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Pregnancy headaches: what's normal and what you can do about them

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Jojo Bierlein-Lodewyk
Pelvic health physical therapist

Although headaches are common in pregnancy (especially in the first trimester), if you’ve ever had a major headache during pregnancy, you’ll know it can be scary! You might struggle to get through the day due to the pain, wonder how many headaches you’ll have before your baby is born, or even worry it’s a sign that something is wrong with you or your baby. I’m here to tell you: I’ve been there. I get how scary it is, and I understand how hard it is. And I have some information that might be able to help.

Sometimes, headaches during pregnancy are a sign of something more serious and you should get in touch with your midwife or doctor. They might be more serious if:

  • Your headache or migraine is severe, persistent and doesn’t change when you make an intervention, such as taking over the counter pain medicine.
  • Your headache or migraine is accompanied by dizziness, blurred vision, pain just below the ribs, change in vision or vomiting.
  • You have had no previous history of headaches or migraines but are now experiencing a sudden onset of them.
  • Your blood pressure is high, as well.

In particular, headaches can sometimes be a sign of pre-eclampsia, which usually starts after 20 weeks and can lead to serious complications if not treated. This means it’s important to call your midwife or doctor if you’re experiencing severe headaches.

Now, let’s talk about the headaches that aren’t necessarily emergency-department level, but are still impacting your quality of life daily. There are several simple triggers for headaches and migraines during pregnancy. Identifying them can help you avoid headaches in the future.

1. Hydration

Drinking water is important for your overall health even when you’re not pregnant. However, during pregnancy, staying on top of your water intake is even more important, as it will help your heart, muscles, gut, and baby!

When your body doesn’t have enough water, this can impact your blood pressure, muscle function (leading to cramping or spasms), stool consistency (constipation). Dehydration can even lead to more serious things like neural tube defects, low amniotic fluid, or premature labour. So get a big glass or bottle of water, and keep of glugging!

2. Diet

Your body needs so many different nutrients to grow your baby. And that’s on top of what your body already needs to support itself aside from pregnancy! Skipping meals, going too long between meals, or not eating quality nutrients can be major triggers for headaches. Sometimes, these headaches can be caused by hypoglycemia (low blood sugar), which can be tough to get ahead of once they come on. This is why it is so important to stay on top of meals, keep snacks closeby for between meals or in case you miss a meal, and try to keep your diet well rounded.

Are you struggling with nausea which is hindering your nutrient intake? It will be tough at first, but the more you can constantly keep something in your stomach (like bland crackers and water), the better the stomach acid will balance out.

Are you later in pregnancy and struggling with meals because it feels like you don’t have room? Eat small meals, more frequently throughout the day. Try to avoid acidic items (tomato, coffee, chocolate, citrus), which can contribute to acid reflux.

3. Sleep

Not sleeping well can definitely trigger headaches. During pregnancy your body is changing a lot, and it may need your sleeping posture to change with it. Try using pillows between your legs, under your belly, behind your back, between your arms - anything that helps you feel supported. Test out using an eye mask to keep the room dark, white noise to drown out distractions, and deep breathing while falling asleep. If you’re having reflux at night, use pillows or a recliner to sleep on an incline.

A warm bath, some lavender aromatherapy, ice packs around the base of your neck, or calm music can assist with quieting the mind and relaxing the body for better quality sleep, too!

4. Stress and muscle tension

These two seem to go hand-in-hand. Whether you’re feeling some stress about the arrival of your baby and that is causing you to tense your neck and shoulders, or perhaps your pregnancy has caused a lot of muscle tension throughout your body and the discomfort has stressed you out because you cannot find relief. Either of these can be a headache trigger.

Gentle stretching and light exercise can be a very beneficial remedy for muscle tension and stress. If you are able to get a prenatal massage or use an at home massager for the neck and back tension, followed by a warm bath, ice packs or heating pads, and deep breathing can be helpful in easing tension, too.

Lastly, identify the things stressing you out, and let them out - talk about them with someone you trust, journal about them every night before bed, or look in the mirror and acknowledge your worries to yourself, validating your feelings. Let it out, mama!

If you’ve tried all the above strategies and are still struggling, sometimes headaches during pregnancy can simply be hormonally triggered - and, unfortunately, the hormone changes are a natural and necessary part of pregnancy. One possible intervention you could ask your healthcare provider about is adding a daily magnesium oxide supplement. Research has shown reduction in severity and frequency of migraines in pregnant women using supplemental magnesium oxide! Bonus: magnesium also helps with blood pressure, muscle relaxation, pooping, and sleeping! As always, do not start taking new supplements without consulting your OB or midwife first!

Headaches are common in pregnancy, and there are lots of things you can try to reduce them. But if you’re worried, always get in touch with your midwife or GP.