C section & epilepsy

[Daisy95]

Just looking for some advice..

I am 33 weeks pregnant, I have epilepsy which has been controlled for 2 years.

I’ve started getting really worried about birth. My triggers for my seizures are tiredness and stress obviously the two main factors of childbirth.

I’ve been starting to think about requesting a c section for the following concerns..

I’m really worried about induction and the long process of that and especially with COVID rules in place my partner can’t be at the trust until I’m in established labour which means I would be by myself & at risk of a seizure.

If I did have a seizure it would mean I would loose my driving licence, job and obviously I’m a risk for caring for my baby. My partner only gets 2 weeks paternity and works in nhs 12 hour shifts and I wouldn’t have anyone would could move in to help.
Again the benefit of a section would mean my partner would get a full 2 weeks with us to help support, as I have increased risk of seizures after birth too, whereas labour could obviously take a while meaning less time at home afterwards..

Does anyone have any advice, whether I’m too negative? Whether anyone with epilepsy has had these worries too?

I appreciate it in advance!

I do have epilepsy, secondary to a brain tumour, and fought to be given the option of delivering naturally. However this was pre covid and I already didn't have my driving license, hehe. Given your history I think you'd have an easy time getting a c section organised (my hospital said it was a "default" one) but also think about what happens if baby comes before your c section date as they're unlikely to give you one before 39 weeks and I'm not sure how far into labour you can be for them to still give you an elective c section. My baby came at 36+6 so it's a good job I turned down the c section!

My epilepsy nurse gave me a lot more medication (clozmobam) to take for during labour and wrote a detailed plan for my birth notes which the midwives said they found useful. They're unlikely to leave you alone if you're a known epileptic - I had my husband and still ended up with 2 midwives.

For what it's worth, I didn't have a seizure during labour or after it. My baby is now 16 months. I appreciate everyone is different though. Have you had extra appointments and scans due to your epilepsy? You could open the conversation then.

Out of interest, why would you lose your job if you have a seizure? What do you do?

Oh and just to say that in terms of your mobility afterwards, it is likely to be much more restricted after a c section than after a seizure. Obviously I only know my seizures and I've never had a c section, but after a seizure I'm back to "normal" much quicker than several weeks minimum which is usually the case with a section. You seem to have ignored the "major abdominal surgery" aspect and are only focusing on the lack of a seizure during a vaginal delivery. Most people's partners only get two weeks paternity so you're no different to anyone else in that respect.

You should have an obstetric consultant appointment at the very latest 36 weeks to discuss delivery. If not, request it. Also whoever looks after your epilepsy should have been discussing delivery with you as well. Perhaps early epidural etc. You need a detailed plan. Ring your midwife and ask them to discuss as soon as possible

I'm only 15 weeks but following with interest. I also have epilepsy and have been seizure free for the las few years. I'm consultant led and my medication has been increased, but I hadn't even considered risk of seizure during labour. Like you OP, lack of sleep was my trigger. I'll definitely make a note to speak to my consultant and midwife about this.

Hi all,

Thank you all for your advice.
I am under consultant care and I have been having extra scans but my consultant is against any elective c section for any reason. Only believes in them for emergencies. Which is why I just wanted some advice whether to make a maternal request.

I’m actually a theatre nurse (I am not allowed to scrub for procedures unless I am seizure free for at least a year, meaning I would have to be redeployed, so wouldn’t loose income but would loose my actual role that I’ve trained for) and so have scrubbed for many c- sections so do know that this isn’t an easy recovery. I’m really comparing it to my seizures which I mostly ended up admitted in HDU for.

I think it’s just weighing up the risk of each if that makes sense. It’s nice to know you didn’t have a seizure either during birth or afterwards.

My epilepsy nurse did advise either a c- section or an early epidural which seems very sensible and I am very prepared that if I go into early labour I would have an early epidural to try and minimise the risks.

Thank you again for your advice.

@Daisy95 maybe you need a different consultant?! Speak with whoever is managing your epilepsy too as tbh unless your consultant is also an expert in epilepsy when pregnant, they should be taking advice from that team too. This actually was my nurse's specialist area so I was quite lucky in that respect. You can have a c section on the NHS just because (check the NICE guidelines) so with epilepsy you shouldn't have too much of a fight.

I also didn't have an epidural as I hated the idea of not being able to feel my legs, but I also had a very short labour (was at the hospital for 2 hours before giving birth, and about 4 at home) so a TENS and gas/air did me fine.

What I will say is I found immediately after the birth really stressful, I was shaking through shock which I then tried to control as I was aware that I looked like I was thaving a seizure and I didn't want to prove them right. That was all I could think about and knew baby would be ok with my husband. I ended up being classed as a cause for concern due to "failure to bond with baby", but when we spoke to the MH midwives later that day they said that my reaction was inevitable and they wished they'd been aware of me before as then they'd have told the midwives that I probs didn't need refering. However, baby did come spontaneously at 36 weeks, I'd not finished work, we'd still not finished discussing how I wanted to give birth, it was such a quick labour AND it was my birthday... So in hindsight, no wonder I was in shock!

Hi, I have epilepsy and have two children (aged 4 & 1).

I like you have a form of epilepsy which is triggered by tiredness and stress. With my first child I was told that I wouldn't need an elective c-section- however the consultant strongly recommended having an EARLY epidural so that I could rest/sleep and reduce the risk of a seizure being triggered. I was also advised not to have pethadine (sp?) as a pain relief.

As it turned out I needed an emergency c section (unrelatedly to epilepsy). I was 5cm dilated by this time.
I had a really robust plan in place for support following both births, in that I had plans in place for when DH returned to work and how I would manage night feeds, spending time on one floor of the house etc. All really practical steps which rely a lot on support from others and combine the steps I take to minimise any risk daily anyway.

I had an elective c section with my 1 year old, the recovery was absolutely fine (much easier than when I had the emergency- there is a huge difference). With my second I was up out of bed the same day! x

Sorry also wanted to say that I was induced with DC1

Hi

How did it go? I'm 23 weeks and considering the same as mine is lack of sleep/ stress related?