How to survive headaches and migraines during pregnancy

If you’re struggling with persistent headaches or migraines during pregnancy you are not alone. It’s estimated that 15 to 20 percent of pregnant women have migraines. But what causes them? How can you prevent or manage them? And are they harmful to you or to baby?

Common triggers of headaches and migraines during pregnancy

The most common reasons for headaches or migraines during pregnancy are hormone changes, this is why they’re most common in the first half of pregnancy. Women often find their symptoms ease after 20 weeks.

If you’re someone who often suffers with headaches or migraines, the same triggers apply during pregnancy as before pregnancy. Common triggers are a lack of sleep, low blood sugar, eye strain, dehydration and hormone changes.  You may also notice more headaches due to reduced caffeine consumption, especially if this was something you relied on before pregnancy.

The challenge during pregnancy is identifying what’s causing your headache and finding ways to manage triggers. 

Things you may have used pre-pregnancy to cope, like painkillers or caffeine, are no longer available.

Tiredness

You’re probably more tired during early pregnancy that you’ve ever been. You’re growing new parts of you and you’re growing a person. That’s exhausting when you consider you’re probably still trying to function in the same way as you did before pregnancy.

If tiredness is a trigger, you may not spot the signs soon enough.

Try resting more on your days off, going to bed earlier (even if you have restless nights) and see if you can take proper breaks during your working day. You can’t push through anymore.

Eye Strain

I recommend all my pregnant participants to check in with their optician, especially if they’re struggling with headaches or migraines.

It’s something I did, since I really struggled with migraines during both pregnancies.

Pregnancy hormones can create laxity in ligaments, blood vessels and joint structures. This can affect your eyes too. Tiredness and eye strain can contribute to headaches. 

In my second pregnancy my optician changed my prescription slightly to help my eyes and there was a noticeable reduction in eye strain. 

Low Blood Sugar

There are 3 reasons you could be struggling with low blood sugar during the early days of pregnancy: 

1. If you’re feeling unwell or you’re sick, it’s probable you’re struggling to eat and when you do, it’s likely you’re nibbling on high sugar/highly processed foods that send your blood sugar crashing. There’s not a lot you can do about this other than trying to ensure you do get some fats, fibre and protein in, even if you’re struggling to eat. It will help to balance your sugar and energy levels.
2. You’re growing a person. You need around 40-50 extra calories per day to sustain your new ‘life growing’ role. If you’re struggling with your appetite or nausea, try to eat little and often to sustain your energy levels and avoid the dips.
3. You’ll be slightly diabetic. During pregnancy your body becomes much more sensitive to sugars and insulin changes. This is a survival mechanism to ensure you lay down fat and energy stores during pregnancy. The upshot of this for you is that you’ll be much more sensitive to sugar highs and lows, so it’s even more important to take on plenty of fats, fibre and protein when you’re snacking or eating meals. 

Dehydration

I know you know and if you’re struggling to eat then drinking in quantity is quite probably also a challenge, especially given you’re likely to need to pee a lot more frequently in the early days of pregnancy but dehydration can sneak up on you. Drink little and often and try to have at least two litres of water every day.

Headaches could also be a sign of low iron. Many women will experience anaemia during pregnancy because of blood and blood volume changes. You can take supplements like Spatone or talk to your GP if you have any concerns. 

Red flags: When does a headache need medical help? 

As a Pilates instructor of nearly two decades, my alarm bells start ringing for three reasons when it comes to headaches: 

1. My client is over 20 weeks of pregnancy and her headaches are severe and she’s got significant water retention. This could be a sign of pre-eclampsia which requires urgent medical attention. 
2. My client has never suffered with headaches or migraines before. 
3. My client has other symptoms like back pain or flu like symptoms. This could be a sign of a UTI. 

It’s always worth raising headaches with your GP or midwife to ensure it’s flagged on your medical records but if you recognise any of the above in your symptoms, get to a GP so they can perform further tests.

Is it okay to exercise when you’re suffering from headaches or migraines?

Some women worry if it’s okay or safe to exercise whilst they’re struggling with headaches or migraines. If you have an acute migraine, then it’s quite probable all you can do is lie in a dark, quiet room. But gentle breathing, or Pilates exercises performed without too much moving around could help.

I offer the option to join me live, online from home and there are plenty of 10 minute sessions you can dip into too. So hopefully you’ll find there’s a way of joining even when leaving home feels like too much effort.

From a long term, pain management perspective, finding exercise that helps you to relax, let go of stress and rest better could help you manage headaches. 

Are painkillers okay?

There some great information on painkillers here: https://www.tommys.org/pregnancy-information/pregnancy-symptom-checker/headaches-pregnancy

Drug free solutions 

For drug free solutions for headaches which are more instant than simply making sure you relax, some aromatherapy can help. I used Forehead sticks and you can pick up Migraine relief oil roll ons from health food shops. Aromatherapist Claire Blackie can also advise on oils that are safe to use during pregnancy. I interviewed her for my 15 minute ask the expert series on Instagram. You can check it out here: Ask The Expert Aromatherapy During Pregnancy Claire creates bespoke oils and products and offers highly recommended massages and treatments too.

You could also try a heated (or cool) eye mask. I have a great gel eye mask that helps to ease eye strain. 

Checklist for managing headaches during pregnancy 

1. Drink at least 2 litres of water every day
2. Take tiredness seriously, make sure you rest
3. Eat little and often to manage energy levels including fats, fibre and protein.
4. Keep an eye on red flag symptoms
5. Check in with your optician.
6. Try a relaxing class like Pilates.
7. Get plenty of fresh air to help with the headaches.
8. Always tell your midwife or GP about your headache symptoms.

These websites provide useful information on headaches during pregnancy:

https://www.nhs.uk/pregnancy/related-conditions/common-symptoms/headaches/

https://www.pregnancybirthbaby.org.au/amp/article/headaches-during-pregnancy

https://www.chop.edu/conditions-diseases/migraine-headaches-during-pregnancy