Bad headaches second trimester

Pregnancy and Headaches: When Should I Worry?

Pregnancy is a beautiful thing to be celebrated, but few people fill you in on the not-so-great symptoms that may occur during the journey. Namely, heartburn, gas, constipation and, for some pregnant mamas, headaches.

While headaches can be just another normal symptom of pregnancy, should they ever be a cause for concern?

“Headaches are common in women both in and outside of pregnancy,” said Kelley Saunders, MD, an OBGYN with Banner – University Medicine Women’s Institute. “But whether they are normal or not should always be discussed with your doctor."

Here is some insight into what causes headaches during pregnancy, some remedies to treat them and why your doctor should be kept in the loop.

Is it a headache or something else?

It isn’t always easy to tell what kind of headache you’re having, but the most common types of headaches during pregnancy are tension-type headaches, migraines and cluster headaches.

Tension headaches are the most common kind of headache in pregnant women. It can feel like someone is trying to squish your head like a watermelon. If you carry your stress in your shoulders and neck, you may be more susceptible to this kind of headache.

Migraines are a particular type of headache that occur on one side of the head. For some women, migraine headaches can get worse the first few months and then improve in later stages of pregnancy. For others, they may experience no change, decrease or difference in their migraines.

Cluster headaches are less common but can occur during pregnancy. You’ll suddenly have severe pain around your eyes or temples usually about the same time every day.

The good news is that there are plenty of pregnancy-safe things you can do to prevent and relieve the most common pregnancy headaches.

Tips for relieving mild headaches

Get plenty of rest. Sleep is especially hard later in your pregnancy but is so important to physical and mental health. Find yourself a comfy prenatal pillow and snuggle away.
Drink plenty of water. Pregnant moms require more water than the average person. While you may want to avoid extra trips to the bathroom, adequate fluid intake is important for you and baby.
Eat regular, well-balanced meals. To prevent low blood sugar, eat small meals throughout the day. Avoid sugar, like soda and candy.
Get a prenatal massage. A full-body massage can release tension in the muscles of your neck, shoulders and back.
Use warm or cool compresses on head, neck and shoulders.
Avoid triggers. Keep a journal to help identify specific triggers so you can learn what to avoid. Some common headache triggers include strong odors and nitrites or nitrates.
Try exercise and relaxation techniques. There’s evidence that regular exercise can reduce stress and boost overall mood. Check with your doctor first before starting any new fitness routines.
Take acetaminophen to relieve symptoms (as approved by doctor).
Take caffeine in doses less than 200mg in a day (as approved by doctor).

If you have a history of migraines, however, your doctor may treat them differently during pregnancy. Discuss with your doctor what medications are safe to take during pregnancy.

Is my headache a cause for concern?

Sometimes. Headaches tend to be more common in the first and third trimesters, but they can occur in the second trimester as well. While there are common causes for headaches during pregnancy, it’s important to note that headaches during the second and third trimester can also be due to high blood pressure, called preeclampsia.

“Preeclampsia is a pregnancy-related condition that requires prompt evaluation and management with an obstetrician or maternal fetal medicine specialist,” Dr. Saunders said. “Elevated blood pressure prior to pregnancy puts a woman at increased risk for preeclampsia.”

When should I call my doctor?

Whether you experience headaches or not, it’s always important to discuss your pre-pregnancy history, obstetrical history and concerns with your doctor for an individualized assessment and management plan. However, if none of the above treatments resolve your mild headache or your headaches become more frequent and severe, talk to your doctor to determine the cause.

“This includes new headaches that present after 20 weeks, a sudden onset of severe headaches, headaches associated with a fever, mental health changes, elevated blood pressure and vision changes,” Dr. Saunders said. “It’s important to keep an open line of communication with your physician and let them know about any changes in your health so they can rule out anything serious."

Got questions? We can help!

If a headache is keeping you up at night and your doctor isn’t available, call the Banner Nurse Now line, a free health care service that offers advice 24-hours a day, seven days a week. Call 844-259-9494.

