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Home Pregnancy

Migraines During Pregnancy | When to Worry

Dawn Reid, EEPM CNCM MMID
by Dawn Reid, EEPM CNCM MMID
Last updated October 9, 2023
Reading Time: 6 min
Migraines During Pregnancy When to Worry

Migraine headaches can occur in pregnancy and might be harmless, very annoying or a sign of complications in the pregnancy.

It can be tricky to know whether or not the migraine headaches are normal, so have a chat with your healthcare providers about your headaches during pregnancy. They can assess the headache to see whether it needs immediate medical attention.

Please read on for more information about your migraines during pregnancy, and when you need to worry about them.

Migraines during pregnancy

It’s thought that migraines run in the family and are genetically passed on. If someone in your family has had migraines, the odds are you will experience them too.

You might have lived all your life without a migraine and then have your first during pregnancy.

The most common reason for migraines during pregnancy is the rise and fall of hormone levels, particularly estrogen.

If you would like more information, please read Pregnancy Headaches – 5 Causes Of Headache During Pregnancy.

You should be worried if you have a severe headache that is persistent, if you have blurred or disrupted vision, and you’re feeling dizzy.

Sometimes these headaches or migraines during pregnancy can mean you’re having problems with blood pressure.

In this instance, you should contact your doctor or health professional to provide medical advice.

What does a migraine during pregnancy feel like?

We’ve all had bad headaches before, or even nagging tension headaches. Most of the time we can take some paracetamol, address hydration, or even do some stretches, and everything’s fine.

Migraine pain, however, is usually a throbbing, pounding, or pulsing pain behind the eyes, the side of the head, and forehead.

Migraine attacks can make you feel sick with nausea. You might also have light sensitivity, and loud sounds can make you feel worse.

Some women experience the neurological symptoms of an ‘aura’ that can happen before a migraine starts. The aura is seeing colors or spots in your vision.

Migraines – early pregnancy

Women might experience a migraine attack in the first trimester due to unstable levels of the hormone estrogen and increased blood volume.

In the first few weeks of pregnancy, your blood volume increases quite a lot. This is because your body needs more oxygen and, therefore, more red blood cells to carry it around your system and to your developing baby.

As the blood vessels in your brain expand to accommodate this extra blood, they press against nerves; this can lead to pain.

Sinus headaches can affect many women in the first trimester. They are caused by a runny nose or nasal congestion, which are both common in early pregnancy.

For more information, you might like to read Headaches In Early Pregnancy – How To Get Fast Relief.

Migraine during pregnancy – remedies

If you experienced migraines before pregnancy, it’s a good idea to talk to your doctor or midwife about strategies to put in place beforehand. Know your triggers and avoid them.

If you have an unexpected migraine, you might wonder what you can do to alleviate the pain. You might like to try any of these remedies:

  • Rest in a dark room
  • Apply a cold compress or ice pack to your forehead or neck.
  • Drink plenty of water, using pregnancy-friendly electrolytes.
  • Use relaxation techniques.
  • Avoid certain foods that might trigger migraine attacks.
  • Minimize emotional stress.
  • Make sure you get enough sleep.

Safe migraine treatment during pregnancy

Many pregnant women don’t like taking medication, as they worry about the effects on their baby. However, migraines can be very intense, and it might be wiser to take medication to relieve the pain sooner.

Always talk to your doctor, midwife or pharmacist about safe medications to use for pain relief when you are pregnant. Some of these medications need a prescription; others are less likely to be recommended due to potentially harmful side effects.

Paracetamol (Acetaminophen) has been shown to be effective, in the right dosage, for migraine attacks.

Ibuprofen is a non-steroidal anti-inflammatory and is only recommended in the second trimester, as there’s a small risk of increased bleeding in the first and third trimesters.

Aspirin is no longer recommended, as its use in pregnancy has been shown to increase the risk of miscarriage, and bleeding in both mothers and babies.

Prescription migraine medication during pregnancy

Triptans are usually helpful for cluster headaches, but there isn’t a lot of research about their use in pregnancy. Sumatriptan is the safest triptan; the others are not recommended in pregnancy.

Opioids are not recommended for the treatment of pregnant women with migraine pain as they can lead to preterm birth, stillbirth, and certain birth defects. Short term use might be suggested but needs to be carefully monitored by a health care provider.

Ergot alkaloids are contraindicated in pregnancy; they have been used in pregnancy, however, as a rescue treatment.

