Things to consider before and during pregnancy: Epilepsy

World Epilepsy Day took place this week and is an opportune time to acknowledge the impact that it has on people’s lives, and to highlight how treatment is managed, and support is provided.

With the right treatment, which can take time to find and optimise, epilepsy for many can be kept under control, and those diagnosed with it can thrive.

However, it is something that must be factored into many aspects of daily life, from the ability to drive to fertility and pregnancy considerations.

Women with epilepsy need to factor their condition into any plans to become pregnant, and the pregnancy itself.

Epilepsy Ireland provides a wide range of information and guidance via its website: www.epilepsy.ie.

It’s best for anyone with epilepsy to get detailed guidance from their doctor, consultant or epilepsy nurse about their epilepsy management plan for this new chapter of life, well in advance of trying to become pregnant.

This would include discussing their treatment up to two years before trying to conceive.

The reason for this is because epilepsy and its treatment can lead to complications, if not appropriately managed at this time.

It’s incredibly important to say treatment for epilepsy should never just be stopped.

Plans can be put in place to make pregnancy feasible in a safe way for mum and baby. This may in some cases include stopping or changing a medicine, or reducing a dose to minimise any risk of harm to a developing baby in that case, but all decisions would be made in close consultation with your doctor and depend on the specific epilepsy type, medications being used, and personal situation.

Of note, it is advisable for some women on certain medications for epilepsy to have an anti-seizure medication drug level taken prior to becoming pregnant. This is measured by a blood sample, and it is used as a reference point should you experience any seizures whilst pregnant. It can help doctors to determine what needs to be done to improve management should anything unexpected happen. The timing of the blood test should be repeated each time for an accurate comparison, e.g, early morning test before your first medication dose.

Lifestyle and general health advice on diet, smoking, and alcohol, for example, will be the same for all women, regardless of whether they have epilepsy or not.

Folic acid is something that all women should be taking for three months prior to pregnancy, and for 14 weeks of pregnancy itself to prevent spina bifida.

Women with epilepsy may need higher doses of this than others to counteract side-effects of some medications.

It is important to recognise also the significant mental toll that epilepsy, and its impact on trying to conceive, can have.

The worry and uncertainty regarding treatment and tailoring of meds to ensure safety, but still prevent future seizures, can be significant. Ensuring to talk about any worries or struggles as you navigate this time will help you to take each step as it comes.

Support groups for people in that particular situation can lend a listening ear and help people feel less alone.

There are, of course, occasions where planning for pregnancy just doesn’t go to plan, and women become pregnant without any forward planning or adaptation of their treatments. In that case, the advice is simply to get in touch with your GP and epilepsy team as soon as possible for advice on the next steps, and they’ll ensure to look after you and your pregnancy.

Epilepsy Ireland signposts women with epilepsy who wish to get pregnant to their local Community Resource Officer, who may be able to provide further information should same be required, or provide directions to those with any concerns.

Safe and successful pregnancy for those with epilepsy is absolutely possible, once the right support and tailoring of treatment is provided.

Balancing the often essential medications with their side-effects and safety profiles is something that the medical experts do really well – being prepared in advance lends to a smoother journey and greater reassurance that all will be well.

It is important to recognise the significant mental toll that epilepsy, and its impact on trying to conceive, can have.