World Epilepsy Day 2025: Risks, precautions, expert advice for pregnancy with epilepsy

Pregnancy is a unique phase in a woman’s life, and for those with epilepsy, early consultation with a neurologist and obstetrician is crucial. A well-planned approach significantly reduces risks for both mother and baby (Image: Canva)

Epilepsy, a neurological disorder, causes recurrent seizures. While most women with epilepsy have healthy pregnancies, the condition requires careful management to ensure the well-being of both the mother and baby. Hormonal changes, medication adjustments, and the increased physiological demands of pregnancy can make epilepsy management more complex. Also, a diagnosis of epilepsy during pregnancy requires additional precautions and expert medical care.

With proper planning, regular monitoring, and informed decision-making, most women with epilepsy can safely carry their pregnancy to term, says Dr Aabha Bhalerao, Consulting Senior Gynecologist at Ruby Hall Clinic, Hinjawadi, Pune. “Pregnancy is a unique phase in a woman’s life, and for those with epilepsy, early consultation with a neurologist and obstetrician is crucial. A well-planned approach significantly reduces risks for both mother and baby,” she says.

Here's everything you need to know about epilepsy during pregnancy: the risks, and how to minimise complications:

Also read | Living with epilepsy: Tips for staying healthy and managing the condition with lifestyle tweaks

Epilepsy is a neurological condition marked by recurrent seizures, which can vary in intensity and frequency. “Pregnancy brings physiological and hormonal changes that may affect seizure control, medication metabolism, and your health. While most women with epilepsy have successful pregnancies, it’s important to be aware of the risks and take necessary precautions,” says Dr Bhalerao.

Risks associated with epilepsy during pregnancy:

Seizures during pregnancy can be dangerous for both the mother and the baby. “A severe seizure could lead to falls, trauma, reduced oxygen supply to the fetus, premature labor, or, in extreme cases, miscarriage,” Dr Bhalerao says, and warns that uncontrolled seizures increase risks for both mother and child, making preconception planning crucial.

“Certain anti-seizure medications (ASMs) have been linked to birth defects like neural tube defects, congenital heart issues, or cleft lip and palate. However, stopping medications without medical advice can be more dangerous than continuing them,” she says.

According to Dr Bhalerao, balancing seizure control with fetal safety is critical, and the goal is to prescribe safer ASMs while minimising risks. “Pregnancy alters how the body processes medications, and hormonal shifts may trigger more frequent seizures. Sleep deprivation and stress further contribute to seizure vulnerability. Women with epilepsy have a slightly higher risk of developing pre-eclampsia, a condition marked by high blood pressure and potential organ damage, which can pose serious health threats if left unmanaged,” explains Dr Bhalerao.

Also read | Ways to manage epilepsy seizures for better quality of life

Babies born to mothers taking ASMs might experience withdrawal symptoms or temporary breathing difficulties. Some medications can also affect neonatal development, making postpartum monitoring essential.

Steps to minimise complications and ensure a healthy pregnancy:

Preconception counseling: It is essential for women planning pregnancy. Consulting both a neurologist and an obstetrician allows for medication adjustments, risk assessment, and seizure control optimization.

Manage medication: It plays a crucial role in epilepsy care during pregnancy. Adjusting anti-seizure medication to the safest possible option is necessary, as stopping medication abruptly can lead to uncontrolled seizures, which pose greater dangers than the medication itself.

Monitor regularly: Monitoring through frequent check-ups, blood tests, and ultrasounds ensures that both mother and baby are progressing well. Tracking drug levels helps maintain optimal seizure control.

Folic acid supplementation: This is vital. Taking 4-5 mg of folic acid daily before conception and during pregnancy reduces the risk of neural tube defects and supports fetal brain development.

Avoid seizure triggers: This can help in maintaining stability. Getting enough sleep, managing stress, staying hydrated, and following a structured routine can reduce seizure risks.

Planned delivery and postpartum care: They are equally important. Having a well-prepared birth plan in place, with medical supervision during labour, ensures a safe delivery. Postpartum care is crucial, as seizure risks can fluctuate after childbirth.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.