Preventive or prophylactic migraine medication in pregnancy

Beta-blockers are an option for preventing migraines in pregnancy. They are mostly used for high blood pressure and have some associated risks for the baby. These include preterm birth and small for dates.

Anti-depressants, such as amitriptyline, can be used to treat headaches in most women during pregnancy. However, as with the beta-blockers, they come with increased risks for the baby, such as breathing problems at birth and having low blood sugar.

Anti-emetics (such as Maxalon) are drugs used to treat nausea and vomiting in pregnant patients. It was discovered they can also relieve pain from a migraine attack.

Do migraines during pregnancy affect the baby?

Migraine headaches during pregnancy might make you feel unwell and require treatment but, fortunately, they don’t harm your growing baby.

If you have to take certain medications, however, as mentioned above, they might affect your baby. Be sure to discuss any possible complications or side effects any medication could cause before taking it.

Should I go to the ER for migraine headaches while pregnant?

If you have a mild headache, you can contact your midwife or doctor for medical advice. They can advise which course of treatment would be best for you – for example, taking paracetamol and using any of the remedies suggested above.

If you have a severe persistent headache, however, accompanied by blurry vision, dizziness and swelling in your hands, feet, and face, seek immediate medical attention.

These might be the warning signs of preeclampsia. This condition is often associated with high blood pressure and is dangerous to you and your baby.

You can read more in Preeclampsia | Signs, Symptoms And Causes.

Migraines during pregnancy – girl or boy?

You might have heard a pregnant woman having a migraine headache is a way to predict the baby’s sex. Currently, there is no evidence to support this idea.

Ultrasound in pregnancy will give you the answer. Or you can wait for a surprise.

Find out more in When Can You Find Out The Sex Of Your Baby?

Migraines – when to worry?

Pregnant women who have high blood pressure might experience severe pain from migraine headaches.

You might have high blood pressure at any time in your pregnancy and it pays to check this at regular intervals throughout your pregnancy.

More common in the second and third trimesters, high blood pressure can be accompanied by flashing lights in the eyes or blurred vision and sternal pain.

Left untreated, it can lead to preeclampsia, as mentioned above. Severe preeclampsia, also called HELLP Syndrome, could be another reason for migraines in pregnancy.

Chronic migraines during pregnancy

Chronic migraines mean you’re having headaches on a regular, persistent basis.

This can be very debilitating as often you are already fatigued during pregnancy, and the symptoms of migraines can make life much harder to deal with.

It can affect your ability to function, work and even cope with regular day-to-day tasks.

Please reach out to your doctor or midwife if you’re experiencing regular migraines during pregnancy. They can discuss potential triggers, check everything is going well with you and your baby, and prescribe medication as preventatives, if needed.

The medication treatment regimens are outlined above, along with some simple tips to relieve your migraine symptoms.

Does a migraine mean miscarriage?

One of the biggest concerns women have during pregnancy is that pain means something is wrong and might cause them to have a miscarriage.

Research has shown migraines in women who are pregnant have been linked to an increased risk of high blood pressure, miscarriage, c-sections, and preterm birth.

Researchers found migraine sufferers had a 10% higher chance of having a miscarriage and were 21% more likely to give birth prematurely.

Although that seems very alarming, researchers also discovered the risk of complications was lower for women who took migraine medication when pregnant, compared with those who didn’t treat their migraines.

What foods trigger migraines?

There are many common foods that can trigger headaches, and these will vary from woman to woman. Most headaches in pregnancy will settle in the second trimester when the morning sickness has gone.

Some foods that might trigger your migraines are:

  • Bread and cakes
  • Chocolate
  • Yogurt
  • Fruits, such as citrus, bananas, raspberries, passion fruit, and plums
  • Nuts and avocados
  • Olives
  • Soy products
  • Tomatoes
  • Vegetables, such as corn, onions, pea pods, sauerkraut, and some beans
  • Vinegar
  • Cheeses

Be careful to avoid food additives such as aspartame and MSG, as these can also trigger a migraine.

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Dawn Reid, EEPM CNCM MMID

Dawn Reid, EEPM CNCM MMID

Dawn Reid is a mother of four and is married to a wonderful man for more than 27 years. She's been a midwife and nurse for over 30 years, with experience in many areas - most recently in her own private practice. Dawn is passionate about advocacy, rights and informed consent for women and their families. She loves travel, reading, fishing and the beach. Dawn is pursuing her PhD in Midwifery in 2021 and is very excited to be a writer at BellyBelly.

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