In general, epileptics can have children normally, but there are just some precautions that need special attention, as pregnancy may become a trigger that affects the condition. Many patients with epilepsy have a tendency to increase the frequency of seizures after pregnancy, mainly because of the lower blood levels of antiepileptic drugs and the change in seizure threshold after pregnancy. The increase in the number and severity of seizures is closely related to the degree of seizure control prior to pregnancy. Therefore, it is important for patients with epilepsy to follow up regularly throughout pregnancy and receive professional guidance from their physicians to try to keep their condition under control in a stable state and to maximize fetal health. The use of medication for pregnant women with epilepsy is also a major concern. Some antiepileptic drugs do have side effects on the fetus. Before conception, patients with epilepsy need to adjust their medication regimen with the help of their doctor to control the number of seizures as much as possible and to minimize the effects of the medication on the fetus. All women with epilepsy who are preparing to become pregnant should receive professional preconception guidance. One of the reasons why epilepsy worsens during pregnancy is that patients lack proper understanding of epilepsy and stop taking their medication. Receiving professional epilepsy counseling before pregnancy can significantly reduce the chance of worsening epilepsy during pregnancy. Preconception counseling includes informing patients and families about the risk of seizures, the teratogenic risk of AEDs, and the limitations of prenatal screening. Patients are educated to improve poor lifestyle habits, ensure adequate rest, and avoid epilepsy triggers such as smoking, alcohol, and coffee, as well as to increase the number of prenatal visits during pregnancy. Pay attention to emphasize the compliance of medication during prenatal screening and avoid unauthorized discontinuation or reduction of medication. Most structural abnormalities of fetal development can be detected in the early and middle stages of pregnancy, and timely termination of pregnancy is recommended. In pregnancy with epilepsy, the complexity and variability of the condition should be balanced with the effects of seizures and antiepileptic drugs on the mother and fetus, and the management of this special population should be strengthened. The selection of reasonable antiepileptic drugs and regular monitoring of blood levels are the core aspects of enhanced management, and attention should be paid to individualization of drug selection and concentration. Folic acid and vitamin K1 supplementation, preconception guidance, pregnancy checkups, and postpartum breastfeeding are all important components of epilepsy management in pregnant women.