Headache During Pregnancy: Types, Causes, And Treatment

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A headache during pregnancy may occur at any time, more commonly during the first and third trimesters. Most headaches are not bothersome and are often caused by hormonal changes and an increase in blood volume during pregnancy (1). These headaches are called primary headaches.

However, pregnant women may also experience severe headaches due to underlying problems such as preeclampsia, stroke, and high blood pressure. Headaches due to these reasons are called secondary headaches (2).

Read this post to learn more about the types, causes, symptoms, and treatments for headaches during pregnancy.

Types Of Headaches

Occasional headaches during early pregnancy are quite common and occur more frequently than usual. However, they generally become better as the pregnancy progresses (3). The following are the types of headaches experienced during pregnancy:

1. Migraine headaches

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• These headaches cause moderate to severe throbbing pain on one or both sides of the head.
• They usually last for four hours to three days.
• They may be accompanied by other migraine symptoms, such as nausea, vomiting, stomach upset, abdominal pain, and sensitivity to light and sound.
• The exact cause of these headaches during pregnancy is unknown, but it may be due to cerebral blood flow changes.
• They may be triggered by stress, biological and environmental conditions, certain foods, fatigue, and weather.
• Over 50% of pregnant women find that their migraine headaches improve after the first trimester; however, they may worsen in the postpartum period.
• Although severe, migraines do not harm the growing fetus.
• Some women with migraine headaches manage their condition with adequate rest and by avoiding headache triggers.
• Learning about medication safety during pregnancy is important, and you should take medications only after consulting a doctor (4) (5) (6).

2. Tension headaches

• They are the most common type of headaches and are caused by lack of sleep, caffeine withdrawal, stress, depression, pregnancy-related hormonal changes, and tense muscles in the shoulders, neck, scalp, and jaw.
• Exercise, good sleep, and relaxation techniques may help in the gradual decrease of these headaches.
• A shoulder massage or placing a warm washcloth on the face also helps in relieving pain during pregnancy.
• Medications may only be taken after consulting your healthcare provider (4) (7).

3. Sinus headaches

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• These headaches are common in early pregnancy and are caused by a runny nose and nasal congestion (8).
• The symptoms of sinus headaches include facial pain and swelling, bad taste in the mouth, fever, mucus discharge, severe pain in the forehead and cheekbones, increase in pain with head movement, and fullness in the ears (6).

4. Cluster headaches

• A cluster headache is a one-sided headache that usually occurs around the eye and lasts for around 15 to 180 minutes.
• The exact cause of these headaches is unknown, but they are believed to be related to activity in the hypothalamus.
• These aches may feel like a constant burning sensation.
• They rarely occur during pregnancy; however, if they do, treatment is difficult because medications may have adverse effects on pregnant women.
• Supplemental oxygen and sumatriptan injections are generally used to relieve such headaches (6) (9) (10).

Causes Of Headaches During Pregnancy

Apart from hormonal changes and increased blood volume, the common causes of headache during the first trimester are (1) (8)

• Stress

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• Poor posture
• Changes in vision
• Dehydration due to nausea and vomiting
• Lack of sleep
• Low blood sugar
• Hunger

During the third trimester, headaches in pregnant women mostly occur due to (1)

• Poor posture
• Weight of the growing baby
• Preeclampsia (high blood pressure during pregnancy)

In some cases, pregnant women develop secondary headaches due to underlying conditions such as (11)

• Stroke during pregnancy
• Ischemic stroke (an artery leading to the brain is blocked or narrowed)
• Cerebral venous thrombosis (blood clot in the brain’s venous sinus)
• Meningitis
• Pituitary tumor

Quick fact

The eye muscles relax during pregnancy, making the eyes more prone to strain. This may result in headaches (12).

When To Call The Doctor

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You may call the doctor if your headaches (1) (12) (13)

• Do not reduce after trying different remedies
• Worsen over time
• Seem unusual
• Are accompanied by swelling in the face and hands, visual disturbances, pain below the ribs, heartburn, or weight gain
• Change in pattern
• Change with posture
• Are accompanied by seizures, trauma, and fever

You should also contact your doctor if you have a history of malignancy, pituitary disorders, elevated blood pressure, or human immunodeficiency virus (HIV).

Treatment For Headaches During Pregnancy

Home remedies

Home remedies are generally considered safe during pregnancy; however, you should consult your healthcare provider before trying them. The following are some common home remedies that may help relieve headaches in pregnancy (6) (12):

• Practice good posture, especially during the third trimester when the baby’s weight increases.
• Cover your eyes and nose with a warm washcloth to relieve sinus infections and headaches.
• Treat tension headaches with a bath or place a warm or cold compress behind the neck.
• Get a massage for your neck and shoulders. A study has revealed that people who received weekly massages experienced decreased stress, anxiety, and heart rate. Massages were also proven to help in managing migraine headaches (14).

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• Strengthen the neck and shoulders through physical therapy.
• Perform gentle exercises and take a walk.
• Avoid chocolates, peanuts, bread, aged cheese, monosodium glutamate, and sour cream for migraine headaches.
• Avoid loud noises, computer or television screens, stress, and excessive exercise for migraine headaches.
• Herbal remedies such as inhaling the vapor of cumin and caraway seeds relieve headaches (15).
• Inhalation of lavender essential oil is considered safe to reduce migraine during pregnancy (16).

Quick tip

Taking a nap or resting with your eyes closed may relieve headaches (12).

Non-pharmacological treatments

The following are some non-pharmacological treatments that are believed to help alleviate headaches (7):

1. Acupuncture: This technique involves stimulating specific points in the body by inserting thin steel needles into the skin. These needles are believed to react to the illness, rebalance the body, and release natural chemicals that control the body’s functions.

