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Epilepsy and Women's Health: Pregnancy, Hormones, and Birth Control

 Pregnancy is undoubtedly one of life's most beautiful phases, filled with anticipation and excitement. However, for women with epilepsy (WWE), this journey can be marred by unique challenges. The connection between pregnancy and epilepsy is a topic of great significance, as statistics reveal. Approximately 3.33 out of every 1000 pregnant women experience convulsive epilepsy, shedding light on the prevalence of this condition among expectant mothers. 

Women with epilepsy can face certain challenges like miscarriage, premature births and at times some fetal malformation. These numbers underscore the critical importance of understanding how epilepsy impacts women health during pregnancy, and in this blog, we'll explore this intricate relationship in simple terms, providing valuable insights.


How Does Epilepsy Make Pregnancy Difficult?

Epilepsy itself doesn't stand in the way of becoming a parent. It's good news that epilepsy alone doesn't make it harder to get pregnant. However, some medicines used to control seizures might be implicated. These medicines can affect the body in a way that makes getting pregnant a bit more challenging. 

Certain anti-seizure medications and contraceptive pills have interactions with each other which leads to reduced efficacy of both which may also lead to an unwanted pregnancy.


Complications of Epilepsy During Pregnancy

Epilepsy as a disease and the anti-seizure medications both can have various effects on both the mom-to-be, the pregnancy itself, and the developing baby. However, women with epilepsy can still have a healthy pregnancy and a healthy baby in most of the cases.  However, it's important to know that epilepsy does increase the chances of certain pregnancy complications. Let's take a closer look at them:



  1. High Blood Pressure: Some women with epilepsy may experience high blood pressure during pregnancy, which needs careful monitoring.
  2. Stillbirth: In extremely rare cases, women suffering from epilepsy may have a stillbirth which is where a child passes away before birth.


  1. Withdrawal Symptoms in the Newborn: Some babies may experience withdrawal symptoms that usually last only a few weeks or months and generally don't lead to any serious or long-term problems.
  2. Birth Defects of the Spine and Brain:  Epilepsy medications per se are safe in almost 95% pregnancies. However, it is important to know that certain medications like sodium valporate especially in high doses can sometimes affect the levels of a B vitamin called folic acid in the blood. Folic acid is crucial for a baby's development, so women of childbearing age are often advised to take supplements. 
  3. Other Birth Defects: Some epilepsy medicines in high doses may be rarely linked to other birth defects, but it's essential to remember that most experts agree that preventing seizures is usually more important than the potential risks of these medications. 


  1. Lower Levels of Vitamin D: Epilepsy medication can affect how your body absorbs vitamin D. However, taking prenatal vitamins typically helps address this issue. 


  1. Sleeping Problems: Newborns who are breastfed by mothers taking anti-seizure medication might be very sleepy or encounter feeding difficulties. This is because some of the medications can pass through breast milk. In some scenarios feeding the baby before taking medications may also help.


  1. Bleeding in the Newborn: Certain epilepsy medicines can impact the levels of vitamin K, which is necessary for blood clotting. All newborns usually receive a shot of vitamin K to prevent bleeding.


What Can Help Lower Risks or Problems for the Baby?

It is very crucial to reduce the risks for your baby in case you have any of the different types of epilepsy during pregnancy. Consider the following steps:


  1. Vitamin K for Bleeding Prevention: If you're taking certain epilepsy medications that can affect blood clotting, Vitamin K can help prevent rare bleeding complications in your newborn.


  1. Folate: Folate, a type of vitamin B, is crucial in preventing birth defects. While it may not offer as much protection for women with epilepsy, it's still a good idea to take it daily before becoming pregnant.


  1. Learn about your medicine: Seek accurate information before and during your pregnancy. If you're taking multiple medications or high doses of anti-seizure medication, consider discussing changes with a neurologist before planning your pregnancy.


  1. Monitor Drug Levels: Throughout your pregnancy and after delivery, it's crucial to have adequate medicines as per body weight. Hence monitoring the levels of antiepileptic drugs (AEDs) in your body may be one such step.  Your doctor may consider increasing the dose of medicine with increase in the body weight, as many of the newer drugs , monitoring drug level may not be feasible.


  1. Consider Breastfeeding: While AEDs can be present in breast milk, breastfeeding is generally encouraged. Benefit of the breast milk is much more than expected side effects.  Babies are already exposed to these drugs during pregnancy, but the amount of medication passed in the breast milk is usually quite low. Strategies like taking seizure medications right after a feeding can help reduce the drug's presence in breast milk.


  1. Preform regular health check-up of the baby: Your obstetrician may perform maternal serum-alpha-fetoprotein testing and high-resolution ultrasounds to monitor the baby's development in the earlier days to track any complications.



Women's health and epilepsy are quite complex, and one thing stands clear: knowledge is power. Understanding the unique challenges, risks, and precautions associated with epilepsy during pregnancy empowers women to make informed decisions. While epilepsy may pose certain hurdles, it doesn't diminish the joy of becoming a parent. With proper guidance from healthcare providers, the right supplements, careful medication management, and sensible safety measures, women with epilepsy can embark on the beautiful journey of motherhood with confidence. The chances of having a normal pregnancy and normal baby can be as high as 95%.


Dr. Atma Ram Bansal
Meet The Doctor
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