Migraine Headaches During Pregnancy

Headaches are quite common in pregnancy. The most common are tension headaches and migraine headaches. Most headaches come and go, but others may be more bothersome or may be caused by other problems. It’s important to talk with your healthcare provider about any headaches you have before, during, or after pregnancy.

Many pregnant women have migraine headaches. Over half of women find that their migraines happen less often in the last few months of pregnancy. But migraines may get worse after birth, during the postpartum period. Although migraine headaches may cause you severe pain, they don’t harm your developing baby (fetus).

What are migraine headaches?

Migraines are a type of headache that affects nerves and blood vessels (neurovascular). The two most common types of migraines are migraine with aura and migraine without aura.

Migraine with aura. This type of migraine includes an aura. You may see flashing lights or zigzag lines or lose your eyesight for a short time. This usually happens 10 to 30 minutes before the migraine starts. The aura may also happen during the migraine.
Migraine without aura. This type of migraine generally does not have an aura. You may have other symptoms before it starts.

How are migraine headaches managed in pregnancy?

Treatment of migraines in pregnancy may include things that soothe the pain. This includes cold packs, a darkened room, and sleep. Staying away from triggers, such as certain foods and stress, may also be helpful. Any medicines to treat pain, nausea, and vomiting must be carefully chosen. Here are some things to know about migraine treatment in pregnancy:

Many medicines pass through the placenta to your developing baby. You shouldn’t take these medicines in the first trimester.
Other medicines can be harmful in later pregnancy.
Generally, small amounts of acetaminophen and caffeine are safe in pregnancy.
Don’t take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.
Migraine headache medicine, such as sumatriptan and opioid, pain medicines, such as morphine, should be used only as directed by your healthcare provider. Opioid pain relievers can be addictive for both you and your baby.

Talk with your pregnancy care provider about which migraine medicine can be used safely during pregnancy.

What are possible complications of migraines?

If you have a history of migraine headaches, and have no other health problems, migraines during pregnancy are not usually a concern.

But if a first-time migraine-like headache occurs in pregnancy, it’s important to check for any other type of condition that may be dangerous. This includes bleeding in the brain, meningitis, high blood pressure, or tumors. You may need further testing to find the cause of the headache. This testing may include urine and blood tests.