Chronic headaches while pregnant

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, migraines 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 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

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Headaches during pregnancy | Pregnancy Birth and Baby

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If you have a severe headache during pregnancy that is not usual for you, seek medical help immediately.

Key facts

• It’s common to get mild headaches in the first few months of pregnancy because of hormonal changes.
• If you usually suffer from migraines, they may get better, worse, change or stay the same when you’re pregnant.
• Headaches during pregnancy may be triggered by poor sleep, stress, dehydration, low blood sugar or eye strain.
• If your headache doesn’t settle with simple measures (for example, rest and rehydration), you can take paracetamol.
• A headache after 20 weeks can be a sign of pre-eclampsia, which is a serious pregnancy condition that needs medical attention – see your doctor or midwife.

Does pregnancy cause headaches?

Many people get mild headaches when they are pregnant. Headaches can often be triggered by a change in hormones. They are more common in the first few months of pregnancy.

If you usually suffer from migraines, you might notice a change when you’re pregnant. There’s a good chance that your migraines will improve after the first trimester. This may be because your oestrogen level starts to stabilise. However, some people don’t notice a change, or may get worse migraines during pregnancy. You also might notice different changes from one pregnancy to the next.

Headaches can develop for many different reasons — it’s not always because of pregnancy hormones.

Why else might I get headaches during pregnancy?

Besides hormonal changes, there are many triggers that cause headaches in general, but might occur more often when you’re pregnant, such as:

• not getting enough sleep
• withdrawal from caffeine — such as in coffee, tea or cola drinks
• low blood sugar from not eating regularly
• dehydration
• feeling stressed, anxious or depressed
• eye strain — especially as your eye muscles relax during pregnancy

Many of these triggers can cause tension headaches, which are very common. The pain is usually mild and on both sides of your head.

Some of these triggers can cause migraines, which are more severe and mostly occur on one side of your head. If you have migraines, you might also feel sick or vomit and be sensitive to light or sound.

Pre-eclampsia

If you start getting frequent headaches after 20 weeks of pregnancy, this could be a sign of a more serious pregnancy condition called pre-eclampsia. Pre-eclampsia is when you have high blood pressure that affects your kidneys and sometimes other parts of your body. If you have a pre-eclampsia headache, you may find that simple pain-relieving medicines like paracetamol don’t help.

It’s very important to tell your doctor or midwife if you are getting headaches in the second half of pregnancy, or if your headaches are very severe.

If you have a severe headache during pregnancy, call your doctor or midwife. It could be something more serious.

Health conditions

Just like when you’re not pregnant, a headache can sometimes be a sign of other health conditions, including:

• infections, such as an ear infection or flu
• sinusitis
• problems with your teeth
• an aneurysm or stroke

What can I do to treat a headache when I’m pregnant?

If you have a headache, you could try:

• having a nap, or resting with your eyes closed
• drinking water
• having something to eat
• putting a cold or heat pack on your forehead or the back of your neck
• asking someone to give you a gentle neck massage

If you need to take medicine for pain relief, paracetamol is safe during pregnancy. Pain-relieving medicines can actually cause headaches if you take them too often, so don’t take paracetamol more than 3 times a week.

When you’re pregnant, avoid anti-inflammatories such as ibuprofen or aspirin and medicines that contain caffeine.

What can I do to prevent headaches during pregnancy?

If you find you are getting mild headaches often, it’s a good idea to:

• getting more sleep
• drink at least 8 cups of water a day
• go to pregnancy yoga classes or do some other type of exercise
• learn relaxation or stress management techniques
• don't go more than 4 hours without eating
• avoid processed foods
• see an optometrist for an eye check

What can I do if I suffer from migraines during pregnancy?

If you suffer from migraines, try to avoid things that may trigger migraines for you. People have different triggers for migraines, so it’s important to learn what your personal triggers are. Keep a headache diary, and see if your triggers include:

• specific foods such as chocolate, or food additives such as caffeine or MSG
• bright or flickering lights, strong smells and loud sounds
• not enough sleep, or too much sleep
• skipping meals
• computer or movie screens
• strenuous exercise
• emotional triggers such as arguments or stress

Check with your doctor, pharmacist or midwife before you take a medicine for your migraine, to make sure it’s safe during pregnancy.

Paracetamol is the safest option for pain relief. If paracetamol doesn’t help and you need something stronger, ask your doctor about if you can take codeine. Try not to take codeine often, as you could become dependent on it and your baby could have withdrawal symptoms after they are born.

Most triptans (migraine medicines) are not considered safe in pregnancy. If you don’t get relief from paracetamol and codeine, you may be able to take sumatriptan occasionally. This medicine is available from a pharmacist and requires a prescription. Speak with your doctor or pharmacist before using it to help you understand the risks and the benefits of this medicine during pregnancy.

You can take metoclopramide if you suffer from nausea or vomiting with migraines.

Acupuncture can help treat migraines. Talk to your doctor or midwife first to check it’s safe for you. Make sure to tell your acupuncturist that you’re pregnant, so they can avoid certain points that shouldn’t be used in pregnancy.

When should I see a doctor?

See your doctor or midwife if you have symptoms of pre-eclampsia, including:

• a headache that doesn’t get better with paracetamol
• severe pain below your ribs
• heartburn that doesn’t disappear after taking antacids
• sudden swelling in your face, hands or feet
• blurred vision

Headaches can sometimes be a sign of other serious health conditions. Contact your doctor straightaway if you have:

• a sudden severe headache
• a change in your usual headaches
• your first-ever migraine
• a headache together with fever, neck stiffness, sensitivity of your eyes to light, drowsiness or weakness of your arm or leg
• a recent head injury

CHECK YOUR SYMPTOMS — If you are feeling unwell and not sure what to do next, check your symptoms using the healthdirect Symptom Checker tool.

• Speak with your doctor or midwife, particularly if you have any concerns about pre-eclampsia.
• For more information about headaches, visit Migraine and Headache Australia.
• For more information about medicines you can take during pregnancy, talk to your doctor or pharmacist.

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call. Available 7am to midnight (AET), 7 days a week.

Sources:

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: September 2022

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