#37 Headaches in Pregnancy

Up to 30 percent of pregnant women are affected by headaches. In general, headaches which precede pregnancy are a nuisance, but benign. On the other hand, headaches occurring during pregnancy can be either benign or harmful. Telling the difference between the two can be tricky.

Nearly all pregnant women have occasional headaches during their pregnancy. Most of these headaches are primary headaches that happen without a clear cause. These are some of the most common types of headaches:

  • Tension Headaches. Tension headaches are the most common type of headache that you can experience. It’s mild to moderate pain that may feel like someone is squeezing you around the head. This can be a response to stress or muscle contractions.
  • Migraines. Migraines are a type of headache that only occur on one side of the head. It can cause severe pulsing headaches that can be accompanied by nausea, vomiting, and sensitivity to light and sound.
  • Cluster Headaches. Cluster headaches are rare in pregnancies, but they still do occur. These are severe attacks of pain on one side of your head, often felt around your eye area. They usually don’t last long but they can come back regularly.


Causes of Headaches During Pregnancy 

During your first trimester, headaches may often happen because your body is going through several changes to prepare you for the birth of your child. Hormonal changes, higher blood volume, and weight changes can trigger headaches.

The most common kind of dangerous pregnancy headache is associated with increases in blood pressure. These elevations of blood pressure precede strokes much like going up the steps of a ladder, with many opportunities to treat the patient for prevention on each step. Know your normal blood pressure and call your doctor immediately if it starts spiking or creeping up and staying up.

Treating Pregnancy Headaches

Current research indicates acetaminophen (Tylenol) has been considered safe for use during pregnancy, but recent warnings have been voiced over possible effects on fetal development which need further investigation. My experience with my patients and Tylenol is that it really is not effective for pain relief.

Ibuprofen, another popular pain relief medication, is not to be used during the third trimester of pregnancy, but is considered to be safe during the first and second trimester. However, ibuprofen closes the ductus arteriosus which circumvents the blood flow to the baby’s lungs. Remember, the baby’s lungs are not working until after birth. If the ductus arteriosus closes, the baby will try to breathe air through its lungs while still in utero, lungs which will not work before birth. My recommendation is to avoid ibuprofen throughout your pregnancy.

If you find relaxing, releasing tension and anxiety doesn’t seem to help your headache and you feel you must have pain relief, call your doctor.

Most pregnancy headaches are benign and can be treated best by decreasing tension. With sudden onset, severe headaches, especially when pregnant, seek emergency medical care immediately.