Recognizing Dangerous Headaches in Pregnancy

While tension headaches and migraines won’t necessarily get worse during pregnancy (and they usually improve for women), occasionally a headache can be a warning sign of more serious problems.

Migraines or other headaches occur during pregnancy for the same reasons they occur in most people, as a result of fatigue, tension, or change in eating patterns. In addition, changes in hormone levels and body chemistry may play a role in headaches (especially migraines) in pregnancy.

Conservative treatment measures such as cold compresses and rest can be effective for many women, but medications such as Tylenol (acetaminophen) may be necessary in others. Be sure to learn more about which medications are safe to use during pregnancy.

When a headache during pregnancy is accompanied by dizziness, blurred vision, or blind spots (scotoma), it's time to call your obstetrician or health care provider. These could be signs of preeclampsia, a condition that develops during the second half of pregnancy. It's marked by elevated blood pressure (hypertension), protein in the urine, and swelling, usually in the feet and legs.

If the preeclampsia becomes more severe, it can cause problems with your liver and a low number of platelets (blood cells that help in the clotting process).

Left untreated, preeclampsia can develop into eclampsia, which includes seizures and possibly coma and blindness. Both conditions are dangerous to the mother’s health (and the baby) and need to be treated urgently. Treatment generally involves delivery of the baby in addition to medications to bring the blood pressure down.

Other headache red flags include a thunderclap headache, which causes a severe and sudden onset of head pain. Many people describe this as a the worst headache of their life.

Neurological symptoms like blurry vision or numbness, a headache associated with fever, and a headache linked to exertion are other indicators to seek medical attention.  

The good news is that most headaches during pregnancy can be easily relieved with simple remedies like rest, relaxation, a cold compress, and eating at regularly scheduled times. Biofeedback and stress management techniques can also be useful. But it's wise to be aware and call your doctor if your headache is persistent, feels different, or is associated with worrisome symptoms, like neurological problems.