What causes headaches in pregnancy?

Quick notes:

  • There are things you can do to treat headaches in pregnancy

  • It is important to be aware of times when a headache in pregnancy is serious

  • Migraines can be especially disruptive during pregnancy.

It’s no secret that headaches come hand in hand with pregnancy. There are common characteristics of pregnancy that can cause headaches, like dehydration, hypoglycemia (low blood sugar), and mood fluctuations due to hormones. These situations are most common during the first trimester and are often labeled “tension headaches,” which are typified by a stripe of pain that goes all the way around the head.

There are many possible causes of pregnancy headaches, including fatigue, stress, eyestrain, infections, and allergies.  Therefore, it is important that you try to figure out what is causing your headache in order to remedy it. Medicinal treatment options are limited in pregnancy, so if there is a natural remedy, that avenue would be preferred rather than medicine.

Headaches in the first trimester are often caused by unpredictable and erratic hormones. By the second trimester, the hormone levels in a pregnant woman should be consistently high, and so there are generally fewer headaches during this time.  Lillian Schapiro, MD, who is an OB/GYN recommends the following:

“Ask yourself, ‘Are my headaches being stimulated by something in my diet?  What medications am I taking?  What time of day are they happening?  Is there anything I can change?'”

What can I do for a headache without meds?

It can be frustrating to treat any sort of health concern while you’re pregnant because medication options are limited.  Therefore, it’s important to try some other methods first for your headache. These include drinking enough water, taking a nap, eating small, frequent meals, practicing good posture, and doing something that helps you relax. Cold compresses at the base of the neck can often help with tension headaches too.

If you think you have a headache because of sinus pressure or an infection, be sure to see your doctor sooner rather than later for treatment.  A warm compress held on your face where it hurts (around the eyes and nose, usually) can also help with symptoms of a sinus infection.

How can I tell if it’s serious?

Usually, headaches in pregnancy are simply a benign nuisance, but there are several things you should watch out for that can be an emergency.  If your headache is severe, or is accompanied by a loss of vision, nausea and/or vomiting, it is extremely important that you see your doctor right away.  These can be symptoms of an undiagnosed brain lesion or pre-eclampsia, which are both serious and need to be treated as soon as possible.


Migraines are much more common in women than men and can be brutally painful. Unfortunately, several of the most effective migraine medicines are labeled Category C, which means that doctors are currently unsure if they are harmful or not. Some are even labeled Category X, which means that they can cause serious harmful effects and should never be used in a pregnant woman.

What medications can I use?

Most doctors agree that Acetominophen is acceptable for a pregnant woman to take for pain, and some will prescribe stronger medications short-term, like narcotic analgesics. Beta-blockers and anti-nausea medicines are also regularly given to lower blood pressure and manage queasiness in pregnancy. Other remedies you can try for migraines include identifying and avoiding migraine triggers, massage, acupuncture, or physical therapy.

Most doctors discourage using any medication unless your symptoms are interfering with your daily routine.  If you do choose to use medicine to treat your headache, you should consult your doctor first.  Infrequently, a headache during pregnancy is a sign of a serious illness, so make sure to tell your doctor immediately if you are experiencing vision loss or nausea with your headache.

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