This article discusses first-aid strategies during seizures and the treatments available during pregnancy. It also discusses the risks seizures have on the pregnant person and the fetus and the steps to take to reduce the risk of seizures.
Seizures can vary greatly in length and severity. A person might lose focus or stop paying attention for a second or two, or they could lose consciousness and have convulsions for several minutes.
Seizure symptoms include:
- uncontrolled muscle spasms
- loss of consciousness
- an abrupt change in mood
- falling
- clenched teeth
- loss of bowel or bladder control
- tongue biting
- abrupt mood changes
- strange taste in the mouth
- drooling
- grunting or moaning
- eye rolling or rapid eye movement
If you suspect a pregnant person is having a seizure, call 911 immediately. A seizure lasting longer than 5 minutes is considered a medical emergency.
While you wait for help to arrive, follow the Centers for Disease Control and Prevention (CDC) guidance for general first aid during a seizure:
- remain calm and keep those around you calm
- stay with the person until help arrives
- check for a medical alert bracelet or necklace
If the seizure causes the person to fall and shake or jerk uncontrollably:
- ease them carefully to the ground
- roll the person on their side
- remove accessories that could poke or restrict breathing
- clear the area around the person
- put something soft and flat under their head
During a seizure, do not:
- hold the person down
- put anything in their mouth
- try to give mouth-to-mouth breaths
- offer food or water
Read more about safety during epilepsy.
According to the Epilepsy Foundation, most people with epilepsy do not see a change in the frequency of their seizures, or they have fewer seizures during pregnancy. However, the foundation notes that 15–30% of people experience more seizures during pregnancy.
Several medications can help prevent seizures during pregnancy. Discussing the risks and benefits of these medications with a medical professional is important.
Safe anti-seizure medications during pregnancy
Multiple medications are available to help prevent seizures. They are known as anti-epileptic drugs (AEDs).
A 2016 study on the relative risks to the fetus from common AEDs suggests that lamotrigine (Lamictal) and levetiracetam (Elepsia XR, Keppra, Spiritam) pose the least amount of risk to the fetus.
According to the Epilepsy Society, several anticonvulsant medications and AEDs do not have enough safety information available on their use during pregnancy. This means there is the possibility they could harm the fetus. For example, rufinamide (Banzel) and vigabatrin (Sabril) are highly unlikely to be used during pregnancy.
The most common risks to the fetus from seizure medications taken during pregnancy include congenital irregularities. Common irregularities include neural tube irregularities, cleft lip, cleft palate, and structural changes within the heart or urinary system. Some medications may also affect childhood development.
People planning on becoming pregnant should discuss their medications with their medical specialists. The Epilepsy Society also suggests taking folic acid before any possibility of pregnancy.
If you are taking seizure medications and find that you are pregnant, speak with your medical professional before stopping any medications.
It is important to control seizures during pregnancy, as they can harm the fetus and the pregnant person.
About 15–30% of birthing parents experience increased seizure frequency, typically in the first or third trimester. The reason is unclear but may be associated with hormonal changes, sodium and water retention, and stress. Not getting enough sleep and not taking medications according to the directions may also play a role.
For the birthing parent
Tonic-clonic seizures pose the most risk to the pregnant person and the fetus because this type of seizure is more likely to cause:
- trauma such as falls, burns, broken bones
- premature labor
- miscarriages
For the fetus
Seizures during pregnancy may cause:
- lower fetal heart rate
- oxygen deprivation which may cause brain damage
- fetal trauma from a fall
- early separation of the placenta from the uterus
- preterm birth
Several steps may help lower the risks of seizures during pregnancy. The first step is discussing the possibility of pregnancy with a neurologist and maintaining good communication with them throughout the pregnancy.
Taking folate and a multivitamin helps decrease the possibility of neural defects. It is best to start this before becoming pregnant.
Take your medications as prescribed. Some people may need periodic AED-level blood tests to ensure they receive the optimal dose. Doctors will also monitor the baby’s growth and development with ultrasounds.
Avoiding infections and maintaining proper blood sugar levels is also important, as fevers, infections, and high or low glucose can trigger seizures.
Be sure to get enough sleep and reduce stress. Also, drink enough fluids to stay hydrated. In addition, follow typical pregnancy guidelines and avoid alcohol.
Most people who have seizures during pregnancy also had seizures before pregnancy. However, some people develop seizures during pregnancy.
Anti-seizure medications can help, and some medication options are low risk for the fetus. Talk with your doctor about controlling seizures during pregnancy because they can cause harm to the pregnant person and the fetus.
Talk with your doctor about additional ways to lower your risk for seizures during pregnancy, which may include some lifestyle changes.
