Epilepsy and Pregnancy: What You Need to Know About Seizure Control and Medication Safety

When you have epilepsy, a neurological condition characterized by recurrent seizures. Also known as seizure disorder, it affects about 1 in 200 pregnant women — and managing it during pregnancy isn’t just about controlling seizures, it’s about protecting both you and your baby. Many women worry that pregnancy will make seizures worse, but for most, the frequency stays the same or even improves. The real challenge? Choosing the right medication. Not all antiseizure drugs are safe during pregnancy. Some, like valproate, carry a high risk of birth defects — including neural tube defects and developmental delays — while others, like lamotrigine, are considered lower risk when properly monitored.

Antiseizure medications, drugs designed to prevent epileptic seizures. Also known as antiepileptic drugs, they’re the backbone of treatment — but their effects on a developing fetus vary widely. Folic acid supplementation before and during early pregnancy can reduce the risk of certain birth defects by up to 80%, especially when taken with certain medications. Regular blood tests help doctors adjust doses as your body changes, because pregnancy can lower drug levels, making seizures more likely. And while some women wonder if they can stop meds entirely, going off treatment without medical guidance can be dangerous — uncontrolled seizures during pregnancy can lead to miscarriage, preterm labor, or even fetal oxygen loss. That’s why working with a neurologist and an obstetrician who specialize in high-risk pregnancies is critical. You’re not just managing a condition — you’re balancing two lives. Many women successfully carry healthy babies while on medication, but it takes planning, monitoring, and staying informed.

Fetal risks, potential harm to the developing baby from maternal medications or uncontrolled seizures. Also known as teratogenic risks, these include physical abnormalities, cognitive delays, and low birth weight. The risk isn’t the same across all drugs — lamotrigine and levetiracetam are often preferred because long-term studies show fewer complications. But even with safer options, you need to track your seizure patterns closely. A seizure during the third trimester can trigger preterm labor. A fall during a seizure can cause injury to you or the baby. That’s why your care team may recommend avoiding certain triggers — lack of sleep, stress, missed doses — and keeping emergency contacts handy. You’ll also want to know what to expect after birth. Some antiseizure drugs pass into breast milk, but most are considered safe for nursing. Your baby may need a short blood test after delivery to check for drug levels, but that doesn’t mean you can’t bond or feed naturally.

What you’ll find below are real, practical articles that break down how these medications behave in pregnancy, what tests you need, how to spot warning signs, and what alternatives exist when risks are too high. No fluff. No guesswork. Just clear, evidence-based info from people who’ve seen this firsthand — whether you’re planning a pregnancy, already pregnant, or just trying to understand what’s possible.