About 1-2% of women with epilepsy will experience a seizure during their labour, and a further 1-2% will experience a seizure within 24 hours after the birth. This is why women with epilepsy are often advised to labour and give birth in a delivery suite (as opposed to a birth centre or at home). However, this may depend on how controlled (or severe) your epilepsy is, and the amount of medications you are taking.
It is sometimes recommended that women with epilepsy have their labours induced when the baby is due. The idea behind this is to have the labour happening when the delivery suite is well staffed, under so-called ‘controlled’ conditions. This could be negotiated though and should not be a blanket rule for all women with epilepsy. You can read more about induction in
Class 4.
Women with epilepsy are usually free to choose either
gas or an
epidural for pain relief during labour if they wish, but injections of
narcotic medications are not usually recommended, because they can trigger seizures.
After the birth
After the birth, the woman’s medication may need to be adjusted again, as her body returns to normal. Women with epilepsy are encouraged to breastfeed, even if they are taking anti-epileptic medication. The baby has been exposed to these medications during the pregnancy and only small levels of them are passed through the breast milk. A sudden withdrawal of these medications (if the baby bottle feeds) may cause the baby to become unsettled and ‘jittery’.
Phenobarbitone can make babies drowsy and may require the mother’s medication to be stopped (or adjusted) if she is breastfeeding. Some women look at the option of alternating
breastfeeding with
bottle feeding, to reduce these affects. A few babies will experience barbiturate withdrawal in the first 24 to 48 hours after the birth. They may require observation in the
intensive care nursery,