Pregnancy and Childbirth

Pre-pregnancy planning and communication between the woman, her neurologist and her obstetrician can reduce the risk of complications during pregnancy and childbirth.

Such risks include maternal seizures and fatal malformations. While more than 90 percent of pregnant women who have epilepsy give birth to healthy babies, they might need special care during their pregnancy. They have a 4 to 6 percent chance of giving birth to a baby with a major defect compared to 2 to 3 percent chance for women in general.

This is in-part related to maternal use of anti-epileptic drugs because they tend to work differently during pregnancy and are likely the reason to have more frequent seizures and added difficulty of nausea. The doctor may have to change their medication or increase the dosage during pregnancy.

The medication taken before conception and during the first three months of pregnancy present the greatest danger since it is the timeframe of the baby’s major organs to develop.

The type of seizure the patient experiences also plays a role in the different degrees of complications. With patients who suffer from partial or absence seizures, the risk to the baby is minimal. However, if the patient suffers from tonic-clonic (grand mal) seizures, injury to the baby and mother increases.

There is a brief interruption of breathing that can lead to oxygen deprivation and that usually affects the baby more than the mother. This type of seizure also increases the risk of trauma to the baby. After a tonic-clonic seizure, the baby’s heart rate can slow down for as long as 30 minutes. A tonic-clonic seizure raises the highest risk during the last trimester because the baby’s brain has become bigger and therefore, needs more oxygen.

Children who are born to parents with epilepsy have a slightly higher chance of having epilepsy, however, parents shouldn’t let this discourage them because there is a 3 percent chance of epilepsy in the general population.

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