You were probably diagnosed with epilepsy before you became pregnant. This condition causes seizures and these can affect the whole body with shaking and tongue biting or only affect particular parts of the body such as losing awareness and staring into space. Ideally you will have been offered pre-conception counselling to optimise your health before pregnancy.
What does this mean?
For Me
Pregnancy can lower the threshold for seizures to occur so it is important that you have care under an obstetrician specialising in medical conditions and a neurologist. You will be asked to take 5mg folic acid (ideally for three months prior to your pregnancy) to reduce the risk of disorders like spina bifida for the baby and you might need to increase your medication during pregnancy or take extra medications around the time of the birth.
For my baby
The medication called sodium valproate should not be taken in pregnancy but the other commonly used anti-epilepsy drugs are all safe to be used in pregnancy. It is really important that your epilepsy is treated effectively as frequent seizures in pregnancy can affect the baby’s growth.
What will the medical team recommend?
You may need extra blood tests to check the level of your anti-epileptic drug in your blood and to ensure you don’t need more. You will be recommended to take 5mg of folic acid to reduce the chances of your baby having a spine abnormality. You may be offered extra scans to check your baby’s growth.
What are the ‘red flag’ symptoms/concerns, which means that they should be reported immediately?
You must tell your medical team immediately if you have any seizures in your pregnancy so that they can ensure you are on the right level of treatment and organise tests to check your baby’s wellbeing.
Your partner and close family should be shown how to place you in a recovery position if you have a seizure.
The risk of seizures is greatest around the time of the birth and in the first 24 hours after the birth.
Likely recommendations
Treatment options
It is normally recommended that you stay on the same medication that you are on at the beginning of your pregnancy (but not sodium valproate) but you may need to increase the dose or add in other medication to control your epilepsy in your pregnancy. This is particularly important around the time you give birth when your sleep may be disrupted which can also increase the chance of having seizures.
Timing of birth
Normally the timing of birth is not affected by your epilepsy. Your medical team may recommend having an epidural for pain relief in your labour so that you can rest and reduce your risk of becoming excessively tired.
How may this impact my birth choices?
It is likely your team will recommend you give birth in the hospital and in a birth setting where doctors are readily available, such as the labour ward, in case you have a seizure during or immediately after your labour. It is recommended not to labour in water in case you have a seizure.
How may this affect care after the birth?
It is really important that you follow normal epilepsy advice such as taking showers instead of baths. Additionally, you will be advised not to change your baby’s nappy on a high surface but to use a change mat on the floor. There are lots of other helpful tips available from the links below.
