Seizure Disorders

Reviewed by James Brann, MD
A seizure happens when the nerve cells in the brain start having abnormal activity. This can lead to a change in emotions, movement, consciousness or mood.

Epilepsy is simply one type of seizure disorder. It’s diagnosed when someone has at least two seizures without a clear cause.

Controlling seizures

If you have repeated seizures, you’ll likely need to take anti-seizure drugs, also called antiepileptic drugs, or AEDs. While these types of drugs can’t cure the disorder, they may prevent seizures at least most of the time. There are more than 20 AEDs out there. The drug you use depends on the type of seizure, the drug’s side effects and a person’s age. If one particular drug doesn’t work, you can try another. You may need more than one type of drug to control your seizures.

Problems during pregnancy

Seizure disorders can impact pregnancy in a number of ways, including:
  • Injuring a mom and her baby
  • An increased risk of having a child with a birth defect - This may be related to the seizure disorder, or to the AEDs used in treatment.
  • Frequency of seizures - While most women don’t have any changes in the frequency of seizures, some have them less often. About one-third of these women have them more often.

A majority of these problems may be avoided, or minimized, by making sure you get quality medical care before you get pregnant, and during pregnancy.

Risks with a seizure

A seizure can harm a mom and her baby. When you lose consciousness with jerking, violent movements, it’s called a grand mal seizure. This is extremely dangerous when a woman is pregnant. The risks of a seizure during a woman’s pregnancy include decreased oxygen going to the baby during the seizure, being injured in a fall, preterm labor and even, preterm birth.

Anti-seizure medications during pregnancy

Some AEDs may cause a small, but increased risk of certain birth defects. These include heart defects, neural tube defects, and cleft lip or palate. This is when either the lip or roof of a person’s mouth isn’t all the way closed. One reason behind AEDs and an increased chance of birth defects may be that the drugs affect how the body uses folic acid, a B vitamin. If you don’t have enough of it before you get pregnant, as well as during the first few weeks of your pregnancy, you’re at a higher risk of delivering a baby with a neural tube defect. If you already take an AED, your doctor may want you to take additional folic acid before you get pregnant, and then for the first three months of your pregnancy.

Because of the serious risks in having a seizure while you’re pregnant, and due to the fact that the risk of harming your baby by taking AEDs is relatively small, most experts recommend that you do control your seizure with AEDs during pregnancy if you need to. The amount, type and number of AEDs you are taking, though, may have to change. You really want to make any changes in your medication before you get pregnant. This gives you and your doctor the opportunity to see how a change in medication will affect you without risking your unborn baby.

Monitoring your pregnancy

Routine blood tests will be done to ensure your medication levels stay constant. With high levels, there could be side effects. Low levels may mean seizures. Your doctor can also use blood tests in screening for certain types of birth defects. Diagnostic testing, including chorionic villus sampling, amniocentesis and an ultrasound exam, may also be done as part of determining if there are certain birth defects.

If you do have a seizure disorder, it won’t affect how you’ll have your child. Just as with most other women, you’ll likely be able to deliver your child vaginally unless there’s another problem during labor and delivery. If this is the case, you may need a C-section.

Birth control later on

After your child is born, you should know that AEDs may lower how effective some hormonal birth control is. This includes the vaginal ring, the implant, the skin patch and birth control pills. AEDs don’t affect the birth control injection, intrauterine devices, and barrier methods like spermicide, condoms or the diaphragm. Many women will choose to use both a hormonal and barrier method together. If you’re done building a family, you also have the option of sterilization.


Even if you have a seizure disorder, you likely can breastfeed your child. AEDs may be found in breast milk, but usually the amount is so small it won’t affect your child.

Shoulder dystocia is considered an emergency, and needs immediate treatment.

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