Headaches in pregnancy

Mild headaches can be caused by hormones and are common in pregnancy.

How can I treat a headache in pregnancy? 

If you have a mild headache, it’s safe to take paracetamol. Make sure you follow the instructions on the packet for how much you can take.

There are some painkillers you should not take while you’re pregnant. These include tablets or capsules that:

  • contain added caffeine (sometimes sold with 'extra' on the label)
  • contain codeine
  • are anti-inflammatory, like ibuprofen or aspirin.

Some women may be advised to take a low dose of aspirin as a treatment if they have had miscarriages before or they are at risk of pre-eclampsia. This will be prescribed by a doctor. Aspirin should not be taken as treatment for a headache.

Try to take the lowest dose of paracetamol that works and for the shortest amount of time. Your midwife, GP or pharmacist can give you more advice if the pain is ongoing and doesn’t go away with paracetamol.

Find out more about drugs and medicines in pregnancy.

What can I do to prevent headaches in pregnancy?

 There are some things you can do to prevent headaches. Try to:

When should I call a doctor or midwife about a headache in pregnancy?

Call your midwife, doctor or hospital maternity unit if you have a very bad headache or a headache that won’t go away. This could be a symptom of pregnancy induced hypertension.  This is a type of high blood pressure that develops after 20 weeks and goes away within 6 weeks of the baby's birth. It’s also known as gestational high blood pressure or gestational hypertension.

Call your midwife, doctor or hospital straight away if you have a headache and vision problems and sudden swelling on your hands, feet, face or stomach. This could be a sign of pre-eclampsia, a pregnancy condition that can be dangerous for you and the baby if it is not monitored and treated. 

Call your midwife, doctor or hospital maternity unit if you have a headache and any of the following symptoms:

  • discomfort in the lowest part of your stomach (pelvis)
  • back pain
  • loin pain (your sides between the lower ribs and pelvis, and the lower part of the back)
  • needing to wee a lot or an uncontrollable need to wee
  • cloudy, foul-smelling (fishy) or bloody wee
  • a raised temperature  (over 37.5°C)
  • feeling sick (nausea) and vomiting.

This could be a sign of a urinary tract infection. UTIs cab be treated with antibiotics that are safe to use in pregnancy.

Migraines in pregnancy

Migraines are a common type of headache. Many people who have migraines may have:

  • severe pain, which feels like a throbbing, pounding or pulsating pain
  • nausea (feeling sick)
  • pain brought on by bright lights
  • an ‘aura’, such as flashing lights before the migraine starts.

 Talk to your doctor or midwife if you’ve had migraines before and if you are taking or have taken any medication for them. This is because some migraine medications can contain codeine, aspirin or ibuprofen, which are not recommended in pregnancy unless prescribed by a doctor and the benefits outweigh the risks.

Don’t wait until you have an attack. Your doctor should be able to give you advice on how you can manage your symptoms while you’re pregnant and if you choose to breastfeed.

Will a migraine hurt my baby?

Women with migraines are at slightly higher risk of developing high blood pressure and pre-eclampsia. This risk is very small and most women with migraines will not have high blood pressure.

If you have any worries at any time, talk to your midwife.

What do I do if I have a migraine in pregnancy?

If you’ve never had a migraine call your midwife, doctor or hospital maternity unit. Serious conditions like pre-eclampsia can be like a migraine, so although it’s unlikely anything is wrong, your healthcare team may want to see you.

If you have always had migraines, you may find that they get better during your pregnancy. But pregnancy can also change the nature of migraines, so if you have a migraine that feels different to what you’ve had before, call your midwife, doctor or hospital maternity unit. 

What can I do to prevent migraines?

One of the best ways to prevent migraines is to recognize what triggers an attack and trying to avoid them. For example, stress, eating certain foods or lack of sleep may bring on an attack.

Avoiding your triggers can be difficult when you’re pregnant. For example, if you have morning sickness you may not feel like eating or drinking much. This can cause low blood sugar or dehydration, so it’s important to try and find ways to cope.

Getting enough sleep may also be difficult during pregnancy. Try our tips for a better night’s sleep.

You should also try to

Acupuncture

You could also try acupuncture, which has been recommended by NICE as helpful for people with migraines. Acupuncture is a type of complementary therapy that involves a practitioner inserting thin needles at particular points on your body. It’s used to control and relieve pain.  Research has shown that it can also help with back pain  for pregnant women.

Acupuncture is generally safe to have when you’re pregnant but talk to your midwife or GP before you book a session. If you do want to try it, make sure your acupuncturist is fully qualified and that they use disposable needles at every treatment session. Tell your practitioner that you’re pregnant because certain acupuncture points can’t be used safely in pregnancy. 

More information and support

Migraine Action

Migraine Trust

Read more

Sources

NHS Choices Headaches in pregnancy https://www.nhs.uk/conditions/pregnancy-and-baby/headaches-pregnant/ (Page last reviewed: 28/02/2018 Next review due: 28/02/2021)

NICE (2011) Hypertension in pregnancy: diagnosis and management. Clinical Guideline 107, London https://www.nice.org.uk/guidance/indevelopment/gid-ng10083

Clinical Knowledge Summaries (April 2015) Hypertension in pregnancy

NHS Choices Urinary tract infections (UTIs) https://www.nhs.uk/conditions/urinary-tract-infections-utis/#treatment (Page last reviewed: 12/12/2017 Next review due: 12/12/2020)

Oxford University Hospitals NHS Foundation Trust. Migraine in pregnancy. (Last reviewed: November 2017 Next review due: November 2020)

NHS Choices. Migraine https://www.nhs.uk/conditions/migraine/ (Page last reviewed: 26/05/2016. Next review due: 26/05/2019)

Pennick V and Liddle SD (2013) Interventions for preventing and treating pelvic and back pain in pregnancy The Cochrane Database of Systematic Reviews 2013 Aug 1;(8):CD001139. doi: 10.1002/14651858.CD001139.pub3

NHS Choices. Acupuncture https://www.nhs.uk/conditions/acupuncture/ (Page last reviewed: 22/08/2016. Next review due: 22/08/2019)

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Last reviewed on September 28th, 2018. Next review date September 28th, 2021.

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