Preconception Planning for a Baby for People With Epilepsy

One of the most common questions asked by people who have been diagnosed with epilepsy is “can you have a baby if you have epilepsy?”. The answer is that the vast majority of women who have epilepsy are able to have normal pregnancies and healthy babies. 

Hopefully this is reassuring for anyone who has been diagnosed and has aspirations to be a parent. However, it is crucial to undergo preconception counselling to help increase the chances of a healthy pregnancy and the safety of both the mother and the child. 

Preconception Counselling 

Preconception counselling is the advisable first step to take before committing to have a baby. This involves a series of appointments with a qualified doctor or nurse who has a specialised knowledge of epilepsy and pregnancy. The main purpose of these appointments is to assess your epilepsy and the epilepsy medication you are taking to determine whether your medication needs to be changed in order to have a healthy pregnancy. 

Some epilepsy medications, such as sodium valproate, have an increased risk of harming the baby during pregnancy. Before having a child, you may need to discuss whether your current treatment course needs to be changed before conceiving. Of course, the aim is to ensure you’re on medication with a low risk of harm to the baby, but that is also effective at managing your seizures. 

Another consideration is that pregnancy can have an effect on your seizures and potentially cause your treatment option to be less effective. 

You can book preconception counselling with your GP at any age if you are considering becoming a mother. It’s particularly important if you are thinking of getting pregnant in the near future. We strongly recommend that anyone considering motherhood with epilepsy takes that time to do this. 

Medication concerns during pregnancy    

As previously mentioned, certain medications carry an increased risk of harm to an unborn child. These medications have an increased risk of birth defects and developmental issues. Ensuring you are on a treatment option that allows for a safe pregnancy for both you and your unborn child is the main concern and something that will be discussed and agreed during pre-conception counselling. 

As mentioned, sodium valproate especially is known to cause birth defects. Children who are born after the mother has been taking sodium valproate are at increased risk of developmental challenges and a risk of autism, ADHD and other disorders. The latest guidance from the Medicines and Healthcare products Regulatory Agency (MHRA) dictates that women of chilbearing age should only be prescribed sodium valproate if they enrolled on a Pregnancy Prevention Programme. 

Pregnancy concerns on your epilepsy

Similarly, your own health is also a concern that needs to be addressed before conception. Everyone reacts differently to pregnancy but as your body undergoes changes and your hormones change, there is a chance that it will affect your epilepsy. 

Some women have noted increased seizures, others have had reduced seizures whilst some have documented no noticeable difference. Preconception planning will help to manage this and ensure you and your care team are on alert during pregnancy for any changes.   

But what if I’m already pregnant?

If you are already pregnant, whether planned or unexpected, don’t panic! Continue to take your prescribed medication (including sodium valproate) as normal and schedule an urgent appointment with your healthcare professional. Whilst preconception planning is the ideal scenario, your doctor should still be able to guide you through a healthy pregnancy. 

Read our post here on epilepsy care during pregnancy.