What to Know About Headaches During Pregnancy

In particular, you may notice an increase in tension headaches, says Eve Espey, M.D., a board-certified ob-gyn at the University of New Mexico School of Medicine, in Albuquerque. Tension headaches are the more run-of-the-mill headaches you’re likely used to getting (not migraines).

What Causes Headaches During Pregnancy?

Tension headaches can happen at different times to different people, but you may notice getting them more often in early pregnancy, Espey says.

There are several reasons you could wind up with a headache while pregnant, including:

• Hormones. The changing levels of hormones like progesterone and estrogen in early pregnancy can increase your headache risk, Espey says.
• Lifestyle changes. Worsened sleep and extra stress are common when you’re pregnant. Poor sleep and stress can also trigger a headache, Espey explains.
• Dehydration. You may be more prone to dehydration and related headaches while pregnant. “We know that blood volume increases during pregnancy and the baby is growing, so the need to take in considerably more fluids can be another common cause of headaches,” Espey says.
• Muscle tension. As your breasts enlarge in pregnancy, you may have more muscle tension in your neck. This can cause more headaches.

What’s the Best Way to Treat a Headache?

Check with your doctor before taking headache medicine during pregnancy.

Tylenol (acetaminophen) is the usual recommendation, since it’s safe for most pregnant people. “Typically, what I tell my patients is to take Tylenol—1,000 milligrams—and relax in a dark room, and try to eliminate external stimuli,” says Andrea Baker, M.D., a board-certified ob-gyn at UT Health Houston in Bellaire, Texas.

Avoid NSAIDs, like Advil (ibuprofen) or Aleve (naproxen). Nonsteroidal anti-inflammatory drugs aren’t typically recommended in pregnancy.

Can You Prevent Headaches During Pregnancy?

To help avoid getting a headache in the first place, there are some things you can do:

• Drink lots of water. “Number one, stay hydrated,” advises Espey, who adds that this can help a variety of pregnancy discomforts.
• Watch for triggers. Pay attention to when you get headaches and what might be causing them. For example, if you always get a headache after you eat chocolate, then avoid it, she says.
• Manage stress. Help ease tension by exercising, meditating, spending time with friends or family, or doing other things that help lower your stress levels.
• Wear a supportive bra. This can help relieve tension.
• Make time for exercise. Move your body and be sure to stretch your muscles.
• Ease neck pain and tension. Heat and massage can help loosen muscles.
• Consider a magnesium supplement. But don’t take anything until after you’ve spoken with your doctor or provider.

When Should You Talk to Your Provider?

If your headaches are difficult to manage with over-the-counter medication and rest, your provider may want to evaluate you further, Baker says. It’s a good idea to check in with your provider if you think your headache is more severe than a tension headache.

Pay close attention to a headache that occurs after the 20-week mark, as you get closer to delivery, Baker says. A severe headache during late pregnancy, when accompanied by other symptoms like nausea, vomiting, upper abdominal pain, high blood pressure, and visual changes (like seeing spots or blurred vision), could be a sign of preeclampsia. This is a dangerous pregnancy complication that your provider would need to address.

Look out for severe headaches in the first few weeks after giving birth, too.

You should also talk to your provider if you have a history of migraines. Some people find their migraines get better during pregnancy, whereas others say they worsen, Espey says. Your doctor can help you find pregnancy-safe migraine relief.

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