How to alleviate headaches during pregnancy

They’re super common, and pretty terrible. Here’s what you need to know.

"I love being pregnant. I like it more than not being pregnant. But the headaches, my god the headaches. Someone. please help. Don't say water. Or Tylenol. Or iron. Or magnesium. I need witchcraft."

Yes, Chrissy Teigan told it straight, back when she was pregnant with baby Miles in December 2017. Pregnancy headaches can make you want to slap the man sitting next to you. It's a bitter irony that pregnancy headaches happen at the same time as pregnancy, so, no you can't have any Advil. But if knowledge is power, here's why they happen and what you can do.

When you are pregnant, what you had previously thought of as your body gets remodeled into something like a single bedroom apartment with a giant waterbed. The waterbed houses a new roommate who stretches your ligaments, pushes your organs up into your chest, pumps you full of hormones, tugs on your back, eats up your food, drinks your water, and uses up lots of energy. And all of these things can cause headaches. Most of the time pregnancy headaches are normal, but it's also good to make sure your headaches aren't a symptom of something more serious.

According to Sarah Prager, M.D., an associate professor in the Department of Obstetrics and Gynecology at the University of Washington, dehydration is probably the most common cause of pregnancy headaches. "Women need to hydrate more than usual, and this is worse if they have significant nausea or vomiting," she says.

Let's recap: you are tired, you might feel ill, you are running around trying to gather the approximately five gazillion things you will need for a tiny new human, and now you need to drink EVEN MORE than normal? Yes. Your new roommate needs water too, and when you don't drink enough for the both of you, a headache is often the unpleasant reminder.

Here the treatment is simple: drink more fluids. And maybe consider something that helps you remember to drink throughout the day. The Fitbit has a fluid intake tracker, there are apps for your phone, and you can even buy a water bottle that reminds you to drink. Though Fitbit and other companies still lack "pregnancy mode," another benefit of health trackers while pregnant is that you can see just how hard your body is working. As one woman who posted her results online wrote, "It is a test of strength and endurance simply to carry a child to term and give birth." Don't forget to hydrate during your marathon.

Another likely cause is muscle stress. Especially in the third trimester, your baby is pushing things around. The organs that normally occupy your torso are literally squeezed up into your chest cavity, you have something about the size and weight of a bowling ball pulling on you, and your ligaments have gotten stretchier. These headaches are tension headaches, so anything that helps with muscle tension can help relieve the pain. That could include massage, warm or cool compresses, relaxing music, meditation, herbal tea, relaxing scents like lavender or botanical oils, a warm rice sock, or a bath. (Just make sure the bath is not too hot, and no, nobody knows exactly how hot that would be.)

There are a dozen other reasons. Some of these are sleep deprivation, stress, hormone fluctuations, low blood sugar, not enough protein, iron, magnesium, or calcium in your diet, food sensitivities, and caffeine withdrawal. If you can, try to determine the trigger. Do you get headaches when you are hungry or go too long without eating? You might need to even out your blood sugar by eating smaller meals, more often.

Migraines are a special form of headache hell. Severe, pulsing pain on both sides, migraines can build over minutes or hours and make you sensitive to light and even throw up. Some women get fewer migraines while pregnant, while others find that pregnancy brings them on. Pregnancy migraines generally have the same causes as less debilitating headaches, but hormone changes are especially to blame.

Virginia Christian, 38, who is pregnant with her third child, says the migraines that began early in this pregnancy were so bad she missed work. "I would get massive headaches and get sick and try to rehydrate and get sick. I lost weight. They were just really making me ill." Now in her last trimester, Christian says her headaches are less frequent, but nothing she tried really helped. Her pregnancy has been so rough that she never wants to do it again. "This one will definitely be the finale," she says.

Christy Batts was 25 and having her third baby when she started getting migraines. "Before when I had a headache it was something I could point to and say, 'yes, this is the cause, and it is temporary,'" she says. Her midwife suggested teas and tinctures, homeopathic treatments, herbs, heat, and ice, but nothing worked. Finally, in desperation, she tried a chiropractor. "I didn't think I was one of those people who went to chiropractics," Batts says, "but I had two other kids and I wasn't ready to be bed-bound with the lights off." The chiropractor made minor adjustments on Batts' hips and massaged a pulled ligament, and she says her headaches stopped.

