A woman lies on an exam table as she gets an ultrasound to see her baby.Planning ahead for pregnancy is important for all women.

But if you have epilepsy, it’s especially important to work closely with your neurology, epilepsy and obstetrical team.

“Most women with epilepsy can have a pregnancy with no complications and can have healthy babies,” said Rachel Fabris, MD, an epileptologist with Spectrum Health Medical Group who specializes in treating women with epilepsy at West Michigan’s first Level 4 epilepsy center.

The center, which follows the guidelines of the National Association of Epilepsy Centers, provides medical and surgical care for patients with complex epilepsy – including those with uncontrolled seizures.

Her advice: Before becoming pregnant, have your doctor check your anti-epilepsy drugs.

Dr. Fabris noted:

  • You’ll need to keep taking your medications when you’re pregnant, but your doctor may want to make some changes.
  • Some of the newer drugs are best for preventing complications and birth defects.
  • It’s likely that your doctor will want you to take one drug at a higher dose instead of a combination of drugs.
  • Be sure to take folic acid to lower your baby’s risk of spina bifida and your risk of pregnancy complications.

During pregnancy, be sure to tell your obstetrician about your epilepsy. Hormone changes can either increase or decrease your risk of seizures, so it’s important to pay special attention to healthy-living guidelines and to seizure triggers. Although the risks of preeclampsia and the likelihood of a cesarean delivery are somewhat higher, most women with epilepsy are able to carry their babies to full term.

Worried about labor? Most women manage labor without problems, despite the increased stress on their bodies. Epilepsy won’t prevent you from having an anesthesia epidural if you need it, and your medical team will monitor your anti-epilepsy medication levels before and after labor.

When that little bundle of joy arrives, consider nursing your baby.

Yes, you’ll still be taking your medication, but your baby’s exposure is lower in breast milk than it was when you were pregnant. Recent studies indicate that breast-fed babies of moms with epilepsy have higher IQs than those who were bottle fed, despite the drug transfer in mothers’ milk.

Those first few months after the baby arrives can be exhausting under the best of circumstances. Stress and sleep deprivation are almost unavoidable, so be sure to continue taking your medications.