Pregnancy headaches: What causes them and safe ways to relieve

Pregnancy brings many changes to your body—some welcome, others less so. If you’re experiencing headaches during pregnancy, you’re not alone. Headaches are a common companion for many expectant mothers, affecting up to 80% of women with a history of primary headaches during pregnancy, though many see improvement by the second trimester according to research in American Family Physician.

Whether you’re dealing with occasional tension headaches or managing migraine, understanding what’s happening and knowing your safe relief options can make all the difference in your pregnancy journey.

Why headaches happen during pregnancy

Pregnancy creates the perfect storm for headache triggers. While research specifically detailing the mechanisms is limited, several factors likely contribute:

Hormonal fluctuations

The dramatic rise in estrogen and progesterone during pregnancy affects blood vessels and neurochemicals in ways that can trigger headaches, especially in women with a history of hormonal headaches. These changes are particularly pronounced during the first trimester when hormone levels increase rapidly.

Increased blood volume

Your body produces approximately 50% more blood during pregnancy to support your growing baby. This increased volume can put pressure on blood vessels, potentially triggering headaches as your circulatory system adjusts to these new demands.

Dehydration

Growing a human requires more fluids than you might expect. Even mild dehydration can lead to headache symptoms, making adequate hydration crucial throughout your pregnancy. Many women find their fluid needs increase substantially, yet morning sickness can make meeting these needs challenging.

Poor posture and physical strain

As your center of gravity shifts with your growing belly, your posture naturally changes. This adjustment can strain your neck and shoulders, leading to tension headaches that may become more frequent as your pregnancy progresses and your body compensates for the additional weight.

Sleep changes and fatigue

Between bathroom trips, physical discomfort, and hormonal changes, quality sleep becomes challenging during pregnancy. Sleep deprivation is a well-known headache trigger, creating a frustrating cycle for many pregnant women struggling to find comfortable rest positions.

Stress and anxiety

The emotional journey of pregnancy brings natural concerns about your baby’s health, your changing body, and your upcoming role as a parent—all potential stress headache triggers that can manifest physically as tension across your forehead, temples, or base of your skull.

When to be concerned about pregnancy headaches

While most headaches during pregnancy are harmless, some warrant medical attention. According to a clinical review, about 90% of pregnancy headaches are primary headaches (like migraines or tension headaches) rather than dangerous secondary causes.

Contact your healthcare provider if your headache:

• Is sudden and severe (“thunderclap” headache)
• Persists despite rest and over-the-counter pain relief
• Is accompanied by fever, stiff neck, or vision changes
• Comes with high blood pressure readings
• Worsens dramatically or changes pattern significantly
• Is accompanied by swelling in your face or hands
• Occurs alongside dizziness, confusion, or slurred speech

These symptoms could indicate pregnancy complications like preeclampsia, which research published by the Migraine Disorders Foundation shows is associated with migraine during pregnancy. Women with a history of migraine should be particularly vigilant about monitoring these warning signs.

Safe headache relief during pregnancy

Finding effective yet safe headache relief during pregnancy requires balancing symptom management with baby’s wellbeing. Here are doctor-approved approaches:

Non-medication approaches

Hydration first: Drink water consistently throughout the day—many pregnancy headaches respond to improved hydration alone. Try keeping a water bottle with you at all times and setting reminders to sip regularly.

Cold or warm compress: Apply a cool pack to your forehead or a warm compress to the back of your neck, depending on what feels best. This simple remedy can provide surprising relief, especially for tension-type headaches.

Rest in a dark, quiet room: Reduce sensory stimulation when possible, particularly for migraine attacks. Even 15-20 minutes of complete sensory rest can help reduce headache intensity for many women.

Gentle stretching and massage: Target tense muscles in the neck, shoulders, and upper back. Ask your partner to learn basic massage techniques for these areas or consider scheduling prenatal massage with a qualified therapist.

Practice good posture: Be conscious of how you sit and stand, especially as your pregnancy progresses. Using pregnancy pillows and ergonomic chairs can help maintain better alignment throughout the day.

Regular meals: Blood sugar dips can trigger headaches, so eat regular, balanced meals and healthy snacks. Consider carrying protein-rich snacks like nuts or yogurt to maintain steady glucose levels.

Stress management: Practice pregnancy-friendly relaxation techniques like gentle prenatal yoga, deep breathing, or meditation to prevent and manage tension headaches.

Safe medication options

If non-medication approaches aren’t providing relief, these options are generally considered safe during pregnancy:

Acetaminophen (Tylenol): The American Family Physician recommends acetaminophen as the initial therapy for acute headaches, with dosing up to 1,000 mg three times daily as needed, according to their clinical guidelines.

Caffeine in moderation: Limited caffeine (under 200 mg daily) can help relieve headaches and is generally considered safe during pregnancy. It works particularly well when combined with acetaminophen for migraine relief.

Magnesium: For migraine with aura, intravenous magnesium (1-2 g) has shown benefit and is considered pregnancy-safe, though discuss oral supplementation with your doctor first to determine appropriate dosing.

Medications to avoid

Several common headache medications should be avoided during pregnancy:

• NSAIDs like ibuprofen (Advil, Motrin) and naproxen (Aleve) should be avoided in the first and third trimesters
• Aspirin at pain-relieving doses (though low-dose aspirin may be prescribed for specific conditions)
• Products containing butalbital, which can increase the risk of medication overuse headaches and fetal cardiac anomalies
• Ergot alkaloids, which can stimulate uterine contractions and should never be used during pregnancy

Prevention strategies for pregnancy headaches

An ounce of prevention is worth a pound of cure—especially during pregnancy:

Stay hydrated: Aim for at least 8-10 glasses of water daily, more if you’re active or in hot weather. Keeping a large water bottle with measurement markings can help you track your intake.

Maintain regular sleep patterns: Try to go to bed and wake up at consistent times, even on weekends. Creating a comfortable sleep environment with supportive pillows can help you get the rest your body needs.

Identify and avoid personal triggers: Keep a headache diary to spot patterns with certain foods, activities, or situations. Common triggers include strong smells, bright lights, and specific foods like aged cheese or processed meats.

Exercise moderately: Regular, gentle activity like walking or swimming can reduce headache frequency by improving circulation and releasing tension. Even 20-30 minutes daily can make a significant difference.

Practice good posture: Consider pregnancy support bands or belts as your belly grows to reduce strain on your back and shoulders, which can contribute to tension headaches.

Manage stress proactively: Consider enrolling in a comprehensive pregnancy course that includes stress management techniques. Our Pregnancy Course at Beginning Academy offers evidence-based strategies for managing pregnancy discomforts, including headaches.

The bottom line

While headaches during pregnancy can be uncomfortable, most are manageable with safe approaches and not harmful to your baby. By understanding your triggers and having a toolkit of relief strategies, you can minimize their impact on your pregnancy journey.

Remember that your healthcare provider is your best resource for personalized advice, especially if you have a history of severe headaches or migraines. Don’t hesitate to discuss your symptoms and relief options at your prenatal appointments.

Pregnancy is a time of immense change, but with the right knowledge and support, you can navigate headache pain safely while nurturing yourself and your growing baby. Try implementing one or two prevention strategies today—your head (and baby) will thank you.