Anthony Noya of Noya Chiropractic in Washington, D.C., is not surprised. "There are a whole lot of postural changes that happen during pregnancy," he says. And according to Noya, if the structure of the body is off, it can't function properly. As you can imagine, pregnancy can throw a body off-center. "The spine and the human frame is really this complex game of Jenga," he says.

As he explains it, the brain sends messages down the spinal cord, which connects to nerves and tissues in the body, and these guide hormones and other processes. If there is something putting pressure on these highways, the messages don't work the way they should, and headache can be a result. "It's not necessarily treating headaches, it's how do we get the body back to normal," Noya explains of chiropractic treatment.

Most of the time, pregnancy headaches are a normal, if painful and irritating, part of pregnancy. But sometimes they can signal something more serious. Blood pressure spikes can also cause headaches, so severe headaches in the last trimester can be a sign of preeclampsia. Prager says pregnant women should pay attention to "headaches that don't go away with hydration and rest; visual changes; and anything that feels really different."

Fortunately, pregnancy headaches often get better with time or treatment. No matter what the cause, if you have pregnancy headaches, try to rest and be kind to yourself. Pregnancy is both a totally normal and totally extraordinary process — and, as you may have heard, some aspects of it may hurt a little.

Headaches are one of the most common discomforts experienced during pregnancy and may occur at any time during your pregnancy, but they tend to be most common during the first and third trimesters.

What Causes Headaches During Pregnancy?

During the first trimester, your body experiences a surge of hormones and an increase in blood volume. These two changes can cause more frequent headaches. These headaches may be further aggravated by stress, poor posture or changes in your vision.
Other causes of headaches during pregnancy may involve one or more of the following:

  • Lack of sleep
  • Low blood sugar (due to many changes)

Women who have regular migraine headaches may discover that they experience fewer migraines during pregnancy; however, some women may encounter the same number or even more migraine headaches. If you are pregnant, it is important to talk to your health care provider about any medications that you may be taking for headaches.
Headaches during the third trimester tend to be related more often to poor posture and tension from carrying extra weight. Headaches during the third trimester may also be caused by a condition called preeclampsia, which is high blood pressure during pregnancy.

How Do I Treat Headaches During Pregnancy?

During pregnancy, you want to try and relieve your headache by natural means if possible, however your health care provider may recommend acetaminophen.

You may want to try to relieve your headache with one or more of the following natural remedies:

  • If you have a sinus headache, apply a warm compress around your eyes and nose
  • If you have a tension headache, apply a cold compress or ice pack at the base of your neck
  • Maintain your blood sugar by eating smaller, more frequent meals – this may also help prevent future headaches
  • Get a massage – massaging your shoulders and neck is an effective way to relieve pain
  • Rest in a dark room and practice deep breathing
  • Take a warm shower or bath
  • Practice good posture (especially during the third trimester)
  • Get plenty of rest and relaxation

You may also reduce the likelihood of migraine headaches by avoiding common triggers of migraine headaches:

  • Chocolate
  • Yogurt
  • Aged cheese
  • Peanuts
  • Bread with fresh yeast
  • Sour cream

When Should I Contact My Doctor?

  • Before taking any medications
  • If you do not experience any relief from the remedies above
  • Your headaches get worse or more persistent
  • You experience headaches that are different than normal
  • Your headaches are accompanied by blurry vision, sudden weight gain, pain in the upper right abdomen, and swelling in the hands and face

Want to Know More?

Compiled using information from the following sources:

1. Williams Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 55.

How to alleviate headaches during pregnancy

Pregnancy is the time when a woman tends to undergo hormonal changes. Due to this hormonal changes, there are certain physical alterations that a pregnant mother bears. One of these is headaches during pregnancy. This headache is related/ similar to tension headache.

