When to Worry About a Pregnancy Headache

Having a headache is unpleasant, but when you're pregnant, it can be worrying, too. Headaches are very common in pregnancy and can be caused by anything from pregnancy hormones and changes in posture to caffeine withdrawal and stress.

More often than not, headaches during pregnancy aren't dangerous. Occasionally, though, headaches can be an indication of a serious pregnancy complication like preeclampsia. But how can you tell the difference?

While you should always consult with a health care provider about any symptoms you are having during your pregnancy, here are some guidelines that may help you distinguish when a headache during pregnancy could mean something more serious.

Causes of Pregnancy Headaches

First-trimester headaches often occur because of a surge in hormones and an increase in blood flow throughout your body, explains Giuseppe Ramunno, M.D., an OB-GYN at Bethany Women’s Healthcare in Phoenix.

During your third trimester, a headache from 27 weeks on might be related to poor posture and tension from carrying increased weight as the baby grows.

Otherwise, many of the things that can cause a headache when you're not pregnant can also cause one when you're expecting.

When to Worry About a Headache During Pregnancy

Occasionally, a headache during pregnancy can be a sign of a more serious medical problem, including preeclampsia (a serious hypertensive disease that only occurs during pregnancy), sinusitis (inflammation of the sinuses, which may require antibiotics), and very rarely, neurological disease.

When a pregnant patient complains of a severe headache, one of the first things a health care provider will want to rule out is preeclampsia. Preeclampsia is a serious condition characterized by high blood pressure and protein in the urine, and one of the hallmark signs is a severe headache that won't go away.

Preeclampsia can be life-threatening to both a pregnant person and their baby if not treated, which is why health care providers check for signs of protein in your urine at every single prenatal checkup to screen for preeclampsia.

While your prenatal health care provider will be monitoring you for preeclampsia during your checkups, you should always call your health care provider immediately if you have a sudden, severe headache or any other warning signs of preeclampsia.

When Does Preeclampsia Happen?

Preeclampsia usually develops after 20 weeks of pregnancy, according to the ACOG, and most cases of preeclampsia occur at or near term. That means that if you have a severe headache at 36 weeks pregnant or after, it's especially important to let your health care provider know.

People who have high blood pressure during or before pregnancy are at a higher risk for developing preeclampsia, but any pregnant person can develop the condition.

Experts aren't entirely sure why preeclampsia can cause a headache, but Matthew S. Robbins, M.D., a neurologist at Weill Cornell Medicine in New York City whose clinical practice and research is intensely focused on headaches and headache disorders, says it could be due to the way the condition affects blood flow in the brain. If you're someone who gets headaches often, it can be hard to distinguish what's a "normal" headache and what warrants a call to a health care provider, but Dr. Robbins says you should always be on the safe side.

He also notes that preeclampsia headaches tend to last longer than previous headaches. "Any pregnant person who experiences a severe headache should seek consultation with their health care provider to make sure there are no worrisome causes, as well as to ensure their symptoms can be treated properly," Dr. Robbins says.

How to Prevent and Manage Pregnancy Headaches

You can't always prevent a headache, especially during pregnancy, but if you know you're prone to them, be sure to talk to a health care provider about a plan for managing them and seeking immediate medical attention. Along with keeping in touch with your health care provider, it may help to follow some tips for managing headaches during pregnancy. Here are some strategies you could try.

• Pinpoint your headache triggers. Keep track of your meals and activities, as well as when a headache strikes, to help you learn how to modify headache-causing habits.
• Exercise. Find light to moderate exercise that you enjoy. Take a daily walk or do prenatal yoga, if permitted by your health care provider.
• Practice relaxation exercises. Deep breathing, yoga, meditation, and visualization can all help you destress.
• Keep your blood sugar stable. Eat small, frequent meals throughout the day to keep your blood sugar on an even keel.
• Stay hydrated. Drink plenty of fluids to stay hydrated, especially with physical activity or spending time outdoors.
• Follow a regular sleep schedule. Go to bed and wake up at about the same time every day, even on weekends.
• Use hot and cold therapy. Using heat to relax the muscles of your neck and face and a cold pack to constrict dilated blood vessels in the head can be an effective to way to stop a headache in its tracks.
• Check your posture. Pregnancy can be a lot of strain on your upper body. It might help to support your posture to alleviate or reduce muscle tension.
• Relieve tension. You could try a prenatal massage and look into belly support for your pregnancy if you're experiencing a lot of pain in your neck and shoulders.