Headaches during pregnancy.

Last Updated on November 18, 2023 by theosteomum

Pregnant women often have many questions about headaches during pregnancy.

Things like:

• Are they normal?
• Should I call my Doctor?
• Do headaches during pregnancy mean I’m having a boy?

We’ll cover all of these and more in this post. 

Topics covered include:

• How common are headaches during pregnancy?
• The 3 different scenarios for headaches during pregnancy, and why you should know them. 
• What are the different types of headache during pregnancy?
• Migraines during pregnancy
• Tension-type headaches during pregnancy
• Other types of intense or serious headaches during pregnancy
• When should you seek medical attention?
• Is there an association between headaches during pregnancy and gender prediction?
• How to relieve headaches during pregnancy.

 

Migraines during pregnancy:

What are migraines?

Migraines are a common type of headache, with 12-15% of women experiencing them at any stage of their lives.

They affect women of childbearing age more frequently than any other age group, peaking at around 41 years of age.

7 out of 10 migraine sufferers have a family history of migraine. So if you’re unlucky enough to experience migraine, you more than likely have family members who get them too.

“What causes migraines, and will they persist during my pregnancy?”

Among other things, swings in oestrogen levels are a known trigger for migraines.

Studies have shown that the high and stable oestrogen levels in pregnancy improve migraine symptoms in pregnant women in the following ways:

• 11% of pregnant women notice an improvement in their migraine symptoms in the first trimester
• 53% see improvement during the second trimester
• 79% have less severe or frequent migraines by the third trimester.

Other studies have shown that 50-75% of women who normally suffer from any type of migraine experience an improvement in their symptoms during pregnancy. These women often note a decrease in both the frequency and the intensity of their attacks.

Risk factors for them continuing appear to be:

• Hyperemesis- a condition that causes severe “morning sickness”
• Pregnancy complications
• Migraines related to your periods before pregnancy

“But these numbers are different. What should I believe?”

The takeaway message is that it is more common for  migraine symptoms to improve during pregnancy than not.

This is good news!

A very small percentage (4-8%) of women notice that their migraines actually get worse during pregnancy.

This is more common in the migraine with aura group, which is discussed below.

“Are migraines harmful to my baby?”

In general, migraines don’t seem to have any negative effects on the pregnancy.

However, there is growing evidence that women who suffer migraines have a higher risk of developing pre-eclampsia and eclampsia.

Studies found an increased association between migraine sufferers and pre-eclampsia/eclampsia in the following groups of women:

• You are over 30 years old when you start to suffer migraines
• You are “overweight” – i.e. your BMI is over 25.

Do any of these factors apply to you?

If so, you’ll need to be on the lookout for symptoms of pre-eclampsia from around 20 weeks pregnant.

Read on for more information on this serious condition.

Migraines are typically divided into 2 groups, as follows:

1. Migraines with aura

Migraines with aura are headaches that occur with associated symptoms, such as:

• flashes of light, blind spots or other vision changes, or
• tingling in your face or hand.

These associated symptoms are known as “aura”.

The headache is usually felt on one side of the head, often as a throbbing-type pain.

The aura can come before, during or after the headache.

Migraine sufferers will also often report a sensitivity to light, sound and head movements.  

Often they just need to lay in a dark, quiet room, possibly sleep, and wait for it to pass.

Migraines with aura account for about 30% of migraines.

It is more common for women to experience their first migraine with aura during pregnancy.

Unfortunately, around half of all pregnant women who normally experience migraine with aura will continue to suffer them during pregnancy. They may also experience new symptoms during this time.

Some pregnant women will develop aura without the headache for the first time.

2. migraines without aura

Migraines without aura are severe and recurrent headaches that usually occur without associated symptoms (such as eyesight changes).

The headache is usually felt on one side of the head. 

You may still feel nauseous or vomit, and you may still be sensitive to light and/or sound.

These account for about 70% of migraines.

Somewhere between 1% and 10% of women will experience their first migraine without aura during pregnancy. This is most common during the first trimester.

 

“Will I experience migraines in any future pregnancies?”

Unfortunately, about half of all migraine sufferers will experience a worsening of their symptoms in future pregnancies.

So they often feel better during their first pregnancy, but worse if they go on to have more children.

The research isn’t clear as to why this occurs.

My theory is that many things change during your second or subsequent pregnancy.

During your first pregnancy, the focus is usually totally on you.

You can sleep when you feel tired. You have more time to focus on things like eating well and stress management.

When you’ve got a baby or toddler, that all changes!

This is not (yet) backed up by research. But I know that my second pregnancy was a whole lot harder than the first for exactly these reasons!

Some women will experience their first migraine without aura while pregnant, but it’s more common to experience their first migraine with aura.

50% of women who suffer migraines with aura when not pregnant will keep getting them while pregnant. Sometimes they’ll have new symptoms as well, and sometimes without the headache.

You’re more likely to keep experiencing migraines during pregnancy if you’ve got some complicating factors in your medical history.

“What can I do to help my migraines?”

The strategies you can try to help ease migraines during pregnancy are the same as if you weren’t pregnant. They include:

• Relaxation techniques and reassurance that migraines are not usually harmful to your baby
• Using ice or warm heat packs on the muscles of the upper back, neck or head
• Massage
• Your usual medications, if you have any. It’s important to check with your Doctor or Pharmacist first though, to ensure that they’re safe during pregnancy.

“How can I prevent migraines during pregnancy?”

Again, the prevention strategies are the same as you would use for migraines when you’re not pregnant. These include:

• Avoiding your migraine triggers, such as certain foods, caffeine etc.
• Sticking to a regular sleep schedule. Check out this post to learn how to sleep safely and comfortably during pregnancy.
• Trying to keep your stress levels in check.