The trimesters

Having a headache during pregnancy is not abnormal. Out of the three stages, the first symptom of headaches start to appear during the first trimester. This happens due to the increase in blood flow and circulation, and the overflowing of hormones in the body. Cutting down on caffeine is also considered to be another factor. Meanwhile, the body of the mother is getting accustomed to the new changes that is taking place. Once the gushing of hormones and the blood flow settle down, which eventually does in the second trimester, the mother can relax a bit for those three months. The unfortunate part is, the headaches might come back in the third trimester. The reasons being:

  • The tension of the final outcome
  • Carrying extra weight that leads to bad posture
  • Lack of sleep
  • Low blood sugar
  • High blood pressure
  • Dehydration

Want to know which headache you’re exactly suffering from and how to deal with it? Then you need to read these posts:
Tension Headache: Understanding Of The Most Common Headache

Migraine during pregnancy

Surprisingly, majority of the women who suffer from migraine said that this form of pain reduced dramatically than before. Migraine is a neurological disorder that triggers the pain severely. It is caused by hormonal fluctuation during menstruation. Out of 80 percent of female migraine sufferers, 58 percent said they have mild attacks of migraine, or those who are very lucky suffer no pain at all. Only a handful of females reported that they suffer from extreme migraine at least twice or thrice during the entire pregnancy period.

The reason for a reduction in migraine headaches during pregnancy is because the hormonal fluctuation settles down in the body during the pregnancy period.

What can be done to relieve headaches during pregnancy?

There is a limitation to medicine intake during pregnancy. Most of the drugs are prohibited, leaving only a few option to be considered. It is always advised to seek natural remedies to cure headaches. Some of the helpful tips are given below.

  • Eat small amounts of healthy meals frequently. Do not stay hungry for a longer period of time.
  • Get adequate amount of rest, especially during the third trimester.
  • Apply cold/ hot compression on the head, neck and shoulders.
  • Go for a body massage.
  • Do exercises as shown by the doctor.
  • Take warm shower never possible.
  • Improve the bad posture to prevent further headache.
  • Take naps whenever possible, preferably in a dark room.
  • Try to go outside and breathe in fresh air.
  • Listen to music that will distract from all the anxieties.
  • Hydrate by drinking plenty of water, and fresh juices.
  • For severe cases, go for acupuncture and acupressure.

If the above natural remedies don’t work, the safest medication is acetaminophen (Tylenol). If the pain persists for few days, the doctor may prescribe beta-blockers. Beta blockers are used to control blood pressure, are safe for pregnant mothers, and can reduce severe headaches.

What else to avoid

There are some food, drink and medications that are recommended in order to avoid headaches during pregnancy. Food like:

  • Chocolates
  • Food containing artificial sweeteners
  • Too much sweets
  • Old cheese
  • Yogurt
  • Sour cream
  • Peanuts
  • processed meat
  • Smoked salmon
  • Alcohol
  • Can juices containing preservatives
  • Fizzy drinks
  • Coffee
  • Ibuprofen
  • Aspirin

Headaches during pregnancy are usually nothing serious. They will come and go, a mother just needs to be cautious and can easily prevent them from coming. It just needs a little persistence, some well balanced lifestyle, eating habits, good posture, and plenty of positivity and happy thoughts. These headaches are preventable. But whatever a pregnant mother does, always ask the practitioner before doing anything.

Nausea and headache are one of the most common symptoms of pregnancy. During the first and third trimester they are more prevalent and dealing with them can be real pain. It becomes difficult to perform daily tasks with frequent headaches. The pain can be due to migraine, sinus or stress. It is important to identify the issue and treat it accordingly. Here are few effective home remedies to get rid of headache during pregnancy.

1. Cold compress

It is one of the most basic treatment for headache. Soak a washcloth in cold water and place it on your forehead for a minute. Remove the washcloth and repeat it for 2-3 times. You will definitely feel some relief from the headache. If your headache is due to cold, avoid this treatment as it can simply aggravate the symptoms of cold.

2. Head massage

A head massage with warm oil is very effective in getting rid of headache during pregnancy. Heat up some olive oil or almond oil. Let the oil cool down a bit and massage your head with it. You can add some calming essential oils like lavender or patchouli to it for some extra calming effect.

3. Balm

Pain relief balms are very useful when it comes to getting rid of headache. Herbal pain relief balms are infused with essential oils like eucalyptus oil that have pain relieving properties. They also calm your nervous system and relieve headache caused due to conditions like migraine or sinusitis. Massage your temples with some balm for few minutes to experience quick relief. If you have sensitive skin, do a patch test before using the balm.

