication as advised is very important. No changes should be made on own, or without consulting the doctor.

Some lifestyle changes that should be taken up are:

The healthcare provider might also recommend a high dose of folic acid. Folic acid help prevents neural tube defect, brain, and spinal cord abnormality and increases the baby’s health. Ideally, folic acid is started three months prior to conception.

Labor and Delivery In Females With Epilepsy

Most of the pregnant females suffering from epilepsy deliver the baby without any complications.

Seizures do not occur in labor but if it does it can be stopped with anti-seizure medicine. In case of prolonged seizures, the baby is delivered with C-section.

If the anti-seizure medicine levels are altered during pregnancy, consult your doctor to return to the previous dosage post-pregnancy to keep the seizures under control.
It is very important for the mother to remain stress-free, get plenty of rest, and take her medications as prescribed by the doctor. Friends and family are of great help during the post-partum days to reduce stress.

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