What to Know About Migraine and Pregnancy

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A migraine is more than a headache. It's usually an intense, throbbing pain on one side (or sometimes both sides) of the head. Occasionally, migraines begin with or are accompanied by what doctors call auras—neurological symptoms that include:

  • Blurred vision
  • Flashes of light
  • Numbness, or tingling in your arm, leg, or face

Migraine pain and symptoms affect 39 million Americans yearly, with 28 million of those affected being people with a uterus.

This gender difference is largely attributed to the natural fluctuation of the female hormone estrogen.

Pregnancy can impact migraine symptoms and how you should treat them. In fact, some chronic migraine sufferers will avoid pregnancy because they believe that migraines will worsen during gestation, make their pregnancy difficult, and have negative effects on their baby.

Safe and effective treatment is available for migraines during pregnancy and in the postpartum period. Read on to learn more.

Anxious Black pregnant woman rubbing forehead on sofa


JGI/Jamie Grill/Getty Images

Migraine and Fertility

Migraine has not been proven to affect fertility, but one major migraine trigger is stress, which may have an impact on fertility.

In vitro fertilization (IVF) might be associated with various degrees of headache. Some fertility medicines are taken to encourage the ovaries to produce more eggs than usual, which can increase the risk of hormonal headaches. This is mostly seen in patients with migraine headache backgrounds.

If you are taking regular medication for your migraine and are planning a pregnancy, you should seek advice from your doctor on the management of your condition before and during pregnancy.

Is Migraine Hereditary?

Migraine results from a combination of genetic, environmental, and lifestyle factors. Variations in many genes have been found to be associated with the development of migraines with or without aura. A family history of migraine is the most consistent risk factor for migraine, with a two- to three-fold greater risk of migraine among relatives of people with migraine compared with those without a family history of the condition.

Migraine and Gestation

Some pregnant people with a history of migraines related to their menstrual cycle end up getting headaches less often when they’re expecting. In fact, up to 75% of pregnant people with a history of migraines note improvement over the course of their pregnancy. That said, about 8% report a worsening of their migraine attacks.

Most headaches during pregnancy—including migraines—are nothing to worry about. But that’s not to say that migraine attacks aren’t debilitating, and, in some cases, a symptom of a more serious complication for pregnant people and their babies.

Risks

The risk of adverse pregnancy, birth, and neonatal outcomes in pregnant people who deal with migraines is poorly understood.

But in a large-scale study of people in Denmark with and without migraines who became pregnant, migraines were associated with an increased risk of pregnancy-associated hypertension disorders in the mother.

Also, in newborns, maternal migraine was associated with an increased risk of a variety of adverse outcomes, including:

Treatment

While there are several effective medications for the treatment of migraines, not all are considered safe for you and your developing baby.

Some of the drugs suitable to take during pregnancy (after speaking to your healthcare provider) and medications to avoid are listed below:

Safe to Take During Pregnancy
  • Acetaminophen: A painkiller; the generic name of the drug in Tylenol.

  • Prochlorperazine: An anti-nausea medication; may help with migraine side effects.

  • Nonsteroidal anti-inflammatory drugs (NSAIDS): These include ibuprofen and naproxen and are only suitable to take prior to the third trimester of pregnancy.

Unsafe to Take During Pregnancy

Always talk to your doctor, nurse, or pharmacist before you take any medicines, herbs, or vitamins while pregnant.

For those looking to avoid medications, the following nondrug options have been shown to help people better cope with migraine symptoms:

  • Hydration (dehydration is a very common migraine trigger)
  • Cognitive behavioral therapy or psychotherapy focused on managing stress
  • Relaxation techniques (try deep breathing, yoga, massage, and visualization)
  • Ice packs (applying them to your head or neck may ease symptoms)

Migraine Prevention

If you are prone to migraines, prevention can go a long way toward improving your quality of life. To help manage the frequency of migraine attacks, try to:

  • Get enough sleep.
  • Avoid triggering foods and smells.
  • Regulate caffeine intake.
  • Manage stress.

Concerning Symptoms

Sometimes migraines can be a sign of a pregnancy complication. Call your doctor straight away if you have:

  • Severe headaches
  • Changes in vision, including temporary loss of vision, blurred vision, or light sensitivity
  • Sudden swelling on your hands, feet, face, or stomach
  • Nausea or vomiting

This could be a sign of preeclampsia, a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys. This can be dangerous for you and the baby if it is not treated. 

Prevalence of Migraines During Pregnancy

The prevalence of migraines in pregnant people has been described to be as high as 35%.

While up to 75% of pregnant people with a history of migraines note improvement over the course of their pregnancy, new onset of primary headaches during pregnancy is also possible.

Migraine and Postpartum

Postpartum migraines are common, with the American Migraine Foundation reporting that one in four pregnant people will experience migraines within two weeks of delivery, and nearly half will have migraine attacks within the first month.

If you underwent an epidural for anesthesia during delivery, you may be suffering from a post-lumbar puncture headache (spinal headache). In this case, intravenous fluids, caffeine, or even a blood patch can be helpful.

If your spinal headache hasn't improved within 24 hours, your doctor might suggest an epidural blood patch. Injecting a small amount of your blood into the space over the puncture hole will often form a clot to seal the hole, restoring normal pressure in the spinal fluid and relieving your headache.

