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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

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.

1. 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.

2. 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?

1. 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;

2. 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.

New drugs: jepants and ditans for the treatment of migraine attack Pain 10 out of 10 How to relieve a migraine without medication

which doctor should I contact and how to treat correctly?

• Main
• >Pregnancy

Of course, migraine or chronic tension headache is not a contraindication to pregnancy. And almost every woman, regardless of the presence of any chronic diseases, wants to become a mother. However, in order to survive the most comfortable period of pregnancy in the presence of chronic migraine or headache, it is necessary to prepare for this period in advance. The better your preparation is, the easier it will be for pregnancy, childbirth and postpartum feeding of the baby. Women with migraines are advised to stop all medications at least two weeks before conception and prepare to avoid severe attacks. Ideally, this stage of preparation takes from 6 to 12 months. Clinic of headache and vegetative disorders. Veina in Moscow specializes in the treatment of migraines, headaches and other types of pain syndrome. For a long time of work under the supervision of our doctors, many pregnancies have come and gone successfully, even in difficult patients. Effective assistance was provided to expectant mothers with such diseases as:

• migraine,
• headache,
• panic attacks and anxiety during pregnancy,
• insomnia,
• attacks of vegetovascular dystonia during pregnancy,
• pain in the neck, back, lower back during pregnancy,
• diseases during pregnancy.

Pregnancy and breastfeeding has many restrictions in taking medicines. However, some schemes for taking drugs to relieve headaches and migraines during pregnancy still exist. It is better to clarify and select them in advance together with the attending physician, and also to develop a clear algorithm of actions in case of an impending attack. Enduring pain during pregnancy with migraine is still not recommended, with the exception of the first trimester and the last weeks of the third trimester. But most importantly, non-drug methods of relieving headaches come to the aid of pregnant women, such as:

• biofeedback therapy,
• manual therapy,
• massage,
• acupuncture,
• psychotherapy.

botulinum therapy - prevention of migraine and headache during pregnancy

The most interesting and promising method of treating headache during pregnancy and migraine is botulinum therapy. The essence of this method is prevention. Before becoming pregnant, a woman is given injections of one of the botulinum toxin preparations (multiple injections during the year are possible). Such prophylactic treatment can significantly reduce the frequency and intensity of migraine attacks for up to six months. Thus, it is possible to minimize the frequency and severity of attacks in the most important first trimester. Then, when the laying of the organs and systems of the baby occurs, it is risky to take painkillers. To select the optimal timing and methods of treating your type of headache, it is best to contact a headache specialist a year, six months before the planned pregnancy.

Authorized medicines for migraine and headache

Still, migraine and headache often take pregnant women by surprise. What painkillers are still allowed for pregnant women? During the entire period of pregnancy, you can take paracetamol at a dose of 325-500 mg up to 4 times a day. Caffeine is also allowed. So, you can drink migraine, panadol extra or solpadein fast. Of course, these painkillers are not very strong. And at the usual time, taking them to relieve a migraine attack is not recommended. But during pregnancy, they can be drunk absolutely fearlessly. It is effective to take aspirin, naproxen and ibuprofen during pregnancy for migraine. But they can be drunk without fear only during the first and second trimesters. When planning a pregnancy, they are undesirable. And in the third trimester it is generally prohibited.

DRUGS FOR MIGRAINES AND HEADACHES IN PREGNANCY

There are drugs that are strictly prohibited during pregnancy. These are painkillers with phenobarbital, codeine, old tranquilizers like phenazepam and ergotamines.

Headache and migraine treatment during pregnancy

Dear expectant mothers! If you suffer from migraines, chronic headaches or other types of pain syndrome, experience a feeling of constant anxiety, panic attacks, we invite you to spend your pregnancy under the supervision of our specialists! Our doctors have harmless, but effective methods of treatment.

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