Types of Headaches in Pregnancy

Primary headaches, a type of pain that’s not symptomatic of another health condition, can be quite common in pregnancy. They primarily fall into three categories:

• Tension headaches – This type of pregnancy headache “wraps” around one side of the head and causes a persistent, mild to moderate sensation of pressure. They may be sporadic or chronic, lasting anywhere from several minutes to much longer. Many people believe tension headaches are caused by physical and mental stress. However, evidence suggests they primarily affect people with a lower pain threshold.
• Cluster headaches – These headaches are distinguished by their onset pattern: they tend to arrive in “cluster periods” that can go on for several weeks to a few months. Cluster headaches tend to be much more painful than tension headaches. Note: Both tension and cluster headaches fall under the category of TACs (trigeminal autonomic cephalgias, a type of headache that’s suspected to originate with the trigeminovascular nerve system)
• Migraines – Migraines are estimated to account for 90% of headaches in pregnant women. It’s suspected that fluctuating hormones, especially estrogen, play a significant role in migraines during pregnancy. Migraines typically involve a throbbing sensation of pain, and they may be accompanied by other symptoms like nausea or sensory sensitivity (aura).

In many cases, pregnancy headache may be dealt with by introducing some lifestyle habits that can benefit both maternal and fetal health, as well as a remission of pain.

Coping with Migraines in Pregnancy

Pregnancy congestion and migraines are the most common type of headache you experience while pregnant , and they may crop up in the first, second, or third trimester. They tend to be set off by certain environmental or psychological triggers, from a certain type of food to elevated stress. So, be sure to double check what foods to eat while pregnant.

Many women entering pregnancy have experienced migraines before. However, certain migraine remedies used for non-pregnant women are not considered safe to use during pregnancy, including:

• NSAIDs – NSAIDs, or (nonsteroidal anti-inflammatory drugs), are commonly used to treat migraines and cluster-type headaches. However, some studies indicate they may increase the risk of birth defects or pregnancy loss.
• Preventative measures – Treatments used to ward off migraines, like sodium valproate, may jeopardize neurological and cognitive development in babies after they’re born.

If you’re dealing with migraines during pregnancy, it’s important to treat them in cooperation with your healthcare provider. Your provider can help you develop a treatment plan for this phase of life, such as:

• Tracking your triggers – If you can identify what brings on migraine headaches, you can eliminate or minimize your exposure to them.
• Creating a migraine “safe space” – Lying in a cool, comfortable, and dark room can help to assuage some of the sensory input that can exaggerate migraine headaches.
• Implementing biofeedback techniques – These help to regulate certain bodily functions like heart rate, breathing, and even temperature.

Coping with Headaches in Early Pregnancy

Many women notice the onset of headaches in the first trimester of pregnancy. They’re likely a result of the considerable physical changes occurring during this time, many of which could play a role. For instance:

• The increase in blood volume may be linked to a dilation of blood vessels in the brain, resulting in a migraine.
• Morning sickness (the vomiting kind!) could mean you’re losing moisture, resulting in a headache caused by dehydration.
• Changes in diet, whether voluntary (like limiting caffeine intake) or involuntary (like adjusting dietary needs), can also contribute to headaches.
• Extra congestion in your sinuses is common in early pregnancy, and can often lead to sinus headaches.

How to Treat Early Pregnancy Headaches

Because the root causes of headaches in early pregnancy can vary widely, it’s best to try out some gentler treatment options to see what works. So, you could try:

• Taking a pregnancy-safe painkiller – An OTC like acetaminophen (Tylenol) may help ease the occasional headache until your body gets used to its new blood volume.
• Upping your fluid intake – If you suspect you may have been losing water during bouts of morning sickness, take extra care to keep an eye on your hydration habits. The American College of Obstetricians and Gynecologists recommends drinking 8 to 12 cups (64 to 96 oz.) of water per day.
• Prioritizing prenatal nutrition – Low blood sugar levels may be responsible for early pregnancy headaches. Making sure to eat at regular intervals—and ensuring you’re getting enough key nutrients for fetal health, like folic acid and vitamin D—may help to offset headaches brought on by diet.
• Waiting it out – Data surrounding the use of oral decongestants during pregnancy is inconclusive when it comes to the hazards it may pose to babies in-utero. OTC allergy medication is vasoconstrictive: it works by tightening the muscles around your blood vessels to provide symptom relief. However, your body needs to increase red blood cells and plasma during pregnancy—and it’s thought that depressing this function could lead to birth defects in some cases.

