What To Do About Pregnancy Headaches & Migraines

• Get plenty of sleep.

  Sleep will help combat fatigue and keep stress levels in check, which can help reduce stress-induced headaches and migraines.

• Go to a dark, quiet room.

  If you have a migraine, go to a dark, quiet room and avoid exposure to bright lights and sounds. Consider adjusting your lights to a dimmer level at all times and installing non-fluorescent lighting if possible, as this type of light can trigger migraines. Using an eye mask is also helpful in promoting rest and relaxation.

• Embrace relaxation techniques

  Anything that calms the body and mind can help ease stress, promote quality sleep, and potentially take the edge off headaches. Consider meditation, meditative forms of exercise such as qigong and tai chi, breathing exercises, prenatal yoga, and stretching. Try to integrate some type of relaxation technique daily. Incorporating these into your nighttime routine may promote quality sleep.

Headache and migraine triggers vary from person to person. Keep a headache diary or a running note on your phone to help identify yours and eliminate them (if possible). Write down everything you ate in the 24 hours before your headache and the activities you were doing leading up to it.

Diet-related triggers

Diet-related triggers are a common cause of migraine headaches. Certain foods and additives such as chocolate, caffeine, milk, cheese, nuts, citrus fruits, processed meats, MSG, aspartame, and alcohol have been identified as migraine triggers. Eating small, frequent meals throughout the day can also help prevent headaches from low blood sugar.

Hydration is key in pregnancy and postpartum. There has yet to be widespread consensus on how much water you should drink daily, but the general recommendation is to drink half your weight in ounces daily. If you’re exercising or are in a hot climate, you may need to increase your consumption.

Applying cold compresses or gel ice packs to the head and back of the neck is commonly used to ease pain among migraine sufferers. Warm compresses and heating pads may help, as they alleviate the tightness often associated with tension headaches.

Biofeedback is a particularly promising mind-body technique for migraines. It’s been shown to reduce the number and intensity of migraines, making it a potentially great alternative to medication during pregnancy. Typically, it involves wearing sensors that monitor physical markers of anxiety such as blood pressure, heart rate, brainwave activity, and muscle tension. Biofeedback is particularly effective when relaxation-based strategies accompany it. During a session, you may hear a sound or see a visual cue indicating you’re too tense. Then, a biofeedback practitioner will guide you through a relaxation exercise that helps return you to a balanced state, indicated by another sound or visual cue. To learn this technique, ask your healthcare provider for a referral to a biofeedback practitioner, preferably one who works with maternity patients.

Acupuncture is a traditional Chinese medicine therapy considered safe during pregnancy. It’s often used to alleviate various types of chronic pain through the stimulation of acupuncture points on the body with ultra-thin needles, and studies suggest it may be effective in reducing the number and intensity of migraines.

Getting a full-body massage from a certified prenatal massage therapist can help curb stress and release the muscle tension contributing to headaches. If this isn’t an option, ask your partner to massage your back, shoulder, and neck muscles with a pregnancy-safe massage oil.

Medication for headaches and migraines during pregnancy — whether over-the-counter or prescription — should be thoroughly discussed with your healthcare provider. The frequency and severity of your headaches and migraines will play a large role in what they recommend.

Acetaminophen (Tylenol)

This is considered the first-line over-the-counter treatment for headaches. Recently, a group of scientists issued a consensus statement urging caution when using acetaminophen during pregnancy, noting a growing body of evidence that it may increase the risk of neurodevelopmental and other disorders. That said, the research is not conclusive, and acetaminophen is still commonly used in pregnancy for pain relief.

Aspirin

Discuss the use of aspirin for headaches with your healthcare provider. It is safe to use in low doses in the first and second trimesters but can increase your risk for postpartum bleeding and is typically not recommended during breastfeeding. Low-dose (81mg/day) aspirin is also a recommended treatment for the prevention of preeclampsia for moderate to high-risk patients.

Non-steroidal anti-inflammatory drugs (NSAIDs) (Advil or Motrin)

NSAIDs, like ibuprofen, may be safe during particular weeks in the second and early third trimester when used under the guidance of a healthcare provider but are not typically recommended in the first trimester or after 30 weeks when headaches are the worst.

For severe and persistent headaches and migraines, your healthcare provider may recommend prescription medications to reduce and prevent headaches. Discussing options and the risks and benefits of various medications approved for use in pregnancy is important.

Preeclampsia is persistently high blood pressure that develops during pregnancy or postpartum. It can occur before, during, or after delivery and is estimated to impact 2-8% of people during pregnancy and postpartum. It can progress rapidly and is more common in black women, women over 40, and teens. It’s a serious condition that can often go undetected since high blood pressure may not be easily identified without a blood pressure reading. Untreated preeclampsia can become eclampsia, a leading cause of preventable maternal death in the United States. Blood pressure at or over 140/90 means you should contact your healthcare provider, and blood pressure at or over 160/100 means you seek emergency medical attention immediately. You can monitor your own blood pressure at home with a digital cuff. If you experience any signs of preeclampsia, contact your healthcare provider.