While headaches are one of the most frequently experienced discomforts during pregnancy, most of the time they’re not harmful to you or your baby. Headaches are most common during the first and third trimesters of pregnancy and are not usually related to any other underlying condition. In some cases, there may be a concerning factor at play (such as high blood pressure), so be sure to tell your OB/GYN or midwife about any headaches you’re experiencing while you’re pregnant.
Read on to learn about the three types of pregnancy headaches, their causes and expert advice from OB/GYN, D. Ashley Hill, MD, on how to treat them safely and effectively.
What are the 3 Types of Pregnancy Headaches?
- Cluster: Unilateral pain (affecting one side of the head), pain in one eye, pain that radiates to the jaw
- Migraine: Usually starts with warning signs for up to 48 hours with symptoms like fatigue, nausea, mood changes, light sensitivity and/or aura
- Tension: Bilateral (affecting both sides of the head), pressure-like pain that does not pulsate
What are Pregnancy Headache Symptoms?
Dr. Hill explains, “Every woman is different and may experience their headaches uniquely.” However, common complaints during pregnancy are:
- Dull ache
- Severe pain on one or both sides
- Sharp pain behind one or both eyes
- Throbbing or pulsating pain
Migraine pain may also include:
- Aura (seeing lines or flashes of light)
- Blind spots
- Nausea
- Vomiting
What Causes Pregnancy Headaches?
First Trimester
“Tension headaches are common in the first trimester of pregnancy. This may happen because your body is undergoing several changes during this time,” says Dr. Hill. Physical changes that may trigger headaches include:
- Higher blood volume
- Hormone changes
- Weight changes
Other common causes of headaches during the first trimester include:
- Being sedentary
- Caffeine withdrawal
- Dehydration
- Foods that trigger headaches (cheese, chocolate, dairy, tomatoes, yeast)
- Nausea and vomiting
- Lack of sleep
- Light sensitivity
- Low blood sugar
- Poor nutrition
- Stress
- Vision changes
Second and Third Trimesters
Causes of headaches during your second and third trimesters can be:
- Diet
- Extra weight
- Gestational diabetes
- High blood pressure
- Lack of sleep
- Muscle strain and tightness
- Posture changes
How Do You Treat Pregnancy Headaches?
Dr. Hill advises, “For headache prevention, we recommend using antihistamines such as Benadryl and calcium channel blockers (used to lower blood pressure). Be sure to discuss your options with your provider so they can recommend or prescribe the best, safest fit for you.”
For safe headache/migraine treatment during pregnancy, you can try the following:
- 1,000 mg acetaminophen (Tylenol) every 6 hours
- Use up to a maximum of 200 mg of caffeine a day if necessary
- Add 10 mg metoclopramide and/or diphenhydramine (25 mg if necessary)
- NSAIDs like ibuprofen may be used for 48 hours or less only in the second trimester if the above options don’t work but always speak with your physician or midwife first
Again, talk to your physician or midwife first and let them know of any over-the-counter medicines you take, including how much and how frequently.
What Should You NOT Take During Pregnancy?
Dr. Hill advises that the following should be used only rarely and usually in consultation with a headache expert due to concerns about safety:
- Butalbital (Fioricet, Esgic, Anolor, Dolgic)
- Ergot alkaloids such as Cafergot
- Opioids
- Triptans (Cautionary)
Important Note: It's urgently important to address and treat "thunderclap" headaches, or headaches of rapid onset with visual changes, new neurological deficits, vomiting, fever or headaches associated with high blood pressure. Call 911 or get to your nearest emergency room.
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