Planning a baby
Most women with epilepsy have healthy pregnancies and give birth to healthy babies. However, there is a small risk that having seizures or taking anti-epileptic drugs may affect the health of you and your unborn baby. This is why you are advised to plan your pregnancies, where possible.
Pre-conception counselling happens at an appointment with a doctor or nurse who knows about pregnancy and epilepsy. The aim of pre-conception counselling is to plan to make your future pregnancy as safe as possible. To do this, your doctor or nurse may suggest making changes to your anti-epileptic drugs (AEDs) before you get pregnant. This might help you to have fewer seizures or lower the risks of your AEDs affecting an unborn child.
The advice you are given will depend on your own situation. But you may be advised to take fewer AEDs, a lower dose of your AED or a different AED. In some cases, your doctor may help you to gradually stop taking your AEDs altogether, before you become pregnant. This would usually be if you have not had any seizures during the last two years and you are at a low risk of having further seizures.
When you are pregnant, it is important that you don’t make any changes to your AEDs without following advice from your doctor. If you stop taking your AEDs it could cause you to have more seizures. This could put your health and your baby’s health at risk.
You can ask your doctor to refer you for pre-conception counselling at any time. For example you might want it before or when you start a sexual relationship, just in case you become pregnant unexpectedly. Ideally, all women with epilepsy should have pre-conception counselling before every pregnancy.
● Folic Acid
During pre-conception counselling, you might be advised to take five milligrams of folic acid all the time, just in case you get pregnant. This is to help reduce the risk of your baby having a malformation such as spina bifida. As it is a much higher dose than for women not taking AEDs, you will need to get a prescription for this dosage from your GP.
Folic acid can affect how well the AEDs phenytoin, phenobarbital or primidone work. Your doctor will be able to advise you about this.