Giving birth and epilepsy

Information about the risk of seizures and pain relief available for women with epilepsy during childbirth.

Will having epilepsy affect the birth?

Your doctors may advise you to give birth in hospital. For 2 - 4 women in every 100 (2 - 4%) who have epilepsy, the stress of labour may trigger a tonic clonic seizure either during labour or during the 24 hours afterwards, even if they don't normally have tonic clonic seizures. If you have a seizure during labour your baby's oxygen supply may be reduced. Drugs can usually be given to control the seizure.

Most women with epilepsy have normal deliveries and healthy babies. It can be useful for the midwife and medical team who will be at the birth to know about your epilepsy, including what type of seizures you have, which anti-epileptic drugs (AEDs) you take and when you normally take them. Ideally, AEDs are taken as normal during labour.

If you want to have a home birth you need to carefully consider the possibility of having a seizure during labour, which could lead to complications. If you would like to have a water birth, you may also need to consider the possible risks if you become confused or lose awareness during your seizures.

Generally, a caesarean section (C-section) is only necessary if it is in the best interests of you and your baby.             

What pain relief can I have?

Women with epilepsy can have most types of pain relief during labour. These include:

• an epidural (an anaesthetic into the spine)
• breathing techniques
• gas and air (called Entonox).

It is helpful to tell the midwife and medical team if your seizures have any particular triggers. For example if pain, tiredness or over-breathing have triggered seizures in the past.

TENS

Another way to relieve pain is by using a TENS (transcutaneous electrical nerve stimulation) machine, which uses electrical impulses to stop pain signals getting to the brain. There is no evidence that TENS machines are not safe for use in epilepsy, but many manufacturers still include a warning in their instructions and advise women with epilepsy to speak to their doctor before using a TENS machine.

Pethidine

Pethidine, a strong painkiller, has been thought to trigger seizures in some women and, if possible, should be avoided.

After your baby is born         

Why is vitamin K prescribed?

Vitamin K plays an important part in making our blood thicken (clot). A very small number of newborn babies (about 0.01% or 1 in 10,000) are born without enough vitamin K. This can cause nose bleeds, mouth bleeds and in some cases, internal bleeding. Some AEDs can reduce a mother's vitamin K levels, and this can increase the risk of their baby having low vitamin K levels.

The Department of Health recommends that all newborn babies are given extra vitamin K at birth or within the first month of being born.              

What’s next?

See parenting and epilepsy for ideas about keeping you and baby safe if you have seizures.

Information produced: April 2019