 

“What causes tension-type headaches, and will they persist during my pregnancy?”

In theory, tension-type headaches should improve during pregnancy.

This is because hormones that allow loosening of joints to allow for growth and delivery should help with relaxation.

In reality, though, almost 20% of women say that their tension-type headaches don’t change during pregnancy.

Around 25% of women say that their tension-type headaches improve during pregnancy.

The good news is that only around 5% of women find that their tension-type headaches worsen during pregnancy.

“Are tension-type headaches harmful to my baby?”

There seems to be no association between tension-type headaches and harm to you or your baby.

This should help you relax, which is important to help relieve them!

“What can I do to help my tension-type headaches in pregnancy?”

The strategies you can try to help ease tension-type during pregnancy are the same as if you weren’t pregnant. They include:

• Relaxation techniques and reassurance that tension-type headaches are not usually harmful to your baby
• Using ice or warm heat packs such at this on the muscles of the upper back, neck or head. I particularly like these heat packs in pregnancy because they’re unscented- perfect for those who may be feeling super sensitive to smells, or who want to avoid essential oils due to safety concerns.
• Massage
• Your usual medications, if you have any. It’s important to check with your Doctor or Pharmacist first though, to ensure that they’re safe during pregnancy.

“How can I prevent tension-type headaches during pregnancy?”

Again, the prevention strategies are the same as you would use for tension-type headaches when you’re not pregnant. These include:

• Sticking to a regular sleep schedule. Check out this post to learn how to sleep safely and comfortably during pregnancy.
• Trying to keep your stress levels in check.
• Getting regular exercise. For the latest information about how to exercise safely during pregnancy, you can read this post.

Pre-eclampsia and eclampsia headaches in pregnancy:

Pre-eclampsia affects between 5-10% of all pregnant women.

It can occur at any point from 20 weeks’ of pregnancy, or in the first few days post birth.

Pre-eclampsia is a serious condition, that can be extremely dangerous and even fatal for mother and baby.

If left untreated, it can progress to the point where the mother suffers convulsions (where her body shakes uncontrollably).

This condition is then known as eclampsia.

What are the symptoms of pre-eclampsia?

The following symptoms may indicate pre-eclampsia:

• Persistent headaches that are not relieved by over-the-counter medications.
• Usually the headache is on both sides of the head, at either the back, sides or front.
• Some women experience the headache throughout their entire head, and some will feel pulsations of pain.
• The headache will get worse with physical activity.
• Blurred vision
• Significant swelling in your hands, face or feet.

If you are experiencing these symptoms, it is vital that you seek urgent medical attention.

It’s also important to note here though, that around 30-50% of women with pre-eclampsia do not suffer headaches.

If you’ve got the other symptoms BUT not the headache, it’s still vital that you seek medical attention.

Cluster headaches:

Cluster headaches are usually severe, stabbing-type headaches.

They may have other associated symptoms, such as:

• eye irritation,
• nasal stuffiness,
• sweating, or
• feeling restless.

Attacks usually occur in groups.

During a cluster, people will experience 1-8 episodes per day, lasting 15 minutes to 3 hours.

No-one really knows what causes cluster headaches.

Thankfully, they are relatively rare.

Triggers include:

• alcohol,
• some medications, and
• complications from sleep apnoea.

Cluster headaches are also more common in men, which explains why only 0.3% of pregnant women experience them.

Because they’re so rare in pregnant women, there’s very little research into the effects of them. What little research there is, however, seems to indicate that apart from the pain, they shouldn’t cause too many problems.

Cluster headaches are more common in people who smoke. Just another reason to quit, especially if you’re pregnant!

Cluster headaches aren’t necessarily “serious”, in that they’re unlikely to indicate that something more serious is happening. However, the pain is usually so severe that you’ll want to speak to your Doctor about effective treatments.

 

Vascular events and other serious pathologies:

Some more serious medical conditions can also cause headaches. The headaches associated with these events are usually:

• Sudden and severe- sometimes described as “thunderclap”. They hit like a bolt of lightning out of nowhere, and are debilitatingly painful.
• Made worse by physical activity, or under pressure such as with lifting, coughing or sneezing
• Associated with other signs or symptoms, such as:
  • altered consciousness,
  • vomiting, or
  • other neurological signs such as vision or balance changes.

If you are experiencing a new headache with these types of features, or if your typical headache type has changed to include these, it is vital that you seek urgent medical attention.

How to relieve headaches during pregnancy.

Have you read through this post and decided that you’re not suffering from any of the more serious headache types?

Then there are some simple things you can do to help your headaches during pregnancy.

These include:

Get some manual therapy:

Manual therapy, such as Osteopathy or Physical Therapy, has been shown to be a safe and effective tool for relief of headaches.

Be sure to search for someone who is experienced in managing pregnant patients to ensure you receive the most up-to-date and effective care.

Get some gentle exercise:

When you’re tired, feeling huge or weighed down by headaches during pregnancy, exercise may be the last thing you feel like doing.

But there is a stack of evidence to show that regular exercise can help prevent headaches and migraines.

If you’re unsure of the best ways to exercise during pregnancy, check out this post.

Try some (pregnancy-safe) medications:

If you’ve suffered from headaches prior to your pregnancy, you may have previously been prescribed medications for them.

Check with your Doctor or Pharmacist before taking any medications while pregnant.

However, there are a number of pregnancy-safe medications that can help your headaches.

Rest, and drink a lot of water:

Pregnancy is hard work!

Your body is working overtime to not only get you through each day, but to also grow another person.

This takes a lot of energy, and a lot of fluids.

Be kind to yourself and rest if you need to.

Sometimes just a 20-minute power nap is all you need to wake up feeling (almost) brand new!