Epilepsy does not rule out motherhood, specialist says

Malindi, Kenya- For women with epilepsy, the decision to become pregnant can bring a host of concerns, from whether seizures will worsen to the possible effects of medication on an unborn baby.

But an epilepsy specialist says the condition does not necessarily prevent women from having a safe pregnancy or delivering a healthy baby, provided they receive appropriate medical care and maintain good seizure control.

Dr Eddie Chengo, an epileptologist with the Foundation for People with Epilepsy (FPE) and Epilepsy Neurology Centre in Malindi, says women with epilepsy should seek medical advice before planning a pregnancy.

“A woman can have pregnancy complications even if she does not have epilepsy, but for a woman with epilepsy, she is at high risk,” Dr. Chengo says.

He, however, notes that proper seizure management can significantly help women navigate pregnancy and childbirth.

“If the seizures are well controlled, then they can carry pregnancy well and deliver safely with no complications,” he says.

Medical review before pregnancy

Dr Chengo advises women with epilepsy who are planning to conceive to discuss their plans with their doctors before becoming pregnant.

“We advise women living with epilepsy to inform their doctor if they are planning to conceive so that the doctor can walk with them throughout their pregnancy journey,” he says.

This is particularly important because some antiseizure medicines may carry risks during pregnancy. A healthcare professional may therefore need to review the treatment and determine whether any adjustments are appropriate.

At the same time, stopping medication without medical advice can be dangerous because uncontrolled seizures can also pose risks to both the mother and baby.

The International League Against Epilepsy (ILAE) recommends maintaining seizure control during pregnancy while balancing the benefits of treatment against potential risks to the developing baby.

Women should therefore not stop, reduce, or change their epilepsy medication on their own after becoming pregnant.

What happens to seizures during pregnancy?

Pregnancy does not affect every woman with epilepsy in the same way.

Dr Chengo says some women may experience more seizures, while others may see no change.

“For some patients yes, and for some, no,” he explains.

Changes during pregnancy, including hormonal changes, may affect seizure patterns differently from one woman to another. The type of epilepsy, medication, sleep patterns and individual seizure triggers can also play a role.

“Sometimes epilepsy can get triggered easily by any little changes, or even the weather,” Dr Chengo says.

This makes regular medical monitoring particularly important during pregnancy.

A global health concern

The concerns facing women with epilepsy are part of a wider public health challenge.

The World Health Organization estimates that about 50 million people worldwide live with epilepsy, with nearly 80 percent living in low- and middle-income countries.

WHO also estimates that up to 70 percent of people living with epilepsy could become seizure-free if they are appropriately diagnosed and treated.

For women of reproductive age, access to appropriate treatment and specialist care is particularly important because epilepsy management can intersect with pregnancy, childbirth, and family planning.

Care continues after delivery.

For women with epilepsy, medical care should not stop after giving birth.

Dr Chengo says women should also consult healthcare professionals when choosing a family-planning method because some contraceptives can interact with certain antiseizure medicines.

“It’s good for a woman to inform the doctor to advise on the best family planning method to help the woman not affect the epilepsy medication journey,” he says.

He emphasises the importance of seeking medical guidance throughout the entire reproductive journey—from planning a pregnancy to pregnancy, delivery, and the period after childbirth.

“A pregnant woman living with epilepsy can conceive and deliver a healthy baby just like any other woman,” Dr Chengo says.

With appropriate treatment, seizure monitoring, and medical support, epilepsy does not necessarily stand in the way of motherhood. The key, specialists say, is to plan, maintain treatment, and ensure that decisions about medication and family planning are made together with a qualified healthcare professional.