5 facts about pregnancy in women with epilepsy
Planning pregnancy in women with epilepsy
Women with epilepsy can successfully plan to expand their family, and the pregnancy itself is no different from that of completely healthy women. Their children are also fully healthy. However, for a woman to feel safe during this special time, pregnancy must be planned under the supervision of an experienced epileptologist. The key is to conceive at an optimal time when the antiepileptic treatment is properly adjusted for effectiveness and safety. Therefore, during preparation, the woman should remain under systematic care of both a gynecologist and a neurologist.
There are several things to remember:
- Before pregnancy, the neurologist verifies the effectiveness and safety of the current antiepileptic therapy. If necessary, changes are made to the treatment, and their effects are observed. This stage may require time, so inform your neurologist about plans to try for a baby as early as possible.
- Antiepileptic treatment is a risk factor for lowering blood folate levels. Meanwhile, folic acid is needed for proper fetal development – therefore, supplementation should begin at least 3 months before trying to conceive.
- Hormonal changes during pregnancy can cause fluctuations in antiepileptic drug levels in a woman's blood. The neurologist decides on measuring their levels before pregnancy and then in each of its three trimesters.
Are EEG and VEEG tests safe?
EEG (electroencephalography) and VEEG (video electroencephalography) are basic tests performed both in epilepsy diagnosis and after its recognition. They involve observing the brain's bioelectrical activity. During these tests, hyperventilation (deep breathing) and photostimulation (exposure to stroboscopic light) are often performed. These tests do not negatively affect pregnancy. However, the decision about the need for testing is always made by the neurologist supervising the pregnant patient.
Read more about EEG testing in other posts on our blog.
Can a woman with epilepsy have a natural birth?
According to specialists, apart from specific clinical situations, there are no contraindications to natural childbirth. When might a doctor advise against natural birth? There are several such situations:
- increased number of seizures in the last trimester
- history of status epilepticus
However, most women have no neurological contraindications to natural birth. It's recommended to create the most comfortable conditions for the birthing mother by reducing seizure risk factors such as fatigue, pain, and stress. Pain relief through epidural anesthesia reduces stress levels and allows the woman to rest during long labor.
Can women with epilepsy breastfeed?
Absolutely yes! This method of feeding is recommended by specialists, including the Polish Society of Epileptology (PTE) and the Polish Society of Gynecology. PTE issued a recommendation promoting breastfeeding. Why? Both mother's milk and the process itself play an important role in infant development. Depending on the amount and type of antiepileptic drugs used, the neurologist will advise on the most optimal way to feed the baby. In certain situations, when exclusive breastfeeding isn't possible, mixed feeding is often an option.
The way antiepileptic medications are taken during the breastfeeding period is also important. These should be taken immediately after feeding or right before the baby's longest sleep period.
The topic of feeding should always be discussed with the neurologist during pregnancy.
What should postpartum support look like?
Organization of life after birth is extremely important. This time is not only special but also very demanding for all family members. Therefore, it's good for patients in the third trimester to attend medical appointments with their partners. This will allow them to properly plan care and prepare for the new life stage.
It's worth discussing safe newborn care principles with your neurologist:
- changing and dressing the baby on the floor rather than on a table
- feeding the baby on the floor on a soft surface, preferably in a lying position
- washing the baby on a mat on the floor, not in a bathtub
- securing the stovetop with a protective barrier
- proper baby carrying in a carrier
Night childcare is also an important issue. Support in this area is particularly important for patients with epilepsy. Childbirth, new childcare responsibilities, night wake-ups for diaper changes and feeding cause fatigue accumulation. Chronic sleep deprivation can lead to seizures. A new mother must therefore have 4 to 6 hours of uninterrupted rest.
Furthermore, remember that epileptic seizures can lead to accidental falls and injuries. Proper preparation for birth, home and environment adaptation, and introducing specific daily habits will help reduce the risk of injuries to both mother and child.
Content collaboration: Dr. Maja Kopytek-Beuzen