Most women with epilepsy will have a vaginal delivery, without complications. If you are considered to be at risk of having seizures during delivery or the following 24 hours, you will be advised to give birth in a consultant-led maternity unit. This is to make sure you receive one-to-one care from a midwife. It’s also to make sure that facilities are available if you or your baby need emergency treatment.
To decide the safest place for you to have your baby, your midwife and doctors will work with you to do an individual risk assessment and care plan. They will ask about when you last had seizures, and whether you are still taking epilepsy medicines. Depending on your answers, it might be safe for you to give birth in a lower risk midwifery-led maternity unit or have a home birth.
It’s important that you have a choice of where you give birth, and that your wishes are central to any decision making. You might find it difficult to agree on the safest option for you and your baby. You might want to give birth in a midwife-led unit, or have a home birth. But your midwife or doctors think a consultant-led maternity unit would be safer. If you still decide you want to have a midwife-led unit or home birth, your midwife will arrange for you to speak to a senior midwife, or the head of midwifery. This is to make sure your choice is as safe as possible for you and your baby.
If you are taking epilepsy medicines but have decided to give birth at home, make sure you have a supply of your medicines packed in a bag. This is so they are ready in case you or your baby need emergency transfer to a consultant-led maternity unit.
You could use the epilepsy maternity toolkit to do your risk assessment.
Suggestions for lowering your risks of having seizures during labour
- Make sure you have your own epilepsy medicine with you, and set up a reminder system to take it at the usual time
- Know your seizure triggers such as tiredness and stress, and make sure you have as much support as you can to avoid them
- If you find it hard to take or keep your epilepsy medicine down, ask the midwife for an injection to stop the sickness
What pain relief can I have during labour?
There are different options for pain relief during labour. Here are some important things to consider:
- Breathing exercises and gas and air can be good for managing pain, but try not to over-breathe, as this could trigger a seizure
- Epidurals can be given to women with epilepsy
- High doses of the pain relief drug pethidine can trigger seizures
- Diamorphine can be used instead of pethidine
- TENS machines are often used as pain relief during labour and are reported to be suitable for women with epilepsy
If you want to use water for pain relief, it’s important that you discuss this with the maternity team in advance. This is to minimise the risk of drowning if you had a seizure in the water. Someone should always be with you and there should be a hoist available to get you out of the pool or bath, if need be. It’s also important that staff know how to manage a seizure in water.
For anyone who has seizures, it’s important to take extra care when bathing, because there is a risk of drowning during a seizure. There are some things that might reduce your risk of drowning, such as:
- Having a shower instead of a bath - it’s safer because the water runs away
- If a shower isn’t possible, keep the water depth shallow and turn off the taps before you get in or
- Don’t put the plug in, but sit in the bath with the water running from the taps or a shower attachment
Epilepsy Action has more information about safety.
If you would like to see this information with references, visit the Advice and Information references section of our website. If you are unable to access the internet, please contact our Epilepsy Action Helpline freephone on 0808 800 5050.
Epilepsy Action would like to thank Epilepsy Specialist Midwife Kim Morley for her contribution to this information.
Kim Morley has no conflict of interest.
This information has been produced under the terms of The Information Standard.
- Updated January 2017To be reviewed January 2020