Women and girls with epilepsy

Subbulakshmi was married two years ago. She is an epileptic and has been avoiding a pregnancy because she and her husband are worried that the baby might be affected by the medicines that she is taking. They need not worry. With good preconceptional counselling and optimal obstetric care, she can have a normal pregnancy and baby. She can also safely breast feed her baby.

How common is epilepsy?

There are 5.5 to 7.8 million persons with epilepsy in India. To put it in perspective, this is about 1/8th of the world population! Unfortunately, the statistics in India are not accurate due to the stigma still associated with this disorder. Both in the urban and rural population, people still try to conceal the disease. Girls and women particularly delay seeking professional help.

As late as 1976, persons with epilepsy were denied the fundamental right of marriage and procreation by prejudiced legislation enacted in India. It is due to the selfless efforts of Dr. Mani, Dr. B. Ramamurthi and Dr. G. Arjundas, leading physicians of Chennai, and the Indian Epilepsy Association, that a public interest litigation was filed in the Supreme Court. It is only since 1999 that patients with epilepsy can have a legally valid marriage.

Gender and epilepsy

The effects of epilepsy on men and women are the same and both get treated with anti-epileptic drugs. There are, however, several features peculiar to women with epilepsy which need exceptional attention, individual care and empathy. The public attitude towards a person with seizures is, even in the 21^st century, fraught with fear, superstition, discrimination and erroneous beliefs.  This is exaggerated in the case of a girl/woman and is true both in the educated and less educated population. The failure to convince people that epilepsy is like any other illness such as hypertension, diabetes, or asthma leads to difficulty in finding a good life partner.

Even in the urban setting, women continue largely to conceal the fact of their having seizures prior to marriage, urged on and prompted by parents. To avoid problems later in the marriage, it is best to have an informal discussion with a doctor by both parties so that all doubts can be laid to rest.  There are many cases where a disclosure of epilepsy after the marriage ends up in the woman being sent back to her parents’ home, even if she were pregnant. Many times if a baby boy is born, custody is taken by the man’s family but girl babies are invariably left with the mother!