Benign and Serious Causes of Headaches After Pregnancy

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After the emotional and physical exhaustion of delivering a baby, the last thing you need is a headache. But a headache in the postpartum period is a common complaint. Hormonal changes, dehydration, anesthesia, and sleep irregularity can all contribute to headache after delivery of your precious newborn.

Usually, fluid, rest, relaxation, and anti-inflammatory medication (like ibuprofen) would help alleviate the discomfort. But sometimes headaches in postpartum women last longer than 24 hours, are more severe than usual, and/or are not relieved by typical measures.

When this happens, you should contact your healthcare provider, as this could signal a medical condition specific to the postpartum period (which can rarely be life-threatening).

when to visit a doctor for a postpartum headache
Illustration by Brianna Gilmartin, Verywell

Causes

One older study reviewed the outcomes of 95 women with postpartum headache. These women had no prior history of seizures or strokes. In the study, the postpartum period was described as occurring 24 hours from the time of delivery to within 42 days after delivery (so a pretty long time out).

The study found that nearly 50% of the women's postpartum headaches were either migraines or tension-type headaches. Twenty-four percent were caused by preeclampsia/eclampsia, and 16% were spinal headaches. The other 10% of the patients had more serious brain abnormalities, including bleeding into the brain and stroke.

A migraine is classically throbbing in nature, one-sided, and associated with nausea and/or vomiting, and a sensitivity to light and sound. The pain of a migraine tends to be much more disabling than the pain of a tension-type headache, which causes a dull tightening or pressure sensation on both sides of the head. Women who experience postpartum migraines typically have a prior history of migraines, but postpartum can be the first time the present due to the fluctuation in hormones after delivery.

Serious Headaches

Examples of rare but dangerous headaches that require immediate medical attention include:

Preeclampsia/Eclampsia

Another serious headache disorder, which may develop after 20 weeks' gestation or during the postpartum period, is preeclampsia/eclampsia, signaled potentially by a headache with high blood pressure and/or swelling of the legs and feet.

When to See a Doctor

Red flag warning signs to seek emergency medical care are if you are having the worst headache of your life or are experiencing a thunderclap headache.

Other headache warning signs include:

  • Headache with fever and/or stiff neck
  • Headache related to exertion, sex, or Valsalva maneuver
  • New-onset migraine-like headache
  • Change in headache pain, pattern, or severity

Diagnosis

Your doctor will listen to your report of symptoms and review your medical history, as well as performing a physical examination. To rule out preeclampsia, your doctor will check your blood pressure and perform a urinalysis.

If you have high blood pressure and protein in your urine, your doctor will likely give you medication to bring your blood pressure down and/or medication (magnesium sulfate) to prevent seizures. If your symptoms don't resolve with the above treatment, brain imaging may be recommended.

While your doctor may order a brain imaging test to be on the safe side, this is generally reserved for women who have worrisome signs or symptoms along with their headache. For instance, a neurological problem like blurry vision, difficulty walking, weakness, or numbness and tingling is worrisome for a blood clot or bleed in the brain.

To rule out potentially life-threatening headache causes, imaging of the brain with computerized tomography (CT) scan or magnetic resonance imaging (MRI) is required. A lumbar puncture, or a spinal tap, is also sometimes needed.

Headaches Doctor Discussion Guide

Get our printable guide for your next doctor's appointment to help you ask the right questions.

Doctor Discussion Guide Woman

Treatment

After ruling out potentially life-threatening and serious causes of a postpartum headache, the diagnosis of your headache at this point is probably a migraine or tension-type headache. For both of these primary headache disorders, pain medication, fluids, and sleep will be recommended.

If you are breastfeeding, be sure to talk with your physician before taking any medications to relieve a headache. Complementary treatments like yoga, mindfulness, and breathing exercises are sometimes helpful for headaches and safe for women who are breastfeeding.

Spinal Headache

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.

A blood patch entails a surgery, in which your own blood is injected into the puncture site where your epidural was done. This compresses the hole, preventing any further spinal fluid leak.

A Word From Verywell

If you experience a postpartum headache, contact your doctor, or page your nurse if you are still in the hospital. There's likely a simple solution, such as sleep, fluids, or pain medication.

However, your doctor will want to make sure there is nothing more serious going on. As a parent, you also want that reassurance so you can obtain appropriate headache relief and get back to enjoying your newborn.

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  1. 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

  2. Klein AM, Loder E. Postpartum headache. Int J Obstet Anesth. 2010;19(4):422-30. doi:10.1016/j.ijoa.2010.07.009

  3. Kuruvilla DE, Lipton RB. Appropriate use of neuroimaging in headache. Curr Pain Headache Rep. 2015;19(6):17. doi:10.1007/s11916-015-0490-3

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