Epilepsy = manditory epidural?

[MellyMel]

Hello everyone! I am posting on behalf of a new friend of mine. She is pregnant with her second son and is due in early Dec. She is epileptic and unmedicated for the pregnancy. Her doc (obgyn) had told her that it is manditory for her to have an epidural during labor/birth because she can't get too stressed/tired and run the risk of having a seizue. Anybody have experience with this? Any advice for her or articles to read? Thanks!

[LoveChild421]

My friend is also epileptic and due soon, her OB recommended a C-section because she does have some pretty severe seizures even when medicated and has been known to stop breathing at times. I really don't know enough about epilepsy to have an opinion on it. I would think that it would vary with the severity of the epilepsy and how bad seizures get. I have heard of medications that lower the risk of seizure that can be taken right before labor or during, so that you don't have to have a C-section or epidural.

Either way, its her choice, she should research her options, epidurals are not without risk.

[laohaire]

I know a bit about epilepsy because I did a fair amount of research when a coworker revealed she had it. From what I've seen, the experience varies wildly. People have very different types of seizures and very different triggers.

If I were your friend, I would speak to the doctor that follows my epileptic condition to answer these questions. To me, this is the doctor with the relevant knowledge, not the OB. Of course, the OB would be the one "responsible" for me if I were to seize, so I'm not trying to say the OB would have no say, but I'd take my direction from my primary doctor and perhaps request the OB to consult the primary on the subject.

[thebarkingbird]

Originally Posted by laohaire

If I were your friend, I would speak to the doctor that follows my epileptic condition to answer these questions. To me, this is the doctor with the relevant knowledge, not the OB.

i wish doctors would stop using the word "required" in reference to their patients accepting medical services! may be a good idea, may not. however, i'm never REQUIRED to accept medical services of any kind. i have a medical condition that required meds in my 1st pregnancy and continues to be monitored. when something to do w/ the medical condition comes up i talk to my specialist. now that i'm seeing an OB instead of going UC i think i would suggest my specialist and OB communicate w/. each other or talk to the OB about what the specialist told me.

[erika412]

I have epilepsy and have never been told that I had to have an epidural. I just had my 3rd dd on the 4th and had her in the hospital med free. My seizures are "grand mal" where my whole body convulses and I lose consciousness. Like someone else posted, there is a wide range of seizures.

Are her seizures controlled with medication? If they aren't controlled, then I can see where this might be a concern, but if she's been controlled before getting pg and throughout the pg, then there is no reason to force something on her if she doesn't want it. She should be having at least monthly blood tests to make sure her medication(s) are at a therapeutic level as well. My dose had to be increased numerous times throughout my pregnancies.

I would have her talk to her neurologist and make sure the OB and neuro are communicating as well.

Editing because I just re-read your post about her being unmedicated during her pregnancy. That is not something I did and would not feel comfortable doing so ignore my questions/statements about meds.

[AlexisT]

It may be that her neurologist did not want her on the meds during pregnancy. Some anticonvulsants are associated with neural tube defects (I know Depakote is because I used to take it, though not for epilepsy).

I don't know any epileptics in this situation, but I do know people who were on these meds during pregnancy. It's something that requires the coordination of an experienced neurologist and obstetrician.

I don't like the blanket statement that an epidural is required for an epileptic patient, but I don't know that that's exactly how it was put to the OP's friend. It may well be possible that this is necessary in her case.

[mtn.mama]

nak
I have a seizure disorder, temporal lobe partial complex. I got off my meds 10 years ago and regulate with sleep patterns, nutrition, stress management and exercise. I was worried that I wouldn't be able to find a midwife who would assist my homebirth, but I got lucky. Unfortunately after 45+ hours of back labor and 7 hours of pushing I ended up with a cesarean birth. During my labor my seizure disorder was very much on my mind, and I was trying to my best to keep it together so I could stay home. But what sent me to the hospital was being unable to move the baby to crown. I didn't tell the OB or anesthesiologist that I had seizures, a judgment call on my part. And it worked out okay for me. Your friends condition is unique, but like the pp said- no medical interventions are mandatory. Please tell your friend I wish her luck- she can PM me if she wants to chat.

[mamakay]

I guess it would depend on how severe her epilepsy is, and what her triggers are. For reasons that are unknown, having a seizure during labor is actually extremely rare for epileptic women.
FWIW, I'm epileptic and have never heard anything about epileptic women being required to have an epidural, and my OB is about as mainstream "everything according to the recommendations" as they come. Hanging out on epilepsy forums I've never heard of that, either.
So I'm thinking your friend got something confused, or the OB's making that up or something.

[brookely ash]

i do not have any experience with epidural for epilepsy, but i hope your friend finds a solution she is comfortable with. i definitely think she should ask her neurologist.

i started a thread in special needs parenting hoping people could share info/stories about seizures. http://www.mothering.com/discussions...28#post9224028 maybe someone will post something there or if anyone ever replies they might have some info for you.

[mrskennedy]

First of all, an epidural is NEVER, EVER mandatory!!! Secondly, go to www.unassistedchildbirth.com and read the birth stories there. I remember at least 2 where epileptic mothers had natural, uncomplicated births--and one was twins! No epi required, unless you *want* one!