If you suffer from epilepsy, you’ll most likely be used to managing your seizures – but how does that change when you’re pregnant?
Epilepsy may be a condition you’ve lived with, and coped with, for many years. You’ll know what tends to cause your fits and which situations you can and can’t cope with. As long as you take your medication there is no reason why you’re pregnancy should be any different from another woman’s. But that doesn’t mean you might not be worried.
How is epilepsy managed during pregnancy?
Thankfully, most mums-to-be with epilepsy don’t experience an increase in seizures during pregnancy. If you’re taking epilepsy medicines when you become pregnant, you’ll most likely be advised to continue to do so during pregnancy.
‘Whether or not you’re using treatment to control your epilepsy, talk to your doctor if your seizures change,’ says Nicole Crosby-McKenna, women’s officer at Epilepsy Action. ‘You may be advised to take a higher dose of your epilepsy medicine or to start taking another epilepsy medicine.’
The type, dose and number of epilepsy medicines taken are important. ‘Taking sodium valproate is shown to carry a higher risk for your baby but this risk is related to dosage and the amount of drugs taken,’ says Nicole. ‘The medicines carbamazepine, lamotrigine and levetiracetam have been show to carry a lower risk.’
It can all be scary, but don’t stop taking your medication without talking to your doctor first as the risk of uncontrolled fits has to be balanced against the risk of harm to your baby.
How does epilepsy affect my baby?
Fortunately, your baby shouldn’t be harmed if you have a fit, but it does increase your risk of having an accident.
‘There’s a small risk of harm to you and your baby if you have frequent full (grand mal) seizures, or a very prolonged seizure,’ explains Nicole. ‘This is because the amount of oxygen in your body is reduced.’
There’s no reason why your baby shouldn’t be born completely healthily, but there are risks. Sadly, around one or two babies in every 100 who are born to an epileptic mum has a physical defect. As do one in every 25 babies born to mums who took epilepsy medicines during pregnancy.
Will my baby inherit epilepsy?
There isn’t a huge risk of your baby having epilepsy – around two to five in every 100 children born to parents with epilepsy will inherit the condition.
‘Each type of epilepsy has a different level of risk for being inherited, and some types seem to run in families,’ says Nicole. ‘However, even with the types of epilepsy that are most likely to be inherited, the risk that your baby will inherit it is thought to be less than 15 per cent.’
How will my care differ from other pregnant women?
There may be a few differences in your care, depending on the health of you and baby.
You should be referred to a midwife or obstetrician early in pregnancy and might also be referred to your epilepsy doctor or nurse.
‘The professionals should develop a shared care plan,’ Nicole says. ‘This will include information about your epilepsy, seizure type, future appointments and check-ups, as well as contact details of all your specialists.’ If your seizures increase, your doctor might decide to change your epilepsy treatment.
You will also have a foetal anomaly scan at around week 18-20, as there is a small increased risk of your baby having a malformation. You might also be offered another scan closer to your due date, depending on yours and your baby’s health. ‘You’ll be advised to give birth in an obstetric-led unit in hospital,’ Nicole explains. ‘This is to make sure that a doctor can care for you and your baby if you have a seizure during labour.’
Will it affect labour?
Chances are you’ll have a normal vaginal delivery, as the risk of having a seizure during labour is really small – just one or two epileptic women out of 100 will have a fit in labour. ‘You’ll need to take your medication as normal during labour,’ says Nicole. ‘If you’ve had a few seizures during your pregnancy, your doctor might prescribe an additional medication to further reduce your risk of having a seizure.’
You can use pain relief during labour including epidurals and TENS machines, but it’s generally advised to avoid pethidine as high doses of this pain killer have triggered seizures in some people.
As much as possible, stay calm and relax – try not to over-breathe during labour, particularly when using gas and air, as this can be a seizure trigger for some people.