Check out other pregnancy articles on our Banner Health blog

Pregnancy is an exciting, but also a bit scary time (especially if this is your first baby). Here are some other reads to help guide you through the trimesters and welcoming baby:

5 Tips for Having a Happy, Healthy Pregnancy
Expect the Unexpected: How Your Body Changes During Pregnancy
What To Expect In The Second Trimester
Understanding Pulmonary Embolism Risk During Pregnancy

Women's Health Pregnancy

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Headaches During Pregnancy | Maternal and Infant Health Program

What is Normal and What is Not

Headaches are one of the most common discomforts of pregnancy. Especially in the first trimester, headaches may occur more frequently than usual. Some common causes of headaches in pregnancy include:

Changes in hormones
Tiredness, including lack of sleep
Changes in blood circulation
Low blood sugar (hypoglycemia)
Dehydration (not drinking enough water)
Stress from upcoming family changes
Caffeine withdrawal

Types of Headaches

Tension Headaches

Tension headaches are the most common type of headache. They are often described as a squeezing pain on both sides of the head. Tension headaches are most often caused by lack of sleep, depression, or caffeine withdrawal. Changes in pregnancy hormones may also cause tension headaches. Making an effort to relax, exercising regularly and getting enough sleep will often reduce the number of headaches. If headaches occur, try treating them with extra rest, a shoulder massage, or a warm washcloth placed on face. After consulting with your doctor or midwife, Tylenol may be used to treat headaches that do not improve with other measures.

Migraine Headaches

About 18% of women experience migraine headaches at some time in their lives. Migraine headaches cause a severe throbbing pain on one (or occasionally both) sides of the head. The exact cause of migraines is not known, but it is thought that they result from changes in blood flow in the brain. Migraines may occur with other symptoms, such as nausea and sensitivity to light or loud noises. Some people experience an “aura” a few minutes before a migraine attack. During the aura, the person may have problems seeing normally (such as seeing lines or flashing lights), speech problems, or a tingling sensation in their hands or face.

Migraine headaches usually occur less frequently in pregnancy, especially after the first trimester. However, some women find that their migraine headaches worsen or stay the same while they are pregnant. The best way to treat migraine headaches in pregnancy is to avoid them. Some people are able to reduce the number of migraine attacks by avoiding common triggers and getting the right amount of sleep.

If you need medication for migraine headaches while you are pregnant or nursing, discuss the use of prescription pain medication with your doctor or midwife. He or she will help you find the medication with the least risk. There is very little information about how migraine medications such as Sumitriptan (Imitrex), Ergotamine (Cafergot) or Midrin affect the developing baby. Because of this, pregnant women are usually counseled to avoid these medications.

Other Types of Headaches

Pregnant women may also experience other types of headaches such as cluster headaches, sinus headaches, or headaches caused by other rare problems. If you are unsure about a headache, it is important to see your prenatal care provider to get an accurate diagnosis.

Headaches and Preeclampsia

A severe headache in the second or third trimester of pregnancy can be a warning sign of preeclampsia, or high blood pressure in pregnancy. Preeclampsia is a rare condition that affects about five to ten percent of pregnancies. Headaches caused by preeclampsia are persistent and throbbing. Women with preeclampsia may also have symptoms such as blurry vision or seeing spots, sudden weight gain (more than a pound in one day), pain in the upper right abdomen, and swelling in the hands and face. If you have any of these symptoms, or if you get a headache that is different from normal, call your doctor or midwife right away.

Migraine during pregnancy: what to do

Migraine is a benign disease, it does not affect the course of pregnancy and fetal development. However, migraine and pregnancy is a combination that requires a responsible attitude. Especially with frequent migraines (more than 2 times a week) and migraines with aura, because:

medicines approved for use, few,
and the approach to the treatment and prevention of migraine during this period is extremely individual: it depends on the frequency, severity and duration of headache, the degree of impact on life.

Our neurologist Daria Korobkova conducted a live broadcast on the clinic's Instagram account, where she told how migraine and pregnancy are connected, why attacks become more frequent or disappear, and answered subscribers' questions. The ether was saved, see “Air recording: migraine during pregnancy and GV.

We will tell about migraine during breastfeeding separately.

The statistics of clinical observations of migraine during pregnancy looks like this:

In 60-70% of pregnant women with migraine, headache attacks become less frequent, milder, or even completely disappear in the second and third trimesters. This is due to the stabilization of estrogen levels. By the beginning of the second trimester, it rises 6 times and its fluctuations stop.

