Frequently Asked Questions

What can I expect when receiving care from you?

When you come to see us, we start with a thorough examination and diagnostic workup with tests. We want to know what is causing your condition, its current state, how your condition manifests, and how we can prevent it from advancing or flaring during pregnancy. You can expect us to carry out a detailed care plan with regular check-ins where we fine-tune your health, avoid complications, and limit risks to you and your baby.

First, you will meet with our maternal-fetal medicine specialist at Lucile Packard Children’s Hospital Stanford who will guide your care throughout your pregnancy journey. She will partner with a neurologist at Stanford Hospital (our next-door adult hospital) who specializes in your type of neurological condition. The two will guide your care before, during, and after pregnancy to ensure the very best outcome possible for you and your baby.

Will my symptoms get worse while I am pregnant?

Many women with neurological conditions believe pregnancy is a difficult time, when their symptoms will worsen and they have to simply suffer through. Or, they believe they must stop their medications while trying to conceive or when pregnant. It’s important to never stop your medication without guidance from a physician. While it is true that some medications, like those for multiple sclerosis or older epilepsy drugs, can be dangerous for a developing baby, there are often safe alternatives—something we help guide you in taking.

You never have to suffer through your symptoms. We can stabilize your condition before you conceive to help you have a peaceful, healthy pregnancy.

Will my developing baby be affected by my neurological condition?

With many neurological disorders, your baby will not be affected, but some do put unborn babies at risk. For example, if you have epilepsy, a large, uncontrolled seizure could affect your unborn baby. This is why we use the very latest treatments to help control your seizure activity before, during, and after pregnancy. Epilepsy patients are also at a higher risk for a preterm delivery, and some epilepsy medications can affect developing fetuses. Our world-renowned Stanford Medicine epileptologist has led several studies on the safe use of epilepsy medications during pregnancy. If you have a history of stroke, pregnancy is a high-risk time for repeat stroke—which may affect your baby. It’s important to remember that although pregnancy is considered a high risk for mothers with epilepsy and stroke, the vast majority of our patients’ babies do just fine. We partner with fetal, neonatal, and other deeply specialized obstetric specialists, such as our Fetal and Pregnancy Health Program providers, to ensure the highest level of care.

Why do I need specialized care?

During pregnancy, the neurological system goes through a lot of changes, so it makes good sense to receive specialized care. With mild conditions, such as tension-type headache, after we evaluate you, we may simply partner with your community obstetrician to carry out a care plan. However, with more advanced neurological conditions, such as multiple sclerosis (MS), stroke, epilepsy, and certain autoimmune and neuromuscular conditions, it’s important that you receive specialized care. That way, we can closely watch for any signs—signs we are trained to see even before they present themselves—to reverse any chance of a poor outcome for you or your baby. We can also diagnose the source of your disease and sometimes resolve symptoms prior to pregnancy. We work to get your condition under good control, as with MS, before pregnancy to make pregnancy more successful.

Why should I see you before I get pregnant?

There are lots of studies showing that women with a neurological condition who are seen before pregnancy have better outcomes. Getting your condition stable before pregnancy is vital to optimize pregnancy outcomes. We also will work together to develop treatment plans that balance maternal risks while minimizing effects for your future baby.

I was told I should never get pregnant. Can you help?

In many cases, if an individual with a neurological condition wants to get pregnant, they can with specialized care—even if their condition is severe or complex. We are here to guide you in making that happen. You do not have to let your disease stop you from achieving this dream. The following misconceptions exist for these conditions:

• Stroke or a blood disorder. You may have heard that you should not get pregnant. This is not necessarily true. By providing in-depth, targeted care before, during, and after pregnancy, we have been able to help women with stroke have a healthy pregnancy and deliver a healthy baby.
• Neuromuscular disorder that affects your physical ability to carry a baby. We can help you ready your body for pregnancy by strengthening your muscle function and using adaptive strategies to reduce the physical load and conserve your energy. For example, we may recommend that you work with one of our neuro-occupational therapists within the Neuromuscular Program at Stanford Health Care.
• Multiple sclerosis (MS). Women hear that they will have fertility issues or that they cannot carry a baby to term. Another myth is that they can’t have a natural delivery or receive pain treatment during delivery, and their baby may have a low birth weight. All of these are untrue. In fact, during pregnancy there is a good chance that you will go into remission, thanks to changes that occur during pregnancy and the baby’s immune system—which is half your partner’s. Because of advances in MS care, most of our patients with multiple sclerosis do quite well during pregnancy.

Why is receiving prompt care during pregnancy so important?

When you have a neurological condition, pregnancy is a time-sensitive and high-risk period. Your condition could affect your health, your pregnancy, or your unborn baby, so you should be seen by a specialist as quickly as possible.

In a research study by some of our team members titled Improving Reproductive Neurological Care, we found that the median wait times for Bay Area peripartum patients from referral to neurology appointment was 61.5 days. That’s simply too long. It’s why we have a streamlined process that prioritizes individuals seeking pregnancy or already pregnant. With this new model, we significantly decreased wait times.

Ask your obstetrician for a referral if you are seeking an evaluation from our Pregnancy Neurology Program.