How to alleviate headaches during pregnancy

4. Yoga

Yoga is great not only for your body but also for your mind. During pregnancy, yoga ensures healthy blood flow throughout your body. It prevents unwanted weight gain and also reduces headache. There are yoga postures that improve blood circulation in your head region. It also de-stresses you and reduces the occurrence of headache.

5. Milk cinnamon and honey

Milk has calming effect on your body. A concoction of milk, honey and cinnamon can be really soothing for your headache. It not only relieves you from the pain but also nourishes you and your child. If you’re lactose intolerant then you may skip this remedy.

6. Tea

Tea is not only a refreshing drink but is also very potent in getting rid of headache. You can make a tea made of basil leaves to get prompt relief from headache. You may also consume the regular milk tea for a refreshing day without any headache.

7. Protein rich food

Sometimes lack of protein can cause ugly headache. Eat protein-rich food like eggs, lentils, beans and meat; if required take protein supplements. Consult a dietician before starting a new diet so that your pregnancy does not get affected due to the changes in your diet. Don’t opt for whey protein supplements if you are lactose intolerant.

8. Sleep schedule

Pregnancy may leave you sleepless and tired. Sometimes messed up sleep pattern can cause dizziness all day accompanied by headache. You need more sleep when you’re pregnant. If you have physically active lifestyle and you’re sleep-deprived, it can be unhealthy for your pregnancy. Such situations lead to unexplained headaches. Try to go to bed at the same time everyday to avoid headaches during pregnancy.

9. Drink water

A dehydrated body can never be healthy and it shows on your face, daily activities and sleep pattern. Dehydration can cause headaches that can make you suffer for hours. Drink ample water to keep your body hydrated. Drink at least 3-4 liters of water daily to stay hydrated.

10. Stress reduction

Stress can trigger headaches. Stress related to pregnancy is common. Try to beat it with a relaxing bath, a hot cup of tea or good sleep. Use calming essential oils like lavender or chamomile essential oils to calm your senses. Get yourself a nice massage or pedicure to pamper your body mind. Stress not only causes headaches but also has negative impact on your pregnancy.

11. Avoiding trigger foods

There are certain food that trigger headaches. If your headache follows a certain pattern due to the consumption of a specific food, identify it and work on your diet accordingly. If you feel any activity is increasing the chances of getting a headache, avoid it.

Always check with your physician before trying any home remedy for curing your headache. If your headache continues despite treatments, go for a thorough check-up without any delay. Give yourself ample rest and destress yourself to have a headache-free pregnancy!

Claudia Chaves, MD, is board-certified in cerebrovascular disease and neurology with a subspecialty certification in vascular neurology.

Many women are hesitant to take medications during pregnancy — especially during the first trimester when their baby’s organs are developing. So finding natural remedies for headaches in pregnancy can be a lifesaver.

Let’s explore some natural remedies for both treating and preventing headaches during pregnancy.

How to alleviate headaches during pregnancy

Treatment

Here are a few ideas from the American Pregnancy Association:

  • For a sinus headache, apply a warm compress around your eyes and nose.
  • For a tension headache, use a cold compress or ice pack at the base of your neck.
  • Eat smaller, more frequent meals to maintain your blood sugar. This may even help prevent headaches.
  • Get a massage, especially around your shoulders and neck.
  • Rest in a dark room.
  • Practice deep breathing.
  • Take a warm shower or bath.
  • Use good posture, especially in the third trimester

Prevention

Preventing a headache from occurring in the first place is the most ideal solution.   Here are simple, lifestyle habits that a woman who is pregnant can adopt to help stop the head pain before it starts.

This is especially true for women who suffer from migraines — although, the good news is that many migraineurs experience relief of their migraines in the second and third trimester.  

  • Eating nutritious meals at regular intervals throughout the day
  • Walking at least 30 minutes a day
  • Sleep hygiene — not over or under sleeping
  • Stress management techniques like yoga, biofeedback, or relaxation training
  • Consider coenzyme Q10 or magnesium supplements for migraine prevention.

