Headaches in Pregnancy: Relief and the Red Flags

Headaches in pregnancy: how to think about it

Headaches are common in pregnancy and most are tension-type or related to ordinary triggers such as dehydration, hunger, tiredness and caffeine change. Hormonal shifts in the first trimester are a frequent contributor, and many people find migraines change during pregnancy, sometimes improving. NHS guidance on headaches in pregnancy describes paracetamol as the usual option and directs people to seek advice for severe or persistent headache. The reason headache carries specific warnings in pregnancy is pre-eclampsia, a condition involving raised blood pressure that develops after 20 weeks and can present with severe headache, visual disturbance, swelling and upper abdominal pain. That combination is treated as urgent rather than as a headache to medicate. This is why guidance draws a line at 20 weeks and at severity, rather than treating all pregnancy headaches the same way.

Headaches: safer choices

• Paracetamol at the lowest effective dose for the shortest time, which NHS describes as the first-choice painkiller in pregnancy.
• Addressing the ordinary triggers first: dehydration, skipped meals, poor sleep, caffeine withdrawal and screen strain.
• Keeping caffeine steady rather than cutting it abruptly, since sudden withdrawal is itself a common headache cause. Guidance is around 200 mg a day in pregnancy.
• Rest in a dark quiet room, a cool cloth, and gentle neck and shoulder stretches for tension-type headaches.
• Telling your midwife if you get frequent headaches, so blood pressure can be checked and patterns noted.

Headaches: what to avoid or double-check

• Do not treat a severe headache after 20 weeks as ordinary, particularly with visual disturbance, swelling of the face or hands, or pain under the ribs. Contact your maternity unit the same day.
• Avoid ibuprofen and other NSAIDs unless a clinician has agreed, particularly from 20 weeks.
• Do not use combination headache products without reading every active ingredient. Many contain caffeine, and some contain aspirin or codeine.
• Do not take migraine-specific prescription medicines you used before pregnancy without checking with the prescriber.
• Avoid repeated daily painkiller use, which can cause medication-overuse headache and needs a different approach.

How SafeMama helps

SafeMama can flag the actives in headache products, including paracetamol, aspirin, ibuprofen, caffeine and codeine inside combination tablets, so you can see whether a product carries something that needs checking.

Open the SafeMama app, scan the barcode or search the ingredient, then use the result as a starting point for a conversation with your healthcare provider.

Sources

• NHS headaches in pregnancy
• ACOG headaches and pregnancy
• NHS paracetamol in pregnancy