Pregnant and bad headaches

Headaches in pregnancy - Should I be worried?

Maternity care is still essential during the coronavirus pandemic and services are still running. If you have any concerns about your pregnancy call your GP, midwife, nearest early pregnancy unit or maternity unit.

How can I treat a headache in pregnancy?

If you have a mild headache, it’s safe to take paracetamol. Make sure you follow the instructions on the packet for how much you can take.

There are some painkillers you should not take while you’re pregnant. These include tablets or capsules that:

contain added caffeine (sometimes sold with 'extra' on the label)
contain codeine
are anti-inflammatory, like ibuprofen or aspirin.

Some women may be advised to take a low dose of aspirin as a treatment if they have had miscarriages before or they are at risk of pre-eclampsia. This will be prescribed by a doctor. Aspirin should not be taken as treatment for a headache.

Try to take the lowest dose of paracetamol that works and for the shortest amount of time. Your midwife, GP or pharmacist can give you more advice if the pain is ongoing and doesn’t go away with paracetamol.

Find out more about drugs and medicines in pregnancy.

What can I do to prevent headaches in pregnancy?

There are some things you can do to prevent headaches. Try to:

drink at least eight glasses of fluid a day to avoid dehydration
get enough sleep
eat a healthy, balanced diet
rest and relax as much as possible. You could try things like mindfulness or yoga.

When should I call a doctor or midwife about a headache in pregnancy?

Call your midwife, doctor or hospital maternity unit if you have a very bad headache or a headache that won’t go away. This could be a symptom of pregnancy induced hypertension. This is a type of high blood pressure that develops after 20 weeks and goes away within 6 weeks of the baby's birth. It’s also known as gestational high blood pressure or gestational hypertension.

Call your midwife, doctor or hospital straight away if you have a headache and vision problems and sudden swelling on your hands, feet, face or stomach. This could be a sign of pre-eclampsia, a pregnancy condition that can be dangerous for you and the baby if it is not monitored and treated.

Call your midwife, doctor or hospital maternity unit if you have a headache and any of the following symptoms:

discomfort in the lowest part of your stomach (pelvis)
back pain
loin pain (your sides between the lower ribs and pelvis, and the lower part of the back)
needing to wee a lot or an uncontrollable need to wee
cloudy, foul-smelling (fishy) or bloody wee
a raised temperature (over 37.5°C)
feeling sick (nausea) and vomiting.

This could be a sign of a urinary tract infection. UTIs cab be treated with antibiotics that are safe to use in pregnancy.

Migraines in pregnancy

Migraines are a common type of headache. Many people who have migraines may have:

severe pain, which feels like a throbbing, pounding or pulsating pain
nausea (feeling sick)
pain brought on by bright lights
an ‘aura’, such as flashing lights before the migraine starts.

Talk to your doctor or midwife if you’ve had migraines before and if you are taking or have taken any medication for them. This is because some migraine medications can contain codeine, aspirin or ibuprofen, which are not recommended in pregnancy unless prescribed by a doctor and the benefits outweigh the risks.

Don’t wait until you have an attack. Your doctor should be able to give you advice on how you can manage your symptoms while you’re pregnant and if you choose to breastfeed.

Will a migraine hurt my baby?

Women with migraines are at slightly higher risk of developing high blood pressure and pre-eclampsia. This risk is very small and most women with migraines will not have high blood pressure.

If you have any worries at any time, talk to your midwife.

What do I do if I have a migraine in pregnancy?

If you’ve never had a migraine call your midwife, doctor or hospital maternity unit. Serious conditions like pre-eclampsia can be like a migraine, so although it’s unlikely anything is wrong, your healthcare team may want to see you.

If you have always had migraines, you may find that they get better during your pregnancy. But pregnancy can also change the nature of migraines, so if you have a migraine that feels different to what you’ve had before, call your midwife, doctor or hospital maternity unit.

What can I do to prevent migraines?

One of the best ways to prevent migraines is to recognize what triggers an attack and trying to avoid them. For example, stress, eating certain foods or lack of sleep may bring on an attack.

Avoiding your triggers can be difficult when you’re pregnant. For example, if you have morning sickness you may not feel like eating or drinking much. This can cause low blood sugar or dehydration, so it’s important to try and find ways to cope.

Getting enough sleep may also be difficult during pregnancy. Try our tips for a better night’s sleep.

You should also try to

drink at least eight glasses of fluid a day to avoid dehydration
eat a healthy, balanced diet
rest and relax as much as possible. You could try things like mindfulness or yoga.

Acupuncture

You could also try acupuncture, which has been recommended by NICE as helpful for people with migraines. Acupuncture is a type of complementary therapy that involves a practitioner inserting thin needles at particular points on your body. It’s used to control and relieve pain. Research has shown that it can also help with back pain for pregnant women.

Acupuncture is generally safe to have when you’re pregnant but talk to your midwife or GP before you book a session. If you do want to try it, make sure your acupuncturist is fully qualified and that they use disposable needles at every treatment session. Tell your practitioner that you’re pregnant because certain acupuncture points can’t be used safely in pregnancy.

More information and support

Migraine Action

Migraine Trust

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

Women's Health Pregnancy

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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.

Follow our Instagram to read the latest materials on the diagnosis and treatment of headaches!

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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 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;
pain in the lower abdomen, as if contractions had begun.

Why pregnant women can get headaches

Pregnancy headaches are 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.