I take Lamotrigine, pregnancy can have quite an effect on the level of medication in your blood, reducing it both because your metabolism is speed up and you have a lot more blood in your body. My specialist organised regular blood level checks and my Lamotrigine dose ended up going from 400mg at the start of my pregnancy to 600mg by the end. My dose was reduced as soon as I had the baby, I now take 450mg, slightly more than before I was pregnant to take into account sleep deprivation which comes with a baby!
I also suffered from morning sickness; I discussed this with my epilepsy nurse who said if you can see the tablets in the vomit to retake them, bit disgusting but made sense. However my morning sickness built over the morning and I only actually vomited after about 9am so I made sure I took my tablets plenty before that.
My epilepsy specialist worked with the hospital I was having my baby at to put a plan in place for the labour. I had an IV put in as soon as I arrived in hospital with IV diazepam in the room to be given as soon as I started to seizure. My specialist recommended I took 10mg of Clobazam every 12hours during labour to boost my seizure threshold a bit. I also saw the anaesthetist during pregnancy to discuss epidurals, it was decided I should have one early to control the pain which could trigger a seizure and also to make it easier to carry out a caesarean in an emergency without having to have a general anaesthetic, if for example, I had a major seizure. It is really important you always follow your specialist’s advice, which is why it is so important to feel confident in their knowledge, feel able to clarify and question what they say and also be able to share your feelings and worries with them. It is also important to make sure your partner is happy with the plan too, my husband played such a huge part in my pregnancy and labour, he was amazing, always there to support me, the labour was as hard for him to watch as for me to go through.
I was particularly lucky in that my friend (from when we were 2 and a half) was a student midwife at the hospital where I was having my baby. She used me as a case study so attended all my appointments; she helped deliver my baby and so had really looked into epilepsy. She made sure all the plans and information were clearly in my notes and was a really good advocate for me throughout. I would definitely say if a midwife student does approach you as a case study do consider agreeing, I know it’s not for everyone but it means that they will become more specialised in looking after women with epilepsy and they can actually benefit you by knowing everything about your pregnancy and labour plans, they won’t deliver your baby alone and you can decide exactly how much input they have. Just something to consider…
In the end although my labour wasn’t straight forward it had nothing to do with my epilepsy and after 24hours of labour and a tug of war with forceps baby Riley Elizabeth was born on 3rd June, Jubilee bank holiday… (Very patriotic but that’s not why we chose the name!) weighing 8lb8oz.