With that, consider skipping OTC decongestants if you think your symptoms are the result of sinus headaches. If your headaches persist, it may be time to reach out to your healthcare provider to discuss your treatment options

Coping with Headaches in Mid- to Late-Pregnancy

The second and third trimesters of pregnancy require the most adjustment for many pregnant women. Pregnancy hormones set off several physiological changes that can contribute to headaches, such as:

• Adjustments in body temperature and an increased need to urinate can make it more difficult to achieve high-quality sleep
• Increased sensitivity to emotions and anxiety, resulting in irritability and restlessness, can contribute to stress headaches
• Anatomical changes—your growing belly being the most obvious—can create muscle tension that may result in headaches

Let’s take a look at some effective and pregnancy-safe ways to approach each of these possible root causes.

Sleep Deprivation

Having a hard time getting sufficient nightly shut-eye is highly common among pregnant women. Sleep deprivation is most commonly associated with an increased likelihood of migraines and tension headaches during pregnancy. Moreover, sleep loss can result in a higher pain sensitivity, which can also feed into headaches.

Managing headaches due to poor sleep during pregnancy can be challenging—everything from a disrupted circadian rhythm to struggling to find a comfy position with your belly can make it difficult to doze off. To improve your sleep quality, consider trying:

• Moving your body – Incorporating more gentle pregnancy workouts at home or a few times a week can help tire out your body naturally (not to mention, raise endorphin levels!).
• Acupressure techniques – Acupressure borrows from therapeutic modalities like massage to promote physical and mental relaxation, encouraging sleep onset.
• Herbal remedies – In a small study from 2022, taking lettuce seed was discovered to improve sleep in pregnant women. However, it’s best to consult with your healthcare provider before incorporating any supplements—including plant-based, herbal ones—into your care routine.

Postural Changes

A pregnant woman’s body typically increases between 15 and 25% during a pregnancy, which can put considerable strain on muscles, joints, and overall anatomy. Even though most of that weight may appear localized to your belly, the burden can put a strain on the shoulders and neck, which can result in frequent headaches.

If you believe your frequent headaches stem from muscle strain, you might try:

• Working with a physical therapist – PT experts can help teach you standing and sitting postures that better distribute excess weight.
• Prenatal massage – Massage has a host of benefits for pregnant women, including joint, neck, and back pain relief—not to mention, relaxation. Just be sure to work with a certified therapist who’s trained in giving prenatal massage.

Stress

Stress is thought to contribute to both the frequency and intensity of headaches during pregnancy, though stressors are unique to every woman. One of the best ways to begin managing stress is to pay close, caring attention to your triggers. You might also try:

• Opening up – Journaling, spending time with loved ones, or speaking to a counselor can help you release and process thoughts and feelings if you tend to keep them to yourself.
• Connecting with other expecting moms – Finding a group of people going through the same significant life change can help you create a community support network.
• Asking for help – Right now, you’re taking care of two lives: your baby’s and yours. If you tend to take on too much, consider asking for support from friends and family or delegating work tasks to colleagues.

If you think your headaches could be linked to stress, it’s important to pay attention to your anxiety for the sake of you and your baby. Elevated stress levels are associated with a heightened risk of pregnancy loss, preterm labor, and low birth weight.

Remember, anticipating a significant life change can make anyone more susceptible to anxiety. Try to be gentle with yourself as you’re learning to manage it.

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