Migraines aren't your typical headache. This severe, throbbing pain can affect one or both sides of your head and last for hours or even days. Sometimes, migraines are preceded or accompanied by what doctors call auras — neurological symptoms that include blurred vision, flashes of light, numbness, or tingling in your arm, leg or face.[1]
To top it off, migraines with or without auras can make you feel nauseated beyond your typical morning sickness and leave you feeling even more fatigued, dizzy and sensitive to light and sound. Here's what causes them — and how you can treat them when you're expecting.
Frequency of migraines during pregnancy
Many women have migraines for the first time when they're expecting; others, including women with a history of migraines, get them more often.
Blame your out-of-whack pregnancy hormones, plus all those other pregnancy-related triggers you're experiencing: fatigue, tension, blood sugar drops, stress, nasal congestion and overheating.
That said, some women who have a history of migraines related to their menstrual cycle actually end up getting these headaches less often when they're expecting, particularly during the second and third trimesters.[2]
That's because their migraines are likely caused by the "withdrawal" of estrogen that occurs just before menstruation; during pregnancy, estrogen levels remain consistently high.
Are migraines during pregnancy a sign of a boy or girl?
Have you read that having more migraines means you're more likely to be carrying a boy? Unfortunately, there isn't a reliable study to back that superstition. So while it's a fun note to add to your list of signals of your baby's sex, don't bank on it until you get the results from your NIPT or level 2 ultrasound.
More About Common Pregnancy Conditions
How to prevent migraines
Often the best way to treat a migraine is to prevent it from happening in the first place. And while migraines aren't always preventable, there are some steps you can take to cut down on the odds and frequency of an attack:
Keep a migraine journal
Jot down what you ate, where you were and what you were doing just before you experienced a pregnancy migraine. Common triggers include glaring lights or loud noises, excessive heat or cold, tobacco smoke and foods such as chocolate, cheese, artificial sweeteners and nitrates in processed meats — though you'll want to avoid the latter during pregnancy anyway.
Once you notice a pattern of what commonly precedes your migraines, try to avoid those potential triggers.
Reduce stress as much as you can
It's easier said than done, but taking time to relax may help with migraines. Because stress is a common trigger, it's thought that holistic therapies — including acupuncture, biofeedback, massage, meditation and yoga — can help alleviate migraine pain.
Get enough sleep
There's no doubt that it can be hard to get adequate shut-eye during pregnancy. But since sleep disturbances and fatigue can trigger migraines, try to make sleep a priority.
Exercise
Regular, pregnancy-safe aerobic exercise like walking and swimming can help reduce the frequency and severity of migraines during pregnancy — and it's good for the rest of your body and your baby, too.
Once a migraine hits, though, don't whip out your sneakers and head for the gym; exercise can make symptoms worse.
Migraine relief and remedies during pregnancy
A migraine bearing down on you? Stay away from ibuprofen and talk to your doctor before taking an aspirin. Try the following instead:
Relax
If you suspect a migraine coming on, lie down in a quiet, dark room with a cold compress on your neck or forehead for two or three hours. With any luck, you'll fall asleep and wake up migraine-free.
Other migraine tips to try include: heat, ice, massage, rest, avoiding triggers (e.g. maintaining a regular meal and sleep pattern) and behavioral therapy (such as relaxation training, biofeedback or cognitive behavioral therapy).
Pop an acetaminophen
While you should never take any pain medication — over-the-counter, prescription or herbal — during pregnancy without the okay from your doctor, the occasional use of Tylenol (acetaminophen) is considered safe. Check with your practitioner for recommendations on dosing.
Talk to your doc
If you relied on strong migraine medications before you conceived, you may have to avoid some of them until the baby arrives. However, there are multiple options available that can be used in pregnancy as needed.
Your doctor may recommend safe drug options, or refer you to a migraine specialist, who can suggest other strategies for managing your pain. The use of migraine medications in any trimester should be discussed with shared decision making.
When to see a doctor
Check in with your doctor the first time you suspect you're having a migraine. Ditto if an unexplained headache persists for more than a few hours, returns very often or is accompanied by a fever.
Some research shows that women who have migraines during their pregnancy may also be at increased risk for hypertension, preeclampsia and other vascular disorders. So if you have symptoms that include sudden dramatic weight gain, visual changes (like blurry vision, seeing double or seeing bright spots), puffiness in your face or hands, or chest discomfort, call your doctor right away.
Migraines in the postpartum period
The many changes — to your body and to your lifestyle — that occur after giving birth can increase the risk of developing headaches. These can include run-of-the-mill tension headaches as well as migraines.
Sometimes, serious conditions can cause postpartum headaches. These include preeclampsia, postdural puncture headache and cerebral venous thrombosis. Following up with your physician about any headaches and seeking proper treatments and evaluation is also very important in this time period.
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