Headaches During Pregnancy: What To Know

Pregnancies are like seashells: No two are exactly alike — which is why you may have experienced headaches and even pounding migraine pain while others enjoy 40 weeks of pure bliss.

Headaches during pregnancy can be caused by hormones, an increase in your blood volume or even other triggers like lack of sleep and stress.

And it’s important to talk to your Ob/Gyn if you’re having headaches, as the medications and treatments you may have used in the past may not be right for you during your pregnancy.

Julia Bucklan, DO, explains pregnancy headaches and what you can do to alleviate pain.

Are headaches common in early pregnancy?

You’ve got a headache. Early pregnancy might be to blame. Most people who are pregnant tend to see an increase in headaches and migraines during their first trimester.

What do early pregnancy headaches feel like?

Headaches fall into two categories: secondary and primary. Secondary headaches are caused by an underlying health problem, such as a sinus infection or high blood pressure. Primary headaches are self-contained — the pain you feel is a direct result of the headache itself. Migraines are a classic example.

People who get migraines often experience:

• Moderate to severe, throbbing head pain.
• Symptoms — including increased sensitivity to light, noise or smells, nausea, vomiting and loss of appetite — that last between four hours and three days.

If you experience a migraine while pregnant, it often can go hand-in-hand with aura, too. Aura is a temporary sensory disturbance that may include visual changes, numbness and tingling, or speech changes.

The good news?

“Most people see an improvement in the number of migraines they experience as their pregnancy goes on,” says Dr. Bucklan.

Why they happen

So, what is it about having a bun in the oven that makes your head hurt (other than thinking about college tuition)? Blame it on the hormones. The very things that help your body keep your fetus healthy and nourished also up your headache quota. So does an increase in blood volume, which happens during the first trimester.

Other factors that lead to headaches during pregnancy include:

• Eating certain foods (migraine triggers).
• Not drinking enough water.
• Lack of sleep.
• Not getting good nutrition.
• Stress.
• Upset stomach.

More than a quarter of women and those assigned female at birth (AFAB) have migraines during reproductive years. Those who have migraines are more likely to have them during pregnancy as well. But in cases involving secondary headaches, causes include:

• Preeclampsia (high blood pressure while pregnant).
• Vein thrombosis (blood clots in the brain).
• Sinus infections.
• Brain tumors.
• Stroke risk.

“We look at everyone closely and assess their symptoms,” states Dr. Bucklan. “The first question we want to answer is, ‘Is this a primary headache or a warning sign of an underlying condition?’”

Remedies for pregnancy headaches

It’s no fun to have a headache. Pregnancy can also mean that if you typically turn to over-the-counter pain medications like NSAIDs (ibuprofen, aspirin and naproxen) to fight headache pain, you’ll typically need to avoid these options during your pregnancy.

So, what can you do to help with pain and other symptoms? Dr. Bucklan recommends these seven tips:

• Keep a headache diary. By tracking your headaches and symptoms, it’s easier to notice any changes that your doctor should know about.
• Know your migraine triggers. A headache diary can also help you recognize and avoid potential triggers. That way, if it’s cheese that sets you off, you won’t put a slice in your afternoon sandwich. Other common triggers include processed meats, chocolate, MSG and ripe bananas.
• Stay hydrated. Dr. Bucklan advises drinking about eight to 10 glasses of water each day, but each person’s water requirements differ.
• Get enough sleep. Eight hours of uninterrupted sleep each night is ideal.
• Try safe home remedies. Lying in a dark room or putting a cold cloth over your head can provide some relief. “But discuss any natural remedies with a physician before using them,” cautions Dr. Bucklan. “The different substances in natural remedies could negatively affect you or your future child.”
• Explore cognitive behavioral therapy or biofeedback. Both can teach you ways to cope with headache pain by changing the way you think.
• Try physical therapy (PT). Poor posture, especially late in pregnancy, can lead to headaches. Strengthening your neck and shoulder muscles through PT can help combat this. (Dr. Bucklan recommends a good prenatal massage, too.)

When to be concerned

Even though it’s common to experience headaches and migraines while pregnant, you should discuss your headaches with your healthcare provider or Ob/Gyn.

And it’s especially important to contact your doctor if you experience:

• Headaches that get worse or are persistent.
• Headaches that don’t respond to any of the remedies above.
• Headaches that are different from what you normally experience.
• Symptoms like blurry vision, pain in your upper right abdomen or swelling in your face and hands.

Your provider will determine if your head pain is caused by hormonal changes or certain triggers. And if it’s a secondary headache that’s brought on by an underlying condition, they’ll work to treat that condition, which, in turn, should help your headaches. 

Dr. Bucklan reiterates that it’s wise to include your doctor in any decision-making, especially when considering medication.

“It should be a joint and educated decision between the patient, their neurologist and often, their Ob/Gyn,” she stresses. “Together, we determine the best treatment approach for primary or secondary headaches.”