Pregnancy Issues

'When a woman with epilepsy learns she is pregnant, she should notify her doctor immediately, but should never stop or alter her medication on her own.'

All women have a 2-3% risk of having a child with a birth defect. However, this risk is higher in women with epilepsy, estimated at 4-6%. Genetic factors and taking antiepileptic medications may both play a role in this risk.

The effects of medication on a developing child seem to occur mostly in the first few weeks of pregnancy, often before a woman knows she is pregnant.

Therefore, it is best for a woman with epilepsy to talk about these issues with her doctor before she becomes pregnant. This discussion should include her primary care physician, neurologist and obstetrician/gynecologist.

For some women planning to become pregnant, it may be appropriate to make changes in the medicine or to try to taper off medication if they have been doing well. However, this should be done only after careful discussion with their doctor.

Taking prenatal vitamins, especially folic acid, before and during pregnancy may decrease the risk of birth defects.

If a woman with epilepsy discovers she is pregnant, she should notify her doctor immediately, but should not stop or alter her medication on her own. Suddenly stopping epilepsy medication can cause frequent or severe seizures that can threaten her life or the continuation of the pregnancy. In most cases, it is unlikely that medications will be stopped.

During pregnancy, there are changes in the way a woman's body processes medication. For that reason, the dose may have to be closely monitored and frequently adjusted.

While pregnancy presents special concerns for women with epilepsy, more than 90% of those who become pregnant give birth to normal, healthy infants.