Headaches are common in pregnancy. Tension-type headaches – low grade, mild headaches – are the most common kind of headache both in general and during pregnancy. Migraine headaches are common as well. Women with frequent headaches outside of pregnancy are more likely to have headaches during pregnancy. For some women, pregnancy is a time of increased headaches, though some women actually find that their headaches are improved in pregnancy.
If you are experiencing migraines, most treatments are still effective while you are pregnant, though in general non-steroidals (NSAIDS, such as ibuprofen and motrin) are avoided in pregnancy, especially in the second half of pregnancy. Tylenol is safe and effect and there are other medications, such as Reglan (an anti-nausea medication) which are also safe and effective for treating headaches in pregnancy IIt is important to talk with your care provider to ensure that any treatment – medication and non-medication- will not have a negative impact you or your developing child. Although some information is available through the Food and Drug Administration about commonly used drugs during pregnancy, it is best to always consult with your doctor regarding any treatments you are taking if you are currently pregnant or thinking about becoming pregnant.
As doctors we are always cautious about recommending typical headache drugs, such as sumatriptan, because of safety concerns. Although there is no evidence that they are dangerous during pregnancy, there is not enough information to be absolutely sure that they are safe. Instead, drugs such as acetaminophen are usually recommended since they have been studied more.
Non-medication treatments are always preferred and emphasized if you are pregnant. Getting enough sleep, not skipping meals, keeping hydrated and reducing stress can help reduce your headaches.
A severe headache can be a sign of a more serious health problem in pregnancy. If you experience a new onset, serious headache, especially one that does not respond to usual medications such as Tylenol, it is important to consult your doctor.
Louise E. Wilkins-Haug, MD, PhD, is the Division Director of Maternal Fetal Medicine and Reproductive Genetics at Brigham and Women’s Hospital
Sarah Elizabeth Little, MD, MPH, is a Maternal-Fetal Medicine specialist in the Department of Obstetrics and Gynecology at Brigham and Women’s Hospital.