Headaches and pregnancy first trimester

What Causes Them and What You Can Do

If you’re pregnant and having headaches, you’re not alone. A medical review reports that 39 percent of pregnant and postpartum women have headaches.

Though during pregnancy you may have a different kind of headache than you usually do, most headaches during pregnancy aren’t harmful.

Headache pain during the first trimester of pregnancy may happen for different reasons than headaches in the second or third trimester. In some cases, headache pain may be a sign of other health problems during pregnancy.

Tell your doctor about any headache you have during, before, and after pregnancy. Keep a journal to record how often you have headaches and how serious the pain is. Additionally, record any other symptoms you have.

Most headaches during pregnancy are primary headaches. This means that the headache pain happens by itself. It’s not a sign or symptom of another disorder or a complication in the pregnancy. Primary headaches include:

• tension headaches
• migraine attacks
• cluster headaches

About 26 percent of headaches during pregnancy are tension headaches. Tell your doctor if you have chronic headaches or migraine during pregnancy or if you have a history of migraine.

Some women with a history of migraine get fewer migraine attacks during pregnancy. Migraine has also been linked to complications that happen later in pregnancy or after the birth of your baby.

Secondary headaches are a caused by a complication in the pregnancy, such as high blood pressure.

Headache pain may vary from one person to the next. You may have:

• dull ache
• throbbing or pulsating pain
• severe pain on one or both sides
• sharp pain behind one or both eyes

Migraine pain may also include:

• nausea
• vomiting
• seeing lines or flashes of light
• blind spots

First trimester

Tension headaches are common in the first trimester of your pregnancy. This may happen because your body is undergoing several changes at this time. These changes may trigger headache pain:

• hormonal changes
• higher blood volume
• weight changes

Common causes of headache pain during the first trimester of pregnancy also include:

• dehydration
• nausea and vomiting
• stress
• lack of sleep
• caffeine withdrawal
• poor nutrition
• low blood sugar levels
• too little physical activity
• sensitivity to light
• changes in vision

Some foods may also cause headaches. Your trigger foods may change during pregnancy. Common foods that may cause headaches in some people include:

• dairy
• chocolate
• cheese
• yeast
• tomatoes

Second and third trimester

Headaches during your second and third trimester may have different causes. These include:

• extra weight
• posture
• too little sleep
• diet
• muscle strain and tightness
• high blood pressure
• diabetes

High blood pressure

Headaches during your second or third trimester of pregnancy may be a sign that you have high blood pressure. About 6 to 8 percent of pregnant women ages 20 to 44 in the United States have high blood pressure.

The Centers for Disease Control and Prevention (CDC) warns that this treatable condition can cause serious complications for both mother and baby. This is most common after week 20 of pregnancy.

If you’re pregnant, high blood pressure can raise the risk of:

• stroke
• preeclampsia
• eclampsia
• low oxygen flow to the baby
• preterm delivery, before 37 weeks
• placental abruption
• low baby birth weight, which is less than 5 pounds, 8 ounces

Treatment for hypertension during pregnancy

Your doctor may prescribe medication to treat your high blood pressure. You’ll also need to cut down on salt and add more fiber to your daily diet. Regular exercise is also very important to help balance your blood pressure.

Other causes of headache during pregnancy include common infections and more serious illnesses:

• sinus infection
• low blood pressure
• blood clots
• bleeding
• sickle cell anemia
• brain tumor
• aneurysm
• stroke
• heart conditions
• meningitis or encephalitis

Talk to your doctor before taking your regular headache pain medication during pregnancy. Don’t take aspirin and ibuprofen (Advil, Motrin etc.).

The CDC warns that these pain relief drugs can be harmful to your growing baby, especially if taken during the first trimester. Many women may take acetaminophen (Tylenol) during pregnancy. However, some studies suggest there may be effects from taking acetaminophen as well.

Your doctor can recommend alternative medications to treat headache during pregnancy and natural headache remedies, such as:

• drinking plenty of water
• rest
• ice pack
• heating pad
• massage
• exercise and stretching
• essential oils, such as peppermint, rosemary, and chamomile

When to see your doctor

See your doctor if you have any headache pain at all during pregnancy. Get urgent medical attention if you have:

• fever
• nausea and vomiting
• blurred vision
• severe pain
• headache that lasts longer than a few hours
• frequent headache pain
• fainting
• seizure

Your doctor may recommend tests and scans to find out the cause of your headaches. These include:

• checking your blood pressure
• blood test
• blood sugar test
• vision test
• ultrasound of the head and neck
• heart or head scan
• checking eye health with a scope
• spine puncture

Headache pain during pregnancy is common. You may have tension headaches during your first trimester of pregnancy. This may happen because of the many changes that you’re going through in a short period.

Headache pain may happen in the second and third period of your pregnancy for other reasons. Some causes of headaches in your mid to late pregnancy may be serious.

High blood pressure is a serious cause of headache pain during pregnancy. You can have high blood pressure at any time in your pregnancy. You may not have any symptoms at all. Check your blood pressure at least once a day with a home monitor.

Tell your doctor if you have headaches at any time in your pregnancy. Let your doctor know right away if you have a personal or family history of migraine, high blood pressure, seizures or diabetes.

Take all medications and treatment exactly as prescribed by your doctor. Follow all diet and exercise advice carefully. See your doctor for all follow-up and regular check-ups. Most causes of headaches during pregnancy are treatable or preventable with the right care.

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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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