What causes headaches in pregnancy?

The exact cause of a headache isn’t always clear. In the first trimester, changing hormone levels and blood volume may play a role. A dull, overall headache can come with stress, severe tiredness (fatigue), and eyestrain. Sinus headaches may be more likely because of the nasal congestion and runny nose that are common in early pregnancy. Hunger and low levels of blood sugar can set off headaches, too. People who suddenly stop their morning coffee and sodas may have caffeine withdrawal headaches. Those who also have nausea and vomiting in early pregnancy can become dehydrated. This can also bring on a headache.

Migraine headaches are a common type of headache in pregnancy. These painful, throbbing headaches are often felt on 1 side of the head. They are due to expansion of the blood vessels in the brain. The misery is sometimes accompanied by nausea, vomiting, and sensitivity to light. A small percentage of pregnant people with migraines also have an aura with the migraine. They see flashes of light or feel tingling in their arms and legs.

When should I be concerned?

Contact your healthcare provider if any of these occur:

• A headache is severe

• A headache doesn't go away

• You have dizziness, blurred vision, or changes in your field of vision

Headaches can sometimes be linked to blood pressure problems in pregnancy. If they are lasting or severe and happen after 20 weeks of pregnancy, let your healthcare provider know. Strokes during pregnancy are rare. But migraines can increase a pregnant person’s risk for them. If you have migraines, report them to your provider.

What can I do about headaches?

Steps to manage headaches include:

• Stay away from any known headache triggers. These include allergens and certain foods, like monosodium glutamate, cured meats, and strong cheeses.

• Smoking is never a good idea in pregnancy. You should also stay away from secondhand smoke.

• Try to eat well and drink plenty of fluids, especially if you are prone to morning sickness.

• Reduce your stress level. Try a massage or cold pack to help with tension headaches. 

• If your headache is a migraine, rest in a cool, dark room with no noise. Try using warm or cold compresses or an ice pack.

But there is some good news. Most people have fewer headaches during pregnancy, especially after the first trimester. And those with a history of migraines often find there is improvement during pregnancy.