Epilepsy and childbirth

[FRowlands]

I'm epileptic and my first baby is due in November. I'm really concerned about the birth as my seizures have been well controlled by a low dose of meds and some careful lifestyle changes and generally just monitoring my well being. My triggers for seizures are lack of sleep, stress and overbreathing. Labour and childbirth are all three in abundance. Having a seizure could severley damage the baby and/or myself not to mention have repercussions in terms of losing my driving licence etc. For these, and other reasons, i would really like a C-section (NHS). Does anyone have any experience around this issue as I'm really very concerned about what's going to happen to me and my baby.

I too am epileptic and had my first baby a month ago. I don't want to worry you as my epilepsy has never been especially well controlled and whilst we were ttc I decided to stop taking my medication as I didn't want to be on them during pregnancy.

A few weeks prior to giving birth I had excruciating back pain which triggered a seizure. Obviously concerned about the relationship between the two I discussed it with the hospital, they weren't worried and assured me I'd be ok and unlikely to have a seizure during labour...

When my contractions were strong and a few minutes apart my husband phoned the hospital as I'd been "twitching" whilst having them - by the time we arrived I was having seizures with each contraction and unable to speak for 4 hours due to aphasia. Because of all this I was given an epidural at 3cm dilated and happily, after this was administered, I was fine. Interestingly the midwife we initially saw told my husband that, in her experience, it's extremely common for women with a history of seizures, who may not have had one for many years, to fit during labour. During all of this they continuously monitored DD and she wasn't distressed by it at all, had she been then they would have performed an emcs. Given this experience I would push for a c-section next time.

Apologies if this is garbled, currently have DD attached to my boob!

Good luck with it all and let me know how you get on

Two SILs, both epileptic and both had c-secs in the last year. I would have thought it was a strong enough reason. Good luck :)

Thanks for the responses. I'm quite emotional about the whole thing and hubby is v worried too. We meet with the consultant next week where I'll really be pushing for it. We have looked at going private just to get the peace of mind but it's just not affordable. Just hoping for them to say yes so I relax and enjoy being pregnant! I'll let u know how we get on.

I am epileptic (and diabetic) and am 31+4. My obstetrician wants to go for vaginal birth at the moment - induction at 38 weeks. Main focus of my pregnancy management is the diabetes, they (medical team) all seem quite relaxed about the epilepsy. I have had epilepsy for 11 years and it has been controlled for 1 year, since I started Tegretol. One seizure in April which resulted in my medication being boosted up slightly. All my tonic clonics are in my sleep. Before Tegretol I would have them pre-menstrually and with disturbed sleep, stress or alcohol use.

Like you lack of sleep is a major trigger for me. This hasn't been discussed in detail yet but I would expect (from discussions so far) them to move for c-section if induction doesn't progress quickly. I have pointed out that I don't want labour to drag on for a sleepless 4 days! I think if I had a preference it wouldn't be difficult to persuade them to go for an elective c-section. I think this is worth considering for you because of overbreathing being an issue and because you have a driving licence to hold on to (jealous!).

I will try to post about my labour after the event (early July). Feel free to PM me in, say August, if I forget. Need to give myself time to get my act together first!

Have you discussed your medication during pregnancy yet? I was on a low dose and only found out your need for medication can increase as the baby grows after I had a seizure. I was so annoyed as I wanted to apply for my licence! So it needs to be discussed by fairly early in the 2nd trimester.

My very good real life friend is epileptic. She had the same concerns with her triggers being lack of sleep and stress. She had a very good consultant who advised a vaginal birth but was very clear about ways in which she would be monitored. She has 4 children, all delivered vaginally and was fit-free for all labours/deliveries. But she was very, very closely monitored.

However, she did find that she fitted more post partum with each child so this is something to be aware of. I'm not sure how common it is but assume that the sleep deprivation/stresses of having a newborn were relevant. She was careful never to be alone with the babies and all was fine. She did fit once while holding her ds1 but her dh was there and able to intervene.

My GP has been trying to get me in to see my neurologist to discuss meds etc but still heard nothing (2 referrals later!). I'm now at the early point of 2nd trimester and I know, according to clinical guidelines, I'm meant to be seeing him as well as the obs consultant!! If I lose my licence and my job because they don't get their act together I don't know what I'll do!!
Thanks for the posts. Just trying to find out as much as I van about othe ppl experiences. It does seem that elcs are much harder to get from some consultants than others. Fingers crossed for next week's appt

Phone up your consultant's secretary and get her to make an appt for you there and then. You shouldn't have to be pushy, but sometimes you have to be to get what you need. Good Luck!

I have the same triggers as you but never thought about an elective c/s, no reason, just didn't.
I was in labour for 3 days with my first before having an EmC/S, I was fit-free. My 2nd I tried for a VBAC before having another EmC/S, again I was fine.
It's a shame you haven't seen a neurologist, have you phoned their secretary yourself?
How long since you last had a seizure?

I've never seen someone with known epilepsy fitting in labour so I don't think it is that common.

Speak to your Consultant.

I would also suggest that anyone with epilepsy discusses carefully the risks and benefits of medication during pregnancy with their doctor prior to conceiving as uncontrolled epilepsy during pregnancy can actually be more dangerous to the fetus than antiepileptic drugs. Recommendations for pre-conceptual counselling for woman with long term health conditions eg. epilepsy, diabetes and cardiac disease have been a feature of the last few CEMACH/ CEMACE reports into maternal mortality in the UK.

However the message doesn't seem to be gettting through (I"m not sure if it is partly because woman with these condition fear being told that they shouldn't get pregnant but certainly for some of them there is quite a bit that could have been done prior to conception if they had sought advice)

Turtles That is interesting about your friend's post-partum fits. My epilepsy was controlled by medication for 6 years until this week. This included during labour when DC1 was born 4 weeks ago. I had met with the midwife in charge of my hospital's midwifery-led unit who agreed that I could give birth there despite being officially ineligible as I was under a consultant due to my epilepsy. However, this week I had my first seizure in 6 yrs, possibly related to lack of sleep but I don't really know. I am lucky that I never learnt to drive in the seizure-free period and especially lucky that I wasn't holding DD at the time and DH was there to look after both of us.

Just thought I'd update. I went to see the obstetrician today. She didn't answer any of my questions or queries about my concerns and just added to them by telling me about more risks - i thought i knew what they all were!! Needless to say I left upset and confused. I have requested a second opinion - basically wanting a consultant to answer some questions. However, we are now looking into private providers. This way hopefully I'll get some reassurance!!