Impact on Recovery

Hormonal changes, dehydration, and sleep irregularity can all contribute to migraines after birth. Sometimes headaches in postpartum people last longer than 24 hours, are more severe than usual, and/or are not relieved by typical measures.

It's important to take care of yourself following your delivery to aid your postpartum recovery and help you stay well. Try to:

  • Get enough rest.
  • Drink plenty of fluids.
  • Eat healthy foods regularly.
  • Relax to reduce stress.

Breastfeeding

There's some good news for breastfeeders who suffered from prepregnancy migraines—there may be a delay in your migraines returning in the postpartum period. One research study found that migraines returned within one month for 100% of pregnant people who bottle-fed their babies and only 43% of those who breastfed.

If you breastfeed, it is still best to avoid medication as far as possible because the baby will be taking whatever you take through the milk. With the exception of aspirin, the same drugs used in pregnancy can be taken while breastfeeding. Taking aspirin or aspirin-containing products when you're breastfeeding can cause adverse effects on your baby.

Frequently Asked Questions

What can you take for a migraine while pregnant?

Most migraine treatments are not recommended during pregnancy, although most pregnant people can safely take acetaminophen (Tylenol) to treat occasional migraines. Compazine (prochlorperazine) and most anti-nausea medications are generally considered safe.

Make sure to speak to your healthcare provider before taking any medication, including over-the-counter medications and herbal treatments.

When should you go to the ER for a migraine during pregnancy?

Some specific headache warning signs (which may signal dangerous headaches in pregnancy) that warrant immediate medical attention include:

  • Experiencing the worst headache of your life, which comes on suddenly and reaches its peak within a minute
  • Blurry vision
  • Neurological symptoms like weakness or numbness
  • Headache with fever and/or stiff neck
  • Headache with high blood pressure and/or swelling of the legs and feet
  • New-onset migraine-like headache
  • Change in headache pain, pattern, or severity

If you experience any of the above, go to the ER straight away.

What causes migraine headaches during pregnancy?

Many things can lead to migraines while you’re pregnant. Some causes include:  

  • Hormonal changes
  • Hunger
  • Low blood sugar
  • Dehydration
  • Caffeine withdrawal 
  • Lack of sleep 
  • Emotional or physical stress
  • Muscle strain from changes in your posture as the baby grows and you gain weight
  • High blood pressure in pregnancy

Do you get a migraine when you’re having an ectopic pregnancy?

Headaches can be common in early pregnancy, and if you have an ectopic pregnancy, you may experience the same symptoms as in any early pregnancy at first. If you are already a migraine sufferer, you may experience migraines as part of an ectopic pregnancy.

A Word From Verywell

Thanks to a more constant supply of hormones, most pregnant people get a break from migraine attacks during pregnancy. For an unlucky few, though, their migraines persist. If you’re one of them, you’ll be more limited in what you can take and when you can take it, but treatment options are available.

Make a migraine management plan with your doctor early on in your pregnancy so you have tools at your disposal. Do not hesitate to contact your healthcare provider if your migraine attacks worsen, or if you exhibit symptoms of pregnancy complications like preeclampsia.

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  1. Migraine Research Foundation. Migraine facts.

  2. Chai NC, Peterlin BL, Calhoun AH. Migraine and estrogenCurr Opin Neurol. 2014;27(3):315-24. doi:10.1097/WCO.0000000000000091

  3. Ishii R, Schwedt TJ, Kim S-K, Dumkrieger G, Chong CD, Dodick DW. Effect of migraine on pregnancy planning: insights from the American registry for migraine researchMayo Clinic Proceedings. 2020;95(10):2079-2089. doi:10.1016/j.mayocp.2020.06.053

  4. Amir BY, Yaacov B, Guy B, Gad P, Itzhak W, Gal I. Headaches in women undergoing in vitro fertilization and embryo-transfer treatment. Headache. 2005 Mar;45(3):215-9. doi: 10.1111/j.1526-4610.2005.05047.x.

  5. Lateef TM, Cui L, Nakamura E, Dozier J, Merikangas K. Accuracy of family history reports of migraine in a community-based family study of migraineHeadache. 2015;55(3):407-412. doi:10.1111/head.12501

  6. Negro A, Delaruelle Z, Ivanova TA, et al. Headache and pregnancy: a systematic reviewJ Headache Pain. 2017;18(1):106. doi:10.1186/s10194-017-0816-0

  7. Skajaa N, Szépligeti SK, Xue F, et al. Pregnancy, birth, neonatal, and postnatal neurological outcomes after pregnancy with migraineHeadache: The Journal of Head and Face Pain. 2019;59(6):869-879. doi:10.1111/head.13536

  8. Raffaelli, B., Siebert, E., Körner, J. et al. Characteristics and diagnoses of acute headache in pregnant women – a retrospective cross-sectional studyJ Headache Pain 18, 114 (2017). doi:0.1186/s10194-017-0823-1

  9. American Migraine Foundation. New moms & migraine: understanding pospartum headache. Updated January 25, 2018.

  10. Stella CL, Jodicke CD, How HY, Harkness UF, Sibai BM. Postpartum headache: is your work-up complete?. Am J Obstet Gynecol. 2007;196(4):318.e1-7. doi:10.1016/j.ajog.2007.01.034