Always speak to your healthcare provider before taking any supplement or medication.

Other strategies include:

  • Reducing work
  • Drinking lots of fluids
  • Acupuncture
  • Physical therapy

What Should You Do?

Be sure to discuss your headaches with your healthcare provider. Let him know if you plan to take a new medication, or if these natural remedies do not relieve your headache. If your headaches get worse or more persistent, or if they are different than headaches you typically experience, share this with your healthcare provider right away.

How to alleviate headaches during pregnancy

How to treat patients for migraine during pregnancy

It’s important for providers who treat women during their reproductive years to be aware of treatment options that are safe during pregnancy. Many women with migraine who are pregnant or considering pregnancy stop taking their migraine medications and assume they don’t have safe treatment options available—but this is simply not true.

Women typically start to experience migraine attacks during adolescence, which aligns with when menstruation begins. The highest incidence of migraine is between ages 18 and 44, which are also the year many women experience pregnancy. The rate of migraine among women is three times higher than it is for men. Because of these figures, it is believed that fluctuations in estrogen levels play a role in migraine development.

Dr. Tracy Grossman, an obstetrician-gynecologist who has completed a fellowship in maternal-fetal medicine and earned a master’s in neuroscience, shares the range of treatment options available for pregnant patients with migraine.

Treatment Options During Pregnancy

Certain medications used for migraine treatment and prevention are contraindicated for pregnancy, due to safety concerns for the developing fetus. For patients who use oral contraceptives to regulate their hormone levels and manage migraine, having a conversation about migraine treatment options may happen when they want to go off of birth control and start trying to conceive. The good news is there are safe options for migraine prior to and during pregnancy.

“I’m always telling my patients, either preconception or patients that are pregnant, that we recommend in general to use the [fewest] number of different medications for anything that we’re treating,” Dr. Grossman says. “And also, of course, the lowest dose possible that we can use in pregnancy and preconception is what we recommend.” Her first-line treatment is non-medication options, and she then layers in other treatments as needed.

Non-medication options

  • Hydration: Staying hydrated is important for all pregnant women, but especially for those with migraine. “Typically a lot of patients are dehydrated and don’t even realize it,” says Dr. Grossman.
  • Caffeine: Many women decide to cut out caffeine completely when they become pregnant, but a low level of caffeine is considered safe and can help prevent migraine. Dr. Grossman suggests about a cup to a cup and a half of coffee per day, with a daily maximum of 200 milligrams of caffeine.
  • Magnesium: Magnesium is a supplement commonly used for migraine prevention. With its low risk of side effects, it is safe to use during pregnancy.

Over-the-counter medications

Over-the-counter medications, like acetaminophen, are safe during pregnancy. In combination with non-medication options, it can be effective in preventing and managing migraine symptoms.

Non-steroidal anti-inflammatories are another option for relieving migraine. “These are things like naproxen, Toradol, ibuprofen, which we don’t recommend use in the first trimester or in the third trimester, but in the mid-second trimester are considered safe to use for a limited amount of time,” says Dr. Grossman. “I would have a patient be on one of these medications for about 48 hours, no more than that.”

Prescription medications

Many women with migraine take triptans prior to pregnancy, but then decide to discontinue the prescription medication when they become pregnant or their provider recommends that they stop taking it. Despite older studies that cited concern for fetal growth restriction and increased blood loss at delivery, new research shows that it’s not necessary to stop using triptans while pregnant. “More recent studies have shown that sumatriptans or triptans are actually very safe in pregnancy and have not been associated with any congenital defects or pregnancy complications,” Dr. Grossman says.

Some anti-nausea medications, including prochlorperazine, metoclopramide and diphenhydramine can also relieve migraine symptoms. Though they’re typically not used for prolonged amounts of time, these medications are safe in pregnancy.

Procedures/Devices

Nerve blocks can give patients relief from migraine during pregnancy. These local injections of a substance like lidocaine or bupivacaine are injected into the scalp to target specific nerves. The location of the injection depends on the type and location of the patient’s migraine. “These are considered safe in pregnancy because it’s a local injection, the medication, not a systemic administration,” says Dr. Grossman, who did a study on peripheral nerve blocks during her residency. The nerve blocks can be used repeatedly throughout pregnancy as a prevention or treatment measure.

