Your pregnant body

• Your body goes through major changes during pregnancy.
• Weight gain, breast changes and aches and pains are common.
• There are ways to deal with common discomforts and changes.

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Headaches are common during pregnancy, especially during the first and third trimesters. They rarely signal a serious problem.

Causes of headaches during pregnancy
The cause of headaches is uncertain. In the first few months of pregnancy, they may be caused by normal changes in your hormone levels and an increase in blood volume and circulation.

In the second trimester, pregnancy-related headaches may disappear as your body becomes used to the hormonal changes. Towards the end of pregnancy, headaches tend to be related more to posture and tension from carrying extra weight.

During the second and third trimesters, headaches may also be caused by a serious condition called preeclampsia (high blood pressure during pregnancy). Preeclampsia requires immediate medical attention (see below).

Headaches and other pains
Some women often have tension headaches, which cause squeezing pain or a dull ache on both sides of the head or the back of the neck. The headaches may increase during pregnancy, especially if the woman experiences any of the following:

• Stress
• Fatigue 
• Caffeine withdrawal (especially if she suddenly stops or cuts down on coffee drinking or other sources of caffeine when she learns she is pregnant) 
• Lack of sleep 
• Dehydration (lack of fluids) 
• Hunger or low blood sugar

Migraines
Some women may have migraine headaches for the first time in early pregnancy. These headaches cause severe, throbbing pains on one side of the head. The woman may also have nausea or vomiting. But many women who are prone to migraines may notice that they improve during pregnancy. Some migraine sufferers may notice no change during pregnancy or may find that their headaches become more frequent and intense.

What you can do
Before taking any medications or herbal remedies, always talk to your health care provider. If you regularly suffer from migraines, ask your health care provider before taking the medications you normally used before becoming pregnant. The following tips may safely help relieve or prevent headaches during pregnancy:

Use warm or cold compresses.

• To soothe a headache in the sinus area, apply warm compresses to the front and sides of your face and around your nose, eyes and temples.
• To relieve a tension headache, apply a cold compress to the back of your neck

Reduce stress.

• Avoid placing yourself in stressful situations.
• Relaxation exercises may help. For instance, try deep breathing or simply closing your eyes and imagining a peaceful scene. 

Rest and exercise.

• Resting in a dark, quiet room can soothe headaches. 
• Getting enough sleep and exercise can also be helpful. 
• Always be sure to find out from your health care provider which exercises are safe for you, and how long you can maintain your exercise program.

Eat well-balanced meals.

• Eat smaller, more frequent meals throughout the day.
• This can help keep your blood sugar from getting too low.

Take care of your body.

• Maintain good posture, especially during the third trimester.
• Get a massage. Massaging your temples, shoulders and neck can help reduce the pain of headaches.

Avoid headache triggers.

• Different kinds of food or stresses can trigger headaches. For instance, triggers of migraine headaches include chocolate, aged cheese, peanuts and preserved meats.
• Keep a diary, and review the kinds of foods and activities that tend to trigger tension or migraine headaches.

When to talk to your health care provider
While most headaches during pregnancy are harmless, some can be a sign of a more serious problem. If you have a migraine for the first time during pregnancy, or if you have a headache that feels unlike any you've experienced before, call your health care provider to make sure it is not a sign of more serious problems. Call your health care provider right away if your headache:

• Is sudden and explosive or includes a violent pain that awakens you from sleep
• Is accompanied by fever and stiff neck 
• Becomes increasingly worse, and you have vision changes, slurred speech, drowsiness, numbness or a change in sensation or alertness 
• Occurs after falling or hitting your head 
• Is accompanied by nasal congestion, pain and pressure underneath your eyes, or dental pain (these may be signs of sinus infection)

Preclampsia
In the second or third trimester, headaches can be a sign of preeclampsia, a serious condition that includes high blood pressure. Contact your health care provider immediately if your headache:

• Does not go away or recurs often 
• Is sudden and very severe 
• Is accompanied by blurry vision, spots in front of your eyes, sudden weight gain, pain in the upper right abdomen, and swelling in the hands or face 
• Is accompanied by nausea and vomiting
• If you've been having any problems with high or rising blood pressure, call your health care provider even if you have a mild headache.

August 2009