You are not alone. Over 90% of women with epilepsy have normal pregnancies and deliver healthy babies. This guide gives you the information you need — based on the latest medical evidence.
Start Planning →Key facts backed by international research registries
Start preparing ideally 3-6 months before trying to conceive
Not all anti-seizure medications carry the same risk. Here's what the evidence shows.
| Medication | Safety Level | Birth Defect Risk | What This Means |
|---|---|---|---|
| Levetiracetam (Keppra) | Safer option | ~2.5 out of 100 babies | One of the safest choices. Close to general population risk. |
| Lamotrigine (Lamictal) | Safer option | ~3.1 out of 100 babies | Well-studied, widely used. Most data available. Dose monitoring needed. |
| Oxcarbazepine (Trileptal) | Safer option | ~2.9 out of 100 babies | Good safety profile. Less data than lamotrigine but reassuring. |
| Carbamazepine (Tegretol) | Discuss with doctor | ~5.4 out of 100 babies | Moderate risk. Dose-dependent — lower doses are safer. Discuss alternatives. |
| Topiramate (Topamax) | Discuss with doctor | ~4.9 out of 100 babies | Increased risk of cleft lip/palate. Also linked to smaller babies. |
| Phenytoin (Dilantin) | Discuss with doctor | ~6.3 out of 100 babies | Higher risk. Consider switching to safer options before pregnancy. |
| Phenobarbital | Discuss with doctor | ~6.2 out of 100 babies | Higher risk. Dose-dependent effects. Discuss alternatives. |
| Valproate / Divalproex (Depakote, Valparin) | Avoid if possible | ~10 out of 100 babies | Highest risk. Also linked to lower IQ (8-11 points) and 2.7x higher autism risk in children. Avoid during pregnancy if at all possible. |
Data source: EURAP International Registry 2024 (Battino et al., JAMA Neurology). General population birth defect risk: 2-3%.
"Birth defect risk" = Major Congenital Malformation (MCM) rate. Individual risk may vary — always discuss with your neurologist.
Never stop your medication suddenly. Stopping anti-seizure medication without doctor supervision can cause dangerous seizures, including status epilepticus — which can be life-threatening for you and your baby. Always talk to your doctor first.
A trimester-by-trimester guide to managing epilepsy during pregnancy
The most critical period for your baby's organ development.
Detailed scans and monitoring.
Preparing for delivery.
Seek emergency care if you have: a tonic-clonic (convulsive) seizure lasting more than 5 minutes, repeated seizures without recovery, a seizure with a fall or injury, vaginal bleeding after a seizure, or if you feel your baby is not moving normally after a seizure.
Caring for yourself and your baby after delivery
Most anti-seizure medications are safe during breastfeeding. Levetiracetam, lamotrigine, and valproate pass into breast milk in small amounts and are generally considered compatible with breastfeeding.
The benefits of breastfeeding usually outweigh the small medication exposure. Your baby was already exposed to your medication during pregnancy — breast milk levels are typically much lower.
Discuss with your doctor, but do not avoid breastfeeding just because you take seizure medication.
If your dose was increased during pregnancy, it may need to be reduced within days to weeks after delivery to avoid side effects.
This is especially important for lamotrigine — levels can rise rapidly after delivery, causing dizziness or double vision.
Your doctor will guide the dose adjustment. Do not change doses on your own.
Sleep deprivation is the #1 seizure trigger in the postpartum period. New parents lose a lot of sleep — this is real and important.
Tips: Share night feeds with a partner or family member. Sleep when the baby sleeps. Accept help. If breastfeeding, pump so others can do some feeds.
Keep your medication schedule consistent even when exhausted.
If you have seizures, take simple precautions:
• Change and feed your baby on the floor, not on a bed or changing table
• Bathe your baby with another adult present
• Use a pram with brakes when walking
• Avoid carrying your baby near stairs if seizures are not controlled
• Make sure family members know seizure first aid
Common questions from women with epilepsy who are pregnant or planning pregnancy
Trusted organizations and registries for more information
The largest international registry studying anti-seizure medications in pregnancy. Data from 47 countries.
Harvard Medical School registry — 15,500+ women enrolled. Publishes safety data on seizure medications.
Expert-led resource with downloadable tools, doctor question checklists, and pregnancy planning guides.
Comprehensive guides on pregnancy, contraception, and family planning with epilepsy.
India's national organization for epilepsy awareness, education, and support.
Global organization providing epilepsy guidelines, classification, and research updates.
DM Neurology | PDF in Epilepsy
KD Hospital, Ahmedabad
This website was created as a free educational resource for patients with epilepsy who are pregnant or planning pregnancy. All information is evidence-based, sourced from international pregnancy registries (EURAP, North American AED Registry), peer-reviewed research, and guidelines from the AAN, ILAE, and NICE.
Our goal is to empower patients with accurate information so they can make informed decisions together with their doctors.