Pregnancy can be an exciting time for an expectant family. Still, the woman carrying the child is likely to experience discomfort throughout the pregnancy, including morning sickness and nausea, intense cravings, a kicking baby, or increased indigestion. One discomfort that many women experience is migraines, either for the first time or at an increased frequency or severity.
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If you get migraines for the first time or experience more severe episodes during pregnancy, you may experience the following symptoms:
Throbbing headaches, usually on one side of your head
Sensitivity to light
Tingling in your arms and legs
Seeing flashes of light (aura)
However, the hormone levels that change due to pregnancy actually cause a reduction in migraines in 50-80% of women¹. For this reason, some doctors use hormone therapy that imitates pregnancy to help women with severe migraines.
If you’ve experienced migraines before, you’re probably familiar with triggers, which are things that set off a migraine attack. Some common migraine triggers include stress, food allergens, strong smells, changes in sleep, and dehydration.
It's currently unclear whether migraines can impact the pregnancy’s outcome. Research is mixed², with some studies pointing toward more pregnancy complications in women with migraines, while others do not show a correlation. One recent study³ suggests there may be a higher risk of complications, such as high blood pressure during pregnancy (gestational high blood pressure), preterm delivery, and preeclampsia in women that experience migraines, especially if accompanied by an aura.
While there isn't enough evidence to say that migraines can cause pregnancy complications, they have the potential to increase the risk. As such, it's helpful to work with your doctor and keep them informed about your migraines and whether you experience aura.
Migraines can be dangerous during pregnancy for you and your baby. This is especially true if you’re experiencing migraines for the first time or they are more severe. When high blood pressure accompanies migraines during pregnancy, it increases the risk of vascular problems and preeclampsia.
Preeclampsia is a condition that sometimes begins after week 20 of pregnancy, and it can lead to organ damage that can harm you and your baby. Some symptoms of preeclampsia include:
Changes in vision
Shortness of breath
Nausea and vomiting
Upper abdomen pain
Puffiness of the face and hands that comes on suddenly
Some women don't have any noticeable symptoms, but they may still suffer from organ damage. Frequent checkups with your doctor can help them monitor your health and look for the signs of preeclampsia even if you can't feel them.
Some common remedies for migraines include various prescriptions and over-the-counter painkillers. Not all of these are safe to take during pregnancy.
If you’re experiencing migraines during pregnancy, talk with your doctor or pharmacist about safe medications. They can help you determine which prescription and over-the-counter medications work for migraines during pregnancy without posing a significant risk.
In general, acetaminophen is considered safe for migraines while pregnant. You can also use non-steroidal anti-inflammatory drugs (NSAIDs) to treat migraines during pregnancy, but you should avoid them during the first and third trimesters.
Some prescription medications can also ease migraines while not impacting your developing baby, such as triptans⁴. Some anti-nausea medications, like diphenhydramine, can relieve symptoms safely during pregnancy in limited amounts.
You can also double-check a prescription medication for its safety during pregnancy by visiting the U.S. Food & Drug Administration Medication Guides⁵ website. However, it is always best to discuss all medications and over-the-counter drugs and vitamins with your doctor before taking them.
While migraine management options are more limited during pregnancy, there are still several ways to prevent and treat migraines.
The best ways to prevent migraine headaches during pregnancy are drinking plenty of water, getting lots of sleep and rest, and eating meals and snacks regularly. It can also help to go to a quiet, dark room when you feel a migraine coming on. Some women find that ice packs can stop a migraine in its tracks.
If you experience severe migraines during pregnancy, your doctor will likely recommend the preventive methods above. They may also suggest over-the-counter pain medications that are considered safe during pregnancy. If the attacks are severe enough, your doctor may give you a prescription for stronger pain medications that pose little risk to you and your baby.
While doctors often recommend avoiding caffeine while pregnant, a small amount of caffeine (no more than one cup of coffee) can alleviate migraine symptoms. Magnesium supplements may help. Talk with your doctor before trying either remedy.
During pregnancy, your doctor and OBGYN may set up a schedule to see you regularly to ensure you and your baby stay healthy. You should seek emergency care outside of these appointments if you experience vision changes, severe headaches that come on suddenly, weakness or numbness, and confusion, especially if you are past 20 weeks pregnant and are at risk of preeclampsia.
Headaches during pregnancy may be a common complaint, but they are usually nothing to be concerned about. Tell your doctor if you have frequent migraines or other unusual symptoms during pregnancy. More severe migraines, especially those that come on suddenly or with aura, maybe more of a cause for concern.
Contact your doctor if your migraines get more frequent or severe. It's essential to attend regular checkups throughout your pregnancy as these appointments prevent complications and keep you and your baby healthy.
AAN 74th Annual meeting abstract | American Academy of Neurology
Triptans in pregnancy (2013)
Medication guides | U.S. Food & Drug Administration
Migraine headaches during pregnancy | Stanford Children's Health