Epilepsy and Pregnancy_2

Epilepsy and Pregnancy_2 by Sinead Murphy, Community Epilepsy Specialist Nurse first published in Epilepsy News Issue 24 - Winter 2003


Sinead continues with the theme of epilepsy and pregnancy and looks at the issue of epilepsy and labour.

Are there any special precautions I should take whilst in labour?
My advice to any women that are pregnant is to discuss a birth plan with your Obstetrician well in advance of your expected date of delivery and for this to be documented. All women during this time are treated on an individual basis. However, it is very important for the doctor and midwife caring for you during your labour to be reminded of the fact that you have epilepsy, the type of typical seizure that you have, how long the seizure lasts and the importance of taking your anti seizure medication at your usual times. The doctor and midwife should also be alerted to the possible triggers that may be individual to you such as stress and tiredness. As a general principal a woman with epilepsy should not stay in labour too long and particularly should not get exhausted. Adequate pain relief should also be administered at the woman's request.

How long should my labour last?
All women are treated individually and this should be discussed with your obstetrician; exhaustion should be avoided where possible.

Am I more likely to have a Caesarean section?
Provided there are no other complications most women with epilepsy deliver their baby naturally. If complications arise during the pregnancy or labour this decision may have to be revised by your doctor and you.

Is there any form of pain relief I cannot have during labour?
As far as I am aware most methods of pain relief used during labour do not carry any more risk to the woman with epilepsy. Some literature suggests that Pethidine is pro-convulsant and may increase the risk of seizures during labour and therefore should be avoided. Women with epilepsy should also be discouraged from hyperventilating (over breathing) with the gas and air as this too may provoke a seizure. There is, however, evidence to suggest that the epidural analgesia is safe for administration with epilepsy during labour.

What if I have a seizure during labour?
If the doctor or midwife is aware of your pre-existing condition they will put procedures in place to manage and control your seizure. If this is a worry for you then I would suggest that you discuss this with your Neurologist or Obstetrician prior to your labour.

 Do I take my usual medication when I am in labour?
Yes - you should take your usual medication dose and at the usual time. You should take a supply of your usual medication to the hospital, as they may not have an adequate supply of it. If for any reason you cannot take your medication please remember to tell the doctor or midwife looking after you. Even if a c-section is planned and you are fasting you should take your anti seizure medication at the normal time.

Please remember that most labours go well for women with epilepsy. If possible try to get plenty of rest prior to the happy event.