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Planning a baby

Most women with epilepsy have healthy pregnancies and give birth to a healthy baby. To have the best chance of having a healthy pregnancy, medical professionals advise you have pre-conception counselling before you become pregnant. This is because your epilepsy and epilepsy medicines might slightly increase your risk of having a baby with a birth problem. The risk varies, depending on the type, dose and epilepsy medicine you take. Getting specialist support at the right time, particularly if you are at risk of an unplanned pregnancy, may reduce these risks.

I’m already pregnant, should I stop taking my epilepsy medicine?

If you are already pregnant, don’t stop taking your epilepsy medicine. If you do, it might not make a difference to your baby, but it could cause you to have more seizures. Or your seizures could be more severe.  This could be harmful for you and your baby. Instead, speak to your family doctor as soon as possible, so they can get you the help and advice you need.

What is pre-conception counselling? 

Pre-conception counselling happens before you get pregnant. It’s an appointment with a doctor or nurse who knows about pregnancy and epilepsy. The aim is to review your epilepsy and your epilepsy medicines. Some medicines carry a higher risk of harming your baby if you take them during pregnancy. Other medicines carry a much lower risk, but might not control your seizures as well. The counselling will help you to decide which is the safest type and dose of epilepsy medicine to prepare for future pregnancy.

The doctor or nurse might suggest you change your epilepsy medicine to one that carries a lower risk, before you get pregnant. Or they might change it to try to get your seizures under better control. Their advice will depend very much on your individual circumstances, and how you feel about making any changes. For some women, a gradual withdrawal of their epilepsy medicine might be considered safe. This would need a risk assessment and very careful planning and support. 

How do I get pre-conception counselling? 

You can ask your family doctor to arrange pre-conception counselling for you at any age – even before you have started a sexual relationship. It’s especially important if you are thinking of becoming pregnant in the near future, or if there’s any chance that you could get pregnant.

Do I need folic acid? 

All women are recommended to take folic acid before and during pregnancy, to reduce the risk of having a baby with spina bifida. For women without epilepsy or not taking epilepsy medicines, the usual dose is 400 micrograms. For women taking epilepsy medicines, the dose you need to take is 5000 micrograms (5 milligrams).

When should I start taking folic acid? 

If you take epilepsy medicine, it is recommended you take 5 milligrams of folic acid daily if there is a chance you could become pregnant. You will usually need to continue with it for the first 3 months of your pregnancy.

Can I buy this from the pharmacist? 

In the UK, you can’t buy the 5 milligram dose of folic acid, but you can buy the standard 400 microgram dose. For the 5 milligram dose you will need a prescription from your family doctor.

Will folic acid affect my epilepsy medicine? 

If you take phenytoin, phenobarbital or primidone, folic acid could affect how well those medicines work. This could cause you to have a seizure, so speak to your doctor before starting folic acid.

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.

Code: 
B112.06

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 2017
    To be reviewed January 2020

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Comments

I am hoping to start trying for a baby after my marriage in August. When do I need to book an appointment regarding a pre-conception counselling and when do I start to take folic acid? I am no longer with a consultant however still take anti-convulsants (Lamotrigine 200mgx2) Do I need to go to my G.P first to be referred? Thanks

Submitted by Jackie Stevenson on