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What to Expect When You're Expecting With Epilepsy

A doctor explains what you need to know.

A pregnant woman and her partner looking over a brochure with a physician
A doctor sitting at a desk holding a model of a brain while explaining something to a person sitting across the desk.

Northwell Health Institute for Neurology and Neurosurgery

Dear Doctor,

My husband and I are considering starting a family, but I'm concerned about how my epilepsy will affect my chances of getting pregnant. I've been on medications for years that have kept my seizures to a minimum, but I'm also anxious about how that medicine might impact the baby. What should I be thinking about as we plan to start a family?


“Excited but Anxious”

Dear Excited but Anxious,

Rest assured that while pregnancy with epilepsy does require more planning, the vast majority of women with this condition carry to term without complications and even have additional children.

You say your seizures are well managed by your medication, which is key for having a safe pregnancy with epilepsy. However, before you even start trying to conceive, you should tell your doctor that you want to do so, so that they can evaluate the medications you're currently on to determine what regimen would have the lowest potential risks for the fetus.

Your doctor may suggest you switch to a different medication, because some drugs have the potential to harm the fetus. As you may have experienced at some point, controlling seizures with a new medication can take time and adjustments may be necessary, so it's important to have that step worked out before you become pregnant.

This is crucial for two reasons: First, because a fetus forms its organs very early on in pregnancy (within the first 12 weeks), being on medication that won't interfere with this development is key. And having your seizures under control at this point is also integral, since convulsions during any point in pregnancy could potentially have a negative impact on the fetus.

As for your other question, the answer is yes—epilepsy can affect fertility. Epilepsy is a result of abnormal activity in the brain, and sometimes that activity affects the way that hormones like estrogen and progesterone are regulated, which in turn affects ovulation and preparation of the ovaries and uterus for pregnancy.

That being said, there are plenty of women with seizure disorders who do get pregnant and have normal, healthy pregnancies. So although it can be more difficult, it’s doable with the right planning. The key is to start the conversation with your doctor well before conception.

Expect to work closely with your doctor throughout your pregnancy. Monitoring and adjusting your medication dosage will be important as your body's metabolism changes and your baby grows. Your doctor will want to make sure your medication levels are correct before and during labor to decrease the risk of seizures.

As epileptologists (doctors who specialize in the treatment of epilepsy), we want our patients to have full, normal lives, and we do everything we can to make sure women have access to all the choices they want. With a little planning, parenthood is absolutely possible for you and your husband.

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Published April 16th, 2019
A doctor sitting at a desk holding a model of a brain while explaining something to a person sitting across the desk.

Northwell Health Institute for Neurology and Neurosurgery