Now you are pregnant
See your family doctor as soon as you find out you are pregnant. They can arrange speedy referrals to healthcare professionals such as a midwife, obstetrician, neurologist, epilepsy specialist nurse or doctor. To help with this process, you could download the epilepsy maternity toolkit.
As you will be supported by a number of different healthcare professionals, the toolkit should list emergency contact details of your team. It should also have a summary of your epilepsy, treatment and your management plan.
Around one in every three women with epilepsy will have seizures during their pregnancy. This can be due to things like their type of epilepsy, whether they are taking their medicine as prescribed, or lack of sleep.
Some women might have seizures because the level of their epilepsy medicine in their blood fluctuates during pregnancy. This is most likely to happen with the drugs lamotrigine, levetiracetam and oxcarbazepine. So, many epilepsy specialists recommend that you have regular blood tests if you are taking these medicines. They will take account of the type of epilepsy you have, your previous seizure control, and the dose of your medicines. It’s up to you to decide whether you want these blood tests.
If your seizures change while you are pregnant, ask your family doctor or epilepsy specialist for a prompt review of your epilepsy medicine.
Taking your epilepsy medicine during pregnancy
It’s really important not to stop taking your epilepsy medicine during pregnancy, unless your doctor advises you to do this. If you suddenly stop taking your medicine, it could cause you to have more frequent or more severe seizures. It could even put your life at risk.
Will my baby be at risk if I have a seizure during pregnancy?
There’s no evidence that says focal (partial) seizures, myoclonic seizures, or absence seizures will harm your baby. But tonic-clonic seizures can cause injury from drowning, motor vehicle accidents and falls. And any significant injury to the abdomen could cause bleeding or your waters to break. This could lead to infection and early labour, although the risk is low. Lack of oxygen from a tonic-clonic seizure can be harmful to your baby, particularly if you have more than one, or have status epilepticus.
Many people have seizures that last for less than 5 minutes and stop without any treatment. But some people have seizures that last too long. These are known as status epilepticus and need treating urgently. This is to try and stop them before they cause long-term damage. The sooner the seizure is treated the easier it will be to get it to stop.
By the time a seizure is lasting for 30 minutes or more, it is much more difficult to stop. If a tonic-clonic or cluster of tonic-clonic seizures last longer than 30 minutes, this can cause damage to the brain, or even death.
Could I be at risk if I get pregnant?
In all pregnancies, there is a small risk that the mother could die. This risk is increased slightly if you have epilepsy. There may be many possible reasons for this, including not having enough epilepsy medicine in their body, or not taking their epilepsy medicine as prescribed. This can cause uncontrolled seizures, which increases the risk of sudden unexpected death in epilepsy (SUDEP).
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 on safety.
Ways to lower the risks of having seizures when you are pregnant
You might not notice a change in the number of seizures you have during your pregnancy - most women don’t. But here are some ways you might lower the risk of having seizures:
- Keep taking your epilepsy medicine exactly as prescribed by your doctor
- If you have sickness and can’t keep your epilepsy medicine down, speak to your family doctor or epilepsy specialist straight away
- Talk to your doctor, midwife or epilepsy specialist about any seizures you have. They might be able to make changes to your epilepsy medicine, to try to reduce your seizures
- Try to get enough rest and sleep. Some people are more at risk of having seizures if they are tired, or haven’t had enough sleep
What scans and tests will I need during pregnancy?
All women are offered scans and blood tests during pregnancy. Some of these are used to check the mother’s health, others are to check the baby’s health and growth.
You probably won’t need any extra tests while you are pregnant, just because you have epilepsy. But if you start having more seizures, or your seizures are different, your epilepsy specialist might do a blood test. This is to find out if the level of your epilepsy medicine in your blood has dropped. If it has, they might suggest you take a higher dose.
You will be offered a mid-pregnancy ultrasound scan between weeks 18 and 22 of your pregnancy. Ultrasound scans can help detect things such as a hole in the heart or cleft palate. You will also be offered a blood test to show the risk of your baby having spina bifida.
It’s up to you whether you want to have screening tests to check your baby’s health and development. You might choose to have all the tests, or to have some tests, but not others. The screening tests occasionally identify an abnormality which needs further investigation to check on what impact it will have on your baby’s life. If this happens, the doctor will give you all the information you need to help you make decisions about what to do next.
If you need further support, or help to make decisions, the maternity team will tell you about the most appropriate support groups or services available.
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 Kim Morley Epilepsy Specialist Midwife 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