Acupuncture is considered safe during pregnancy, but only a qualified practitioner should do it. Some studies indicate that acupuncture may help relieve tension and migraine headaches; however, these positive results may also be due to expectations, beliefs, or placebo responses (17) (18).

2. Biofeedback: This is a mind-body technique where physical functions, such as heart rate, muscle response, and brainwave activity, are digitally monitored. Patients are taught to observe the readings and produce the desired behaviors to control their autonomic nervous system functions. For example, temperature and electromyographic (muscle response) feedback may be shared with a pregnant woman with headaches to help control her symptoms.

Many studies indicate that biofeedback helps treat tension and migraine headaches without adverse outcomes (19) (20).

3. Massage: A massage therapist works on the soft tissue to relieve pain. Pregnant women should consult trained specialists who know which therapies would be safe during pregnancy.

4. Relaxation techniques: Some relaxation techniques, such as breathing exercises, guided imagery, and progressive muscle relaxation, may reduce headaches. They are generally safe during pregnancy; however, insufficient evidence is available to prove their effectiveness.

5. Spinal manipulation: Chiropractors and other health professionals frequently use this technique to treat headaches. Spinal manipulation involves applying controlled force to a joint in the spine with the hands or a device. Studies on this technique indicate contradictory results.

This technique may also cause side effects such as temporary headaches or discomfort in the manipulated area.

6. Tai chi: Tai chi is a Chinese technique that combines meditation with slow movements, deep breathing, and relaxation. The technique is believed to improve headaches; however, the research in this field is insufficient.

Medicines

If alternative treatment options do not help, medications may be taken with the advice of a healthcare provider. The following are some medications that are generally prescribed:

1. Paracetamol (with or without codeine) may be safe to treat migraine pains. However, it is best to avoid aspirin or ibuprofen (12).
2. Sumatriptan is considered safe to reduce headaches during pregnancy and breastfeeding. Studies on around 3000 pregnancies have not shown any major congenital anomalies from using sumatriptan or any other triptan (21).
3. The occipital nerve block is done by healthcare providers at pregnancy clinics. It involves injecting local anesthetic and steroids into the back of the head. The injection is administered in the muscle around a large nerve responsible for headaches. This quick procedure is safe for pregnant women and provides relief for several weeks or months (21).

A study investigated the treatments for headaches adopted by women before and during pregnancy and their perceptions regarding using medicine to treat headaches. A total of 100 women took part in this study. As seen from the graph below, the use of NSAIDs was not preferred during pregnancy by most women but was used before the pregnancy. Pregnant women mostly used acetaminophen (paracetamol) to treat headaches. This study showed that pregnancy altered attitudes toward certain medications that could potentially harm fetal health.

Class of medications used for headache treatment before and during pregnancy

Prevention Of Headaches During Pregnancy

Some of the following lifestyle changes may help prevent pregnancy headaches to a certain extent (10) (21) (22) (23):

• Eating small, frequent meals and sipping on water regularly. This may help since insufficient food and fluid intake may cause low blood pressure and dehydration, causing headaches.

Recalling her episode of headaches during the 15th week of pregnancy, mother, and blogger Kim Song says, “Morning sickness finally subsided, but headaches replaced them. It was so bad that I let out little sobs throughout the day. I was given no relief from the headaches over the weekend, so I called the doctor; she told me that my headaches were possibly tension headaches and prescribed muscle relaxers. Unfortunately, it did nothing for the headache. It made me very drowsy, so at least I could sleep through most of the headache. However, I increased my water intake from 60 ounces a day to 75 ounces. That seemed to help quite a bit with the headaches (i).”

• Getting adequate sleep. Ideally, eight hours of sleep is necessary to feel well-rested and rejuvenated.
• Eating a healthy and balanced diet to get proper nutrition.
• Keeping yourself relaxed with mindfulness techniques and yoga.
• Avoiding triggers such as strong-smelling chemicals, perfumes, and petrol to prevent cluster headaches.
• Giving up smoking also helps prevent cluster headaches.
• Avoiding strenuous exercises since they may overheat the body, causing cluster headaches.

Infographic: How To Manage Headaches During Pregnancy At Home?

Headaches are more common among pregnant women for various reasons, including hormonal changes, stress, sleeplessness, increasing weight, etc. Although several medicines for headaches are available on the market, it is best to look for a home remedy to manage headaches unless needed. The following infographic enlists some simple and pregnancy-safe remedies effective for headache relief.

Illustration: Momjunction Design Team

Image: Stable Diffusion/MomJunction Design Team

Pregnancy can be a difficult time, and having headaches can make it even harder. Discover the causes of headaches during pregnancy and learn how migraines during pregnancy are different from headaches.

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Dr. Mona HardasMD

Dr. Mona Hardas is a practicing Ob/Gyn from Flint, Michigan, with over 20 years of experience in private practice. She is also actively involved in teaching medical students and residents as an associate clinical professor from MSU College of Human Medicine.

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Pragya BhargaviMSc, BEd

Pragya Bhargavi has been in the field of content research, writing and editing for over six years. Her passion for academics and science has enabled her to write creative as well as research-based articles. She has completed her Masters in Microbiology from Bangalore University and obtained a Bachelor’s degree in Education (BEd) from Acharya Nagarjuna University, Guntur.

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Rebecca MalachiBSc

Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU).

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Reshmi DasMSc

Reshmi Das has over four years of experience as a clinical coordinator, medical content writer and medical conference coordinator. Her continuous interest in medical journals and writing makes her write well-researched articles for MomJunction.

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