What are the risks during pregnancy if you have epilepsy?

Published: April 22, 2021 | Updated: September 28, 2023

If you have epilepsy, but are thinking of getting pregnant, you may have questions about how epilepsy affects pregnancy or a fetus. Epilepsy affects each person differently, based on medication, hormones, and other factors. Here are some things to know if you have epilepsy and want to have a baby.

Epilepsy is an umbrella term for a group of seizure disorders. A brain condition, epilepsy is sometimes the result of a brain injury or a family predisposition, but often there is no known cause.

Is it safe for someone with epilepsy to get pregnant?

Most women with epilepsy have normal, healthy babies. However, there are several factors that may make it more difficult to conceive including:

• Women with epilepsy have higher rates of some conditions that can cause infertility including polycystic ovary syndrome (PCOS).
• Women with epilepsy are more likely to have irregular menstrual cycles or cycles where no egg is released (anovulation), which can make it more difficult to get pregnant.
• Anti-seizure medicine and other 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.

What are some things I can do when trying to get pregnant?

Talk with your doctor about the medications you are taking for your epilepsy. Some drugs used to treat seizures may contribute to infertility, but some may reduce the effectiveness of hormonal birth control methods such as the pill. Take care of your general health with a balanced diet and exercise, as directed by your doctor.

What are the risks?

Any medication taken during pregnancy can affect the baby. Anti-seizure medication has been linked to birth defects, including cleft palate, neural tube defects, skeletal abnormality and congenital heart defects. Some studies suggest that the risk increases with higher doses of medication or when taking multiple anti-seizure medications.

Seizures during pregnancy can result in:

• Slowing of fetal heart rate
• Decreased oxygen to the fetus
• Fetal injury, including separation of the placenta from the uterus, or miscarriage from trauma (such as a fall during a seizure)
• Preterm labor
• Premature birth

Talk to your doctor about changing medications if you wish to become pregnant. Try to do it at least a year in advance so you have time to let your body adjust and see if the new medicine works well for you.

Epilepsy during labor and delivery

The most important thing is to work closely with your doctor and care team before and during pregnancy so you can minimize potential risks to your health and the health of your baby.

During labor and delivery, you may be afraid of having a seizure. While it is a possibility, the doctor will be aware of your condition and can give you IV anti-seizure medication. Or you may have a planned cesarean section (C-section).

The risks of pregnancy with epilepsy may sound overwhelming, but remember that the vast majority of women with epilepsy have uneventful pregnancies and normal, healthy babies. It is important to know the risks, follow your doctors’ guidelines and take care of yourself.