Headaches during pregnancy

Does pregnancy cause headaches?

Many people get mild headaches when they are pregnant. Headaches can often be triggered by a change in hormones. They are more common in the first few months of pregnancy.

If you usually suffer from migraines, you might notice a change when you’re pregnant. There’s a good chance that your migraines will improve after the first trimester. This may be because your oestrogen level starts to stabilise. However, some people don’t notice a change, or may get worse migraines during pregnancy. You also might notice different changes from one pregnancy to the next.

Headaches can develop for many different reasons — it’s not always because of pregnancy hormones.

Why else might I get headaches during pregnancy?

Besides hormonal changes, there are many triggers that cause headaches in general, but might occur more often when you’re pregnant, such as:

• not getting enough sleep
• withdrawal from caffeine — such as in coffee, tea or cola drinks
• low blood sugar from not eating regularly
• dehydration
• feeling stressed, anxious or depressed
• eye strain — especially as your eye muscles relax during pregnancy

Many of these triggers can cause tension headaches, which are very common. The pain is usually mild and on both sides of your head.

Some of these triggers can cause migraines, which are more severe and mostly occur on one side of your head. If you have migraines, you might also feel sick or vomit and be sensitive to light or sound.

Pre-eclampsia

If you start getting frequent headaches after 20 weeks of pregnancy, this could be a sign of a more serious pregnancy condition called pre-eclampsia. Pre-eclampsia is when you have high blood pressure that affects your kidneys and sometimes other parts of your body. If you have a pre-eclampsia headache, you may find that simple pain-relieving medicines like paracetamol don’t help.

It’s very important to tell your doctor or midwife if you are getting headaches in the second half of pregnancy, or if your headaches are very severe.

If you have a severe headache during pregnancy, call your doctor or midwife. It could be something more serious.

Health conditions

Just like when you’re not pregnant, a headache can sometimes be a sign of other health conditions, including:

• infections, such as an ear infection or flu
• sinusitis
• problems with your teeth
• an aneurysm or stroke

What can I do to treat a headache when I’m pregnant?

If you have a headache, you could try:

• having a nap, or resting with your eyes closed
• drinking water
• having something to eat
• putting a cold or heat pack on your forehead or the back of your neck
• asking someone to give you a gentle neck massage

If you need to take medicine for pain relief, paracetamol is safe during pregnancy. Pain-relieving medicines can actually cause headaches if you take them too often, so don’t take paracetamol more than 3 times a week.

When you’re pregnant, avoid anti-inflammatories such as ibuprofen or aspirin and medicines that contain caffeine.

What can I do to prevent headaches during pregnancy?

If you find you are getting mild headaches often, it’s a good idea to:

• getting more sleep
• drink at least 8 cups of water a day
• go to pregnancy yoga classes or do some other type of exercise
• learn relaxation or stress management techniques
• don't go more than 4 hours without eating
• avoid processed foods
• see an optometrist for an eye check

What can I do if I suffer from migraines during pregnancy?

If you suffer from migraines, try to avoid things that may trigger migraines for you. People have different triggers for migraines, so it’s important to learn what your personal triggers are. Keep a headache diary, and see if your triggers include:

• specific foods such as chocolate, or food additives such as caffeine or MSG
• bright or flickering lights, strong smells and loud sounds
• not enough sleep, or too much sleep
• skipping meals
• computer or movie screens
• strenuous exercise
• emotional triggers such as arguments or stress

Check with your doctor, pharmacist or midwife before you take a medicine for your migraine, to make sure it’s safe during pregnancy.

Paracetamol is the safest option for pain relief. If paracetamol doesn’t help and you need something stronger, ask your doctor about if you can take codeine. Try not to take codeine often, as you could become dependent on it and your baby could have withdrawal symptoms after they are born.

Most triptans (migraine medicines) are not considered safe in pregnancy. If you don’t get relief from paracetamol and codeine, you may be able to take sumatriptan occasionally. This medicine is available from a pharmacist and requires a prescription. Speak with your doctor or pharmacist before using it to help you understand the risks and the benefits of this medicine during pregnancy.

You can take metoclopramide if you suffer from nausea or vomiting with migraines.

Acupuncture can help treat migraines. Talk to your doctor or midwife first to check it’s safe for you. Make sure to tell your acupuncturist that you’re pregnant, so they can avoid certain points that shouldn’t be used in pregnancy.

When should I see a doctor?

See your doctor or midwife if you have symptoms of pre-eclampsia, including:

• a headache that doesn’t get better with paracetamol
• severe pain below your ribs
• heartburn that doesn’t disappear after taking antacids
• sudden swelling in your face, hands or feet
• blurred vision

Headaches can sometimes be a sign of other serious health conditions. Contact your doctor straightaway if you have:

• a sudden severe headache
• a change in your usual headaches
• your first-ever migraine
• a headache together with fever, neck stiffness, sensitivity of your eyes to light, drowsiness or weakness of your arm or leg
• a recent head injury

CHECK YOUR SYMPTOMS — If you are feeling unwell and not sure what to do next, check your symptoms using the healthdirect Symptom Checker tool.

Where can I find further information?

• Speak with your doctor or midwife, particularly if you have any concerns about pre-eclampsia.
• For more information about headaches, visit Migraine and Headache Australia.
• For more information about medicines you can take during pregnancy, talk to your doctor or pharmacist.