National Epilepsy Day: Yes, Women With Epilepsy Can Have Healthy Pregnancies — Here’s How

For

many women living with epilepsy, the idea of becoming a mother can feel both hopeful and frightening. Long-standing misconceptions suggest that seizure disorders inevitably complicate pregnancy or put the baby at risk. But according to neurologist Dr. Vinit Banga, “most women with epilepsy can and do have healthy pregnancies, given appropriate medical care and planning.” With the right preparation and support, these fears can be replaced by confident, positive outcomes.

Why planning matters

Pre-conception counseling is a cornerstone of a healthy pregnancy for women with epilepsy. Neurologists often review and adjust anti-seizure medications (ASMs) before conception to find a regimen that balances seizure control with fetal safety. Guidelines from epilepsy specialists often recommend medications such as lamotrigine, levetiracetam, or oxcarbazepine, which carry a comparatively lower risk of major birth defects. At the same time, high-risk drugs, like valproic acid, are avoided where possible because of elevated risks to the developing child.

Folic Acid: A simple but powerful step

One of the most effective ways to lower risk is by taking folic acid. Women with epilepsy are often advised to start 5 mg daily, ideally 2–3 months before conceiving, to protect against neural tube defects. In fact, the NHS recommends this higher dose for pregnant women on anti-epileptic drugs. During pregnancy, folic acid supports healthy spinal and brain development and reduces some medication-related risks.

Monitoring during pregnancy

Because pregnancy changes how the body processes medication, the blood levels of some ASMs can drop dramatically during gestation. For example, levetiracetam and lamotrigine — two commonly used ASMs — may need dose adjustments to maintain seizure control. Regular blood tests, coordinated between neurologists and obstetricians, help ensure both mother and baby remain safe throughout.

Understanding the risks, and the reality

It’s true that epilepsy brings slightly higher risks during pregnancy. Seizures can cause fetal distress, low birth weight, or preterm birth. A JAMA Neurology study found that seizures during gestation raised risks of low birth weight, preterm delivery, and small-for-gestational-age infants. Also, women with epilepsy face slightly increased chances of severe maternal complications during pregnancy and postpartum. Still, research and clinical experience tell a hopeful story: with expert care, more than 90% of women with epilepsy deliver healthy babies.

Key take‑home tips

• Talk to your neurologist before conceiving. Always review and, if needed, adjust your medication.
• Start folic acid (5 mg daily) at least a few months before pregnancy.
• Monitor ASM levels regularly; dosages may need tweaking during pregnancy.
• Maintain healthy lifestyle habits. Good sleep, balanced nutrition, and stress management are the main parts of it.
• Stay connected to your care team. Your obstetrician, neurologist, and your pregnancy specialist need to be on your speed dial.

Epilepsy doesn’t have to stand in the way of motherhood. While pregnancy does carry some additional risks, they can be managed very effectively with planning, specialist care, and the right medicine. As Dr. Vinit Banga reminds us, “Women with epilepsy need support—instead of fear—as they enter pregnancy confidently, with evidence-based care, and plenty of success stories that act as inspiration.”