Is it common to get headaches during pregnancy?
It's not unusual to get tension headaches when you're pregnant, especially in the first trimester. Tension headaches – the most common kind of headache – can feel like a squeezing pain or a steady dull ache on both sides of the head or the back of the neck. If you've always been susceptible to tension headaches, pregnancy can make the problem worse.
Experts don't know exactly why carrying a child tends to make your head ache more often, but one good guess is the hormonal free-for-all that's taking place in your body. Your increased blood volume and circulation may also play a part, especially in early pregnancy. Going cold turkey on caffeine can also make your head pound.
Other potential culprits include lack of sleep or general fatigue , sinus congestion. allergies, eyestrain, stress, depression. hunger, and dehydration.
If you have headaches in your first trimester, you'll probably find that they diminish or even disappear during the second trimester, when the flood of hormones stabilizes and your body grows accustomed to its altered chemistry.
What about migraines?
Migraines are another common type of headache. Experts estimate that about 1 in 5 women has a migraine headache at some time in her life, and up to 16 percent of those women get migraines for the first time when they're pregnant (most often in the first trimester).
Migraine headaches cause moderate to severe throbbing pain, typically on one side of the head. They last from four to 72 hours (if untreated) and are aggravated by physical activity. They can also be accompanied by other symptoms, such as nausea, vomiting, or sensitivity to light and noise.
Some migraine sufferers have what are known as migraines with aura – that is, headaches that are preceded by symptoms that may include visual changes (such as bright flashing lights or blind spots), sensations of numbness or "pins and needles," weakness, and speech disturbances. These symptoms may start as long as an hour before a migraine and may last up to an hour.
Fortunately, about two-thirds of women who are prone to migraines notice that they improve during pregnancy. (This is more likely if your migraines tended to be worse around your periods or started when you first began menstruating.) Others notice no change or find that their headaches become more frequent and intense.
Even if you're part of the unlucky minority whose migraines don't improve during pregnancy, you can at least take some solace in the fact that migraine sufferers don't appear to have a higher risk of pregnancy complications than other women.
What kind of pain medication can I take?
Acetaminophen is safe to take as directed on the label, but most other headache medications – such as aspirin and ibuprofen, as well as most prescription migraine drugs – aren't recommended for pregnant women. Consult your practitioner about which medications you can take if you're prone to severe migraines.
If you're having frequent, debilitating headaches, the benefits of certain medications may outweigh any possible risks to your baby, although some drugs will remain strictly off-limits. You may be referred to a maternal-fetal medicine specialist (MFM) or a neurologist to help with your migraines if they are persistent.
What else can I do to relieve the pain?
Here are a few more suggestions that may help you ward off a headache or get relief once you have one:
Figure out what's triggering the pain
Headache specialists often recommend keeping a "headache diary" to help identify specific triggers. Write down anything you've eaten in the 24 hours preceding the onset of a migraine and what you were doing when it started.
Some common migraine triggers include foods that contain:
- monosodium glutamate (MSG)
- nitrites and nitrates (common in processed meats like hot dogs, salami, and bacon)
- artificial sweeteners
- certain beans and nuts
- aged cheese and cultured dairy products (like buttermilk and sour cream)
- certain fresh fruits (bananas, papayas, avocados, and citrus)
- smoked fish
- chocolate and carob
- things that are fermented or pickled (like soy sauce or sauerkraut)
Other triggers may include glaring or flickering lights, loud noises, excessive heat or cold, strong odors, and tobacco smoke.
Use a compress
For a tension headache, apply a warm or cool compress to your forehead or the base of your skull. Cold compresses tend to work best for migraines.
Take a shower
For some migraine sufferers, a cold shower brings some fast – if temporary – relief. If you can't take a shower, splash some cool water on your face. A warm shower or bath can be soothing for
Don't go hungry or thirsty
To prevent low blood sugar (a common headache trigger), eat smaller, more frequent meals. If you're on the go, keep some snacks (crackers, fruit, yogurt) within reach. Avoid straight sugar, like candy, which can cause your blood sugar to spike and crash.
And don't forget to drink plenty of water to stay hydrated as well. Sip water slowly if you have a migraine and have vomited.
Try to make time for naps in your day. If you're having a migraine, try to sleep it off in a quiet, dark room.
Get some exercise
Some evidence shows that regular exercise can reduce the frequency and severity of migraines and reduce the stress that can cause tension headaches. If you're prone to migraines, get started slowly – a sudden burst of activity could trigger one. (And don't exercise once a migraine has started because it will aggravate the headache.)
Doing exercises to help you maintain good posture may be especially helpful with headaches during the third trimester.
Try relaxation techniques
Biofeedback, meditation, yoga, and self-hypnosis may be helpful in reducing stress and headaches in some sufferers.
Consider getting a full-body massage to release tension in the muscles of the neck, shoulders, and back. If you can afford it, look for a trained prenatal massage therapist.
If a professional massage is only a pipe dream, ask your partner to rub your back and head – or slip into a salon for a professional shampoo. Some women who suffer from tension headaches swear by massage, although some studies question whether it's effective in preventing or relieving headaches.
Acupuncture treatment is considered safe during pregnancy, although whether it's effective for headaches is an issue of some debate. If you'd like to give it a try, ask your healthcare provider for the names of acupuncturists and keep her posted on your treatments. If you'd like to see a practitioner who's also an M.D. visit the American Academy of Medical Acupuncture website or call (310) 364-0193 to find one in your area.
Can a headache be a sign of something more serious?
Yes. Most headaches during pregnancy are unpleasant but harmless, but a headache can be a sign of a more serious problem. If you're having a migraine or other severe headache for the first time ever, you'll need a full medical evaluation to be sure nothing else is going on.
In the second or third trimester of pregnancy, a headache could be a sign of preeclampsia. a serious pregnancy-induced condition marked by high blood pressure. Other symptoms can include protein in the urine, vision changes, and liver and kidney abnormalities.
When should I call my healthcare provider?
Call your provider right away if:
- You're in your second or third trimester and have a bad headache or a headache for the first time, which may or may not be accompanied by visual changes, sharp upper abdominal pain or nausea, sudden weight gain, or swelling in your hands or face. You'll need to have your blood pressure and urine checked right away to be sure you don't have preeclampsia. (If you've been having any problems with high or rising blood pressure, call if you have only a mild headache.)
- You have a sudden "explosive" headache, violent pain that awakens you from sleep, a headache that doesn't go away, or one that feels unlike any you've ever experienced.
- Your headache is accompanied by a fever and a stiff neck.
- Your headache is getting worse and you experience any other problems such as blurry vision or other visual disturbances, slurred speech, drowsiness, numbness, or a change in normal sensation or alertness.
- You have a headache after falling and hitting your head (or any other kind of head injury).
- You have nasal congestion, as well as pain and pressure underneath your eyes or other facial or even dental pain. You might have a sinus infection that will need to be treated with antibiotics.
Even if you've had headaches before, talk to your healthcare provider about them so you can decide what kind of evaluation and treatment might be best for you during your pregnancy. If you're a migraine sufferer, you won't be able to take most of the medications you've used before – ask your caregiver before taking any medication other than acetaminophen.
If you feel like your eyes are straining and notice that you get headaches after reading or looking at a computer screen, have your vision checked by an eye doctor.
Finally, don't hesitate to call your practitioner whenever a headache has you worried.