Liquid lidocaine 4% can also be administered as a nasal spray. It is safe for patients to use as often as a couple of times a day. Patients may also benefit from a wearable neuromodulation device that emits a mild electrical current for migraine relief or prevention. You can learn more about device options and how to select the best one for your patient here.

Recommending one type or a combination of prevention and treatment options can help your migraine patients safely manage their symptoms throughout pregnancy.

Primary care practitioners are essential to identifying and treating headache disorders. The American Headache Society’s First Contact – Headache in Primary Care program provides educational resources to empower healthcare professionals and improve headache and migraine care. Learn more about the program here.

How to alleviate headaches during pregnancy

Headaches during pregnancy may not get as much attention as other pregnancy-related symptoms like morning sickness and extreme fatigue, but they are common and can take their toll on your quality of life. Knowing what to look out for can make a big difference in reducing headaches during pregnancy.

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Hormones May Not Be to Blame

Even if you don't usually get headaches, you may develop lots of headaches during pregnancy. Migraines, tension headaches or other types of headaches can occur at any time during your pregnancy, but they are more frequent during the first and third trimesters, according to the American Pregnancy Association. And whether you have a headache on the left side of your head or a headache behind your right eye while pregnant, it's unpleasant.

Some of the lifestyle changes that are recommended in pregnancy, such as reducing or eliminating your caffeine intake, may cause headaches. Also, both dehydration and missing meals can lead to headaches, says Brian M. Grosberg, MD, director of the Hartford HealthCare Ayer Neuroscience Institute Headache Center in West Hartford, Conn.

"When you are pregnant, you may not drink enough water and you may also skip meals because you are nauseated," Dr. Grosberg says. Plus, he says, "your sleep gets disrupted during pregnancy, which also increases risk for headaches."

Headaches During Pregnancy: Special Considerations

Migraines are painful, often disabling headaches that may be accompanied by nausea, vomiting and sensitivity to light, says the Migraine Research Foundation. "The good news for women who have a history of migraine is that pregnancy actually improves these headaches," Dr. Grosberg says. "Levels of the hormone estrogen rise during pregnancy, and this has a protective effect on migraine." However, this holds only for women whose migraines are not preceded by aura or visual disturbances such as flashing lights or a temporary vision loss.

Headaches may be a sign of preeclampsia, or high blood pressure during pregnancy, especially if they are accompanied by blurred vision, floating spots, sudden weight gain, upper right abdomen pain and swelling in the hands and face, according to the March of Dimes. When left untreated, preeclampsia can lead to life-threatening eclampsia, resulting in seizures. "If these symptoms occur with your headache, see your doctor to get your blood pressure checked immediately," Dr. Grosberg says.

Headaches During Pregnancy: Prevention Is Key

There are steps you can take before and during pregnancy to keep your headache pain to a minimum. "If you are prone to headaches, check in with your doctor before you become pregnant, if possible, to discuss medication-free strategies," suggests Dr. Grosberg.

"Drinking more water, eating small meals throughout the day and improving sleep hygiene by setting regular wake and bedtimes can make a difference," he says.

Other drug-free methods such as biofeedback — which involves placing sensors on your body to measure signs of stress in order to help you learn how to control it — may be helpful during pregnancy, notes the Mayo Clinic. Acupuncture is another option. During acupuncture, your practitioner places tiny needles in specific areas on your face, head and neck to restore energy flow and relieve migraine pain, the American Migraine Foundation explains.

Applying a cold towel on your head, taking a cold shower or napping can also help relieve migraine pain when pregnant, according to the American Pregnancy Association.

Some Meds May Be OK

Medication is not always out of the question. "Some headache medications are safe to use during pregnancy, but this decision must be made after weighing the risks and benefits with your obstetrician or headache specialist," Dr. Grosberg says. Your doctor may recommend acetaminophen.

Levels of magnesium in the blood of people who get migraines tend to be lower than those who don't get migraines, and magnesium supplements may be a safe way to prevent migraines during pregnancy. Magnesium oxide in doses up to 400 mg can be used safely in pregnancy, says the American Migraine Foundation.

