Headaches and Pregnancy

Frequently Asked Questions Expand All

• How common are headaches?

  More than 3 billion people around the world have frequent headaches that affect their ability to do daily tasks. Tension headaches are the most common, but migraines cause more problems for women younger than 50.

• What are the symptoms of a headache?

  The most common headaches have the following symptoms:

  • Migraines—These headaches cause throbbing pain that’s usually on one side of the head. Some people have nausea, vomiting, and light sensitivity. It’s also common to have symptoms before a migraine starts, including blurred vision, eye pain, seeing flashes of light, and tunnel vision.

  • Tension headaches—These headaches cause muscle tightness and pain in the head, scalp, or neck. The pain can feel like a band that’s squeezing the head. They can be caused by stress, anxiety, depression, or injury.

  • Cluster headaches—These headaches cause pain on one side of the head and focus around an eye. Other symptoms may include eye tearing, a droopy eyelid, and a stuffy nose.

• When is the best time to talk with an ob-gyn about headaches?

  If you get headaches and you’re planning a pregnancy, the best time to tell your obstetrician–gynecologist (ob-gyn) is during a prepregnancy care checkup. If you didn’t have a prepregnancy care visit before you got pregnant, plan to talk about your headaches as soon as possible. You and your ob-gyn should discuss

  • your symptoms

  • how often you get headaches

  • any medication you take to prevent them

  • any medication you take to treat pain

  Together you can discuss how you will manage headaches if you get them when you are pregnant or breastfeeding.

• What causes headaches in pregnancy?

  Sometimes the headaches people had before pregnancy continue when they are pregnant. These are called primary headaches.

  For some people, headaches develop during pregnancy. These are called secondary headaches. They have several causes:

  • Early in pregnancy, hormone changes can lead to headaches.

  • Later in pregnancy, tension from carrying extra weight can cause headaches.

  • Throughout pregnancy, caffeine withdrawal, dehydration, lack of sleep, and low blood sugar can trigger headaches.

  • In the postpartum period, headache with neck and shoulder pain is common. This type of headache is related to the bodily stress of giving birth and lack of sleep when a new baby is in the house.

  There’s another type of headache that’s caused by preeclampsia, a serious high blood pressure disorder that develops during pregnancy. Read the section “When is a headache a sign of a bigger problem?” for details.

• How can I prevent headaches during pregnancy?

  If you got headaches before pregnancy, you and your ob-gyn should review the medication you took to prevent them and talk about whether it needs to change. Your ob-gyn may recommend continuing or changing your medication. They may also recommend decreasing or stopping the medication that prevents headaches. This may be true if you get migraines because this type of headache sometimes goes away during pregnancy.

• Is there over-the-counter headache medication that’s safe during pregnancy?

  Yes, there are two over-the-counter (OTC) medications that are safe to take during pregnancy.

  Acetaminophen. This medication may be taken for all headaches. There are also acetaminophen tablets that have caffeine. This combination has been shown to help with migraine pain. If you take acetaminophen with caffeine during pregnancy, make sure your total caffeine from all sources (including coffee) does not go beyond 200 mg per day.

  Nonsteroidal anti-inflammatory drugs (NSAIDs). These OTC medications include ibuprofen and naproxen. They can be taken for migraines that don’t get better with acetaminophen, but only in the second trimester and only for 48 hours or less at a time. It’s not clear if NSAIDs are safe for a fetus during the first trimester. Taking NSAIDs during the third trimester may lead to birth defects.

  Talk with your ob-gyn if you plan to take one of these medications. Also let them know if your pain continues or gets worse while taking OTC medication.

• Is there prescription headache medication that’s safe during pregnancy?

  There’s a prescription medication called metoclopramide that can be used for headaches that are new in pregnancy, come every day, and cause constant pain. It may be taken as pills or given through an intravenous (IV) line. It may be combined with a medication called diphenhydramine. You and your ob-gyn may talk about whether this medication is right for you.

• What medication is safe to take while breastfeeding?

  Acetaminophen, caffeine, and metoclopramide are all safe to take when you are breastfeeding. Most NSAIDs are also safe, but you should avoid aspirin.

  Prescription migraine medications called triptans can also be used when you are breastfeeding. Small amounts of triptan medication pass to breast milk. Because of this, your ob-gyn may recommend you not breastfeed for several hours after taking a triptan. Together you can talk about whether this medication is right for you and whether you will need to avoid breastfeeding for a short time after taking it.

• When is a headache a sign of a bigger problem?

  Sometimes a bad headache can be a sign of preeclampsia. This is a serious high blood pressure disorder that can affect all the organs in your body. It usually develops after 20 weeks of pregnancy, often in the third trimester. When it develops before 34 weeks of pregnancy, it is called early-onset preeclampsia. It can also develop in the weeks after childbirth.

• What are the symptoms of preeclampsia?

  In addition to a headache that will not go away, symptoms of preeclampsia can include

  • swelling of face or hands

  • seeing spots or changes in eyesight

  • pain in the upper abdomen or shoulder

  • nausea and vomiting (in the second half of pregnancy)

  • sudden weight gain

  • difficulty breathing

  If you have a bad headache with any of these symptoms, especially if they develop in the second half of pregnancy or within 6 weeks of giving birth, call your ob-gyn right away.

• What is a “thunderclap” headache?

  A thunderclap headache comes on quickly with a lot of pain. It’s often a sign of something serious. There may be pain in the head and down the back of the neck. Some people with a thunderclap headache also have confusion, weakness, loss of vision, or changes in speaking or thinking. If you get a headache like this, go to an emergency room right away.

• Resources

  American Migraine Foundation
  americanmigrainefoundation.org/
  A website with patient guides on living with migraines, getting emergency help, caring for a child with migraines, and more.
  
  Association of Migraine Disorders
  migrainedisorders.org/education/patient-resources/
  A website with blogs, videos, and podcasts on the types of migraines.
  
  MotherToBaby
  mothertobaby.org/?s=headaches
  Fact sheets on different headache medications from the Organization of Teratology Information Specialists.
  
  National Headache Foundation
  headaches.org/resources/
  A website featuring news and resources on all types of headaches.
  
  National Institute of Neurological Disorders and Stroke
  ninds.nih.gov/health-information/disorders/migraine
  A webpage with details on treatments for migraines.

• Glossary

  Birth Defects: Physical problems that are present at birth.

  Fetus: The stage of human development beyond 8 completed weeks after fertilization.

  High Blood Pressure: Blood pressure above the normal level. Also called hypertension.

  Hormone: A substance made in the body that controls the function of cells or organs.

  Intravenous (IV) Line: A tube inserted into a vein and used to deliver medication or fluids.

  Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Medications that relieve pain by reducing inflammation. Many types are available over the counter, including ibuprofen and naproxen.

  Obstetrician–Gynecologist (Ob-Gyn): A doctor with medical and surgical training and education in the female reproductive system.

  Postpartum: Related to the weeks following the birth of a child.

  Preeclampsia [pre-ee-KLAMP-see-uh]: A disorder during pregnancy or after childbirth that causes high blood pressure and other signs of organ injury. These signs include an abnormal amount of protein in the urine, a low number of platelets, abnormal kidney or liver function, pain over the upper abdomen, fluid in the lungs, a severe headache, or vision changes.

  Prepregnancy Care: Medical care that is given before pregnancy to improve the chances of a healthy pregnancy. This care includes a physical exam; counseling about nutrition, exercise, and medications; and treatment of medical conditions that may affect the pregnancy.

  Trimester: A time period of 3 months. There are three trimesters in pregnancy: the first trimester, second trimester, and third trimester.