Pregnancy in women with epilepsy is a common condition in women during the reproductive years, and pregnancy in women with epilepsy may increase the risk of seizures, various complications and malformations in the offspring, necessitating preconception counseling for women with epilepsy. Patients should be aware that children are 2-3 times more likely to be teratogenic than normal when the mother takes antiepileptic drugs, although such drugs are only one reason why the mother’s health is also important. What should be done to reduce the chance of malformation? Continuation of antiepileptic drug therapy: Except for a few patients whose seizures have stopped for many years before the planned pregnancy and whose ancillary tests are no longer abnormal, antiepileptic drugs can be gradually reduced and discontinued before conception, most patients should continue antiepileptic drug therapy during conception and pregnancy because seizures during pregnancy, especially tonic seizures, may cause maternal trauma and lead to miscarriage or other damage to the fetus. Simplification of therapeutic drugs: It is best to use single-drug low-dose therapy because no antiepileptic drug is completely safe for the fetus, so the principle of drug selection remains based on the patient’s seizure type and the drug that is most effective in controlling seizures. Monotherapy can significantly reduce the incidence of fetal malformations. Supplementation with adequate amounts of microbiotics, inorganic salts, trace elements and folic acid, ensuring adequate nutrition and sleep, avoiding other medications as much as possible, and prohibiting alcohol consumption.