In other women, migraines during pregnancy either remain unchanged or worsen. But as the duration of pregnancy increases, the proportion of such women gradually decreases:

If at the end of the first trimester the frequency and intensity of attacks persist, then it is most likely that migraine will disturb the woman throughout the entire period of pregnancy and after childbirth too.

How to manage migraine during pregnancy?

The main thing here is to learn how to control seizures and, if necessary, seek medical help.

Follow lifestyle advice:

get enough sleep;
drink enough fluids;
eat fractionally and without long breaks;
rest;
avoid stressful situations. This is one of the main provocateurs of migraine. Psychotherapy, relaxation and stress management are here to help you.

Keep a headache diary. This will help you take control of migraine triggers.

Yes, these simple recommendations are sometimes enough to make seizures less frequent! Pregnancy is a special state of a woman. If in other periods of life we do not take such recommendations so seriously, then in this situation it is worth trying to change the philosophy of life and attitude towards ourselves =)

How to relieve an attack?

Favor non-drug methods. Sometimes, in order to relieve an attack, it is enough to eliminate an unfavorable factor:

dry biscuits, ginger, or applesauce may help with nausea;
for dehydration - diluted juice or other liquid;
sleep, walking or breathing exercises can also help to cope;

If the attacks are severe, interfere with your life, then under the supervision of a specialist, you can resort to drug therapy.

PARACETAMOL is considered the safest and can be taken throughout pregnancy.

All other drugs have nuances. For example:

ibuprofen can be taken in the second trimester, and in the first trimester it is better to limit, in the third trimester the drug is contraindicated for use;
aspirin is prohibited in the 3rd trimester and is undesirable for taking in the first two, as it can cause extremely undesirable consequences;
It is strictly forbidden to use ergotamine and opioid analgesics;
triptans are not officially approved for use during pregnancy as no controlled studies have been conducted. However, clinical observations of women around the world who took them on their own showed no adverse effects on the fetus. We discussed this issue in more detail on the air.

!Other than paracetamol, we do not recommend the use of any drug without a doctor's prescription.

When to see a doctor:

migraine occurred for the first time during pregnancy;
if migraine attacks suddenly become more frequent and stronger;
if the aura became longer or appeared for the first time;
if the headache is rapidly increasing and has an unusual character;
if the pressure rises during the headache.

Read more articles about headaches in our Telegram channel.

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Sometimes you just need to get some sleep, and sometimes you need to call an ambulance immediately.

When to call an ambulance

Call 103 or 112 urgently if you experience any of the following symptoms:

sudden and severe headache;
consciousness becomes confused or completely lost;
pain worsens over 5 minutes;
flies, spots flash in the eyes;
throbbing and noisy in the ears;
speech has become slurred, words are drawn out;
arms and legs weaken, convulsions set in;
the muscles of the neck are very stiff, it is impossible to reach the chest with the chin;
temperature rises to 39 °C or more;
increased heart rate at rest;
severe shortness of breath;
the child pushes without stopping or stops abruptly;
leaking water or blood;
lower abdomen hurts, as if contractions had begun.

Why pregnant women can get headaches

Headache during pregnancy is not always life threatening. But the doctor needs to be told about it in any case. If the symptom appeared for the first time and does not hurt much, postpone the conversation until a scheduled visit. If your headache is recurring or gets worse, it's best to make an appointment as soon as possible. The gynecologist will decide what needs to be done or refer you to another doctor.

There are many causes of headaches. Scientists have found that in pregnant women in 57% of cases it is primary, that is, not associated with other diseases. The most common are migraines and tension headaches.

Everything else is a secondary headache caused by various pathologies. Usually it is high blood pressure and infections. But there are also more dangerous reasons.

1. Stress and fatigue

The body of a pregnant woman experiences increased stress, because it has to work for two. If at the same time the expectant mother is exposed to stress, strong feelings or sleeps little, she develops a tension headache.

Discomfort lasts from 30 minutes to several days. The head hurts in the forehead, occiput, both temples. But there is no feeling that they put on a tight hoop or helmet. The pain does not get worse when bending over, walking, or climbing stairs, bright lights, or sounds.