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Epilepsy care before and during pregnancy

Planning on getting pregnant 

You will have discussions with a Neurologist or Epilepsy Nurse during hospital clinic appointments to review your epilepsy and your anti-epileptic medication before you get pregnant. Your health professional will advise whether you should continue to take your anti-epileptic medication or change to an alternative which carries a lower risk to your baby before you try to conceive. 

If your epilepsy isn't very well controlled and you are having seizures, health professionals will offer information and advice before you try for a baby. 

Contraception

Contraception is important if you want to avoid an unplanned pregnancy. Some anti-epileptic medication can cause some contraceptives to fail. Speak to your GP, Neurologist or Epilepsy Nurse to discuss what contraception method would suit you best. Find out more information about contraception and epilepsy on the Epilepsy Action website.

Folic acid

If you are planning on getting pregnant and have epilepsy, we recommend you take 5mg of folic acid supplements. This should be taken up to three months pre-pregnancy to reduce the risk of having a baby with neural tube defects or spina bifida.

Those who do not have epilepsy or are not taking anti-epileptic drugs should take the usual dose of 400 mcg of folic acid. Find out more information about folic supplements. 

Your care during pregnancy 

Contact your GP as soon as you find out you are pregnant. You will be referred to a midwife, obstetrician and epilepsy specialist. 

Most women with epilepsy have normal pregnancies and normal pregnancy outcomes. However, some women will continue to experience seizures whilst pregnant.

It is very important that you do not suddenly stop taking your anti-epileptic drugs as this could result in harm to you and your baby. 

During your clinic visit, the Neurologist or Epilepsy Nurse will review your anti-epileptic drugs, and may recommend that you stay on your current anti-epileptic drugs as the drug you are taking carries low risk in pregnancy.

If you find out you are pregnant without having received preconception counselling with your Neurologist or Epilepsy Nurse, it’s recommended that you:

  • Keep taking your anti-seizure medication
  • Ask your GP to prescribe folic supplements of 5mg per day. 

The risks associated with worsening of seizures can vary depending on type of epilepsy you have, how well or not your seizures were controlled before pregnancy, and which anti-epileptic drugs you take.

Useful advice to help reduce common epilepsy triggers

Some common triggers of epilepsy seizures are forgetting to take your anti-epileptic drugs and lack of sleep therefore: 

  • Use an alarm or pill box to help remember to take your anti-epileptic drugs 
  • If your pregnancy is causing you to be sick and that your not able to take your anti-epileptic drugs, it’s important to let you GP or Midwife know as soon as possible 
  • If you are experiencing seizures, speak to your GP or Epilepsy Nurse as they may alter your anti-epileptic drugs to reduce your seizures 
  • Make sure you have plenty of rest and sleep.
  • Some women might have seizures because the level of their anti-epileptic drugs in their blood changes during pregnancy. Your Neurologist or Epilepsy Nurse may recommend that you have regular blood tests throughout pregnancy and if the level of your anti-epileptic drug in your blood changes, your Epilepsy Specialist may adjust the dose.  

Uncontrolled seizures can also increase the risk of accidents. Further information about staying safe and tips to help reduce risks can be found on the Epilepsy Society website. 

Labour, birth and beyond

Most women with epilepsy will have a normal vaginal delivery, without complications. Your obstetrician and midwife will talk to you about your birth plan and what will be the safest way for you to deliver your baby. 

Useful links and resources