Most women deal with headaches at some point in their lives. Data from the Centers for Disease Control and Prevention suggest that one in five women had a severe acute headache or migraine in the previous three months. Additionally, migraines are more common in women than men – approximately 18 percent of women have them compared to 6.5 percent of men.

Because headaches and migraines are so common, it’s probably no surprise that many women deal with them during pregnancy. For the majority of pregnant women, occasional headaches or migraines are no cause for alarm, and most standard treatments are safe. However, suffering a severe headache at key times during or after pregnancy can indicate a serious medical emergency.

Common types of headaches and treatment options

Primary headaches

Primary or acute headaches arise once in a while and typically pass after a few hours. Tension headaches are the most common type and are characterized by muscle tightness and localized pain in the head and neck.

Primary headaches in pregnant women usually can be treated at home. Rest, a neck or scalp massage, hot or cold packs, and over-the-counter anti-inflammatory drugs such as Tylenol, aspirin, or ibuprofen can reduce the pain. However, if you start to have frequent or severe headaches, talk to your doctor to determine the cause.

Migraines

Migraines tend to be episodic (frequent and long-lasting) and typically cause additional neurological symptoms, such as:

● Blurred or tunnel vision

● Nausea and vomiting

Studies have shown that migraines can be triggered by hormonal changes, including right before your period or as a result of taking oral contraceptives. Interestingly, some women who have migraines find that the frequency or intensity of their symptoms decreases during pregnancy. Research does not suggest, however, that pregnancy triggers the onset of migraines – if you have your first migraine during pregnancy, it’s likely coincidental.

Treatment during pregnancy is fairly similar to standard treatment. Anti-inflammatory drugs are generally safe and effective during pregnancy when used in a limited manner. Midrin is a commonly prescribed headache medication that contains acetaminophen along with a mild sedative. Midrin also has vasoconstrictive properties, which means it narrows the blood vessels, thereby reducing blood flow and pain.

Sumatriptan, commonly known as Imitrex, is another medication that reduces blood flow to the brain. It works best to stop a migraine if it’s taken as soon as symptoms present. Most nausea medications prescribed to women with migraines are safe to use during pregnancy, but I suggest reviewing the medications you take for migraine relief with your obstetrician at your first prenatal visit, just to be safe.

Certain drugs called ergotamines have a stronger vasoconstrictive effect and can adversely affect fetal growth. They also can stimulate uterine activity. Because of this, they absolutely should not be used during pregnancy.

Severe migraines might require hospitalization so you can receive fluids, pain medication, or anti-nausea medication through an IV if you are unable to keep medications down.

"Most women don’t require special care for headaches and migraines during pregnancy, and most standard remedies are safe. However, certain types of headaches require immediate medical attention to avoid potentially harmful health issues."

– Robyn Horsager-Boehrer, M.D.

When headaches are secondary to other problems

Headaches can result from other conditions, some of which are life-threatening:

Stroke: Sudden and severe headaches might be a sign of a stroke. Women who have strokes during pregnancy or after delivery typically describe the pain as the worst headache of their lives. They also might report other symptoms, such as speech problems, vision issues, or functional problems on one side of the face or body. At the emergency room, the doctor will evaluate you for stroke symptoms, such as visual changes, facial drooping, and arm or leg weakness. If you are having or had a stroke, we will get you emergency treatment at our Advanced Comprehensive Stroke Center.

Preeclampsia: A headache with preeclampsia (a pregnancy complication characterized by high blood pressure) can indicate a dangerous spike in blood pressure. The doctor will assess you and might admit you to the hospital for management of blood pressure and treatment to prevent seizures.

Spinal fluid leak: A headache after an epidural or spinal block can indicate a spinal fluid leak, especially if it worsens when you sit or stand up. The most effective treatment is an epidural blood patch, in which the doctor injects a sample of your blood into the leaking area, essentially plugging the hole. This therapy provides dramatic relief right away.

Occasional mild headaches are common in women. The vast majority are no cause for alarm and can be treated at home, with guidance from your doctor. However, if your symptoms are severe or something just doesn’t seem right, it’s much better to seek care and be safe rather than sorry.