Migraines are a pain (pun intended!) at the best of times, but when you’re pregnant they can truly become a nightmare. If you’re one of the lucky patients whose headaches lessen during pregnancy, you can be grateful, because many sufferers find the attacks actually worsen during this time. Here’s what to expect from a migraine during your gestation period and how to manage various scenarios.

Why Migraines Occur During Pregnancy

Headaches are a typical discomfort for many women during pregnancy. They can occur at any time but most commonly attack during the first and third trimesters. The main cause is the surge of hormones and increase in blood volume experienced by an expectant mother, which can be aggravated further by stress, poor posture or changes in vision.

Women are already more prone to developing migraines than men, with three times more female sufferers (18% of Americans) than male patients (6%). When a female migraine patient becomes pregnant, her condition is likely to improve during her term. Many women stop experiencing migraines completely during pregnancy, while others report getting their very first migraine episode ever during this time. Several female patients report a lower frequency of migraines during pregnancy while others report more severe headaches.

Research identifies the role of estrogen in migraines, which explains why menstruation and menopause frequently affect women’s migraine patterns. With pregnancy affecting the female hormone levels more than either of these conditions, it’s logical to expect an impact on migraine patients during gestation.

It’s also believed overly-excited brain cells release a rush of chemicals that irritate the brain’s surface blood vessels. This causes them to swell and stimulate the body’s pain response. This is why many women find pregnancy affects their mood and state of mind, and since the neurotransmitter serotonin plays a key role in migraine, it follows that this also has an influence.

Symptoms of Pregnancy Migraines

If you suffer from migraines regularly you should be familiar with the symptoms of an attack, although you may find these differ during pregnancy. Common symptoms include a dull ache that becomes a constant throbbing or pulsating pain. This is usually located in the temples, the front of the head or at the base of head adjoining the neck.

You may find you experience nausea or vomiting, or you could experience aura, a vision of wavy or jagged lines or spots of flashing lights. Patients also occasionally develop tunnel vision or blind spots.

Identifying Your Triggers

Individual migraine patients have a host of different triggers, but the triggers most commonly associated with pregnancy migraines are:

• Stress, which is common, especially during the early stages of pregnancy when you are juggling normal life with the increasing awareness of your baby growing inside you
• Skipping meals, whether it’s due to morning sickness, fasting medical appointments or any other reason
• Lack of sleep due to insomnia, which is normal and affects around 78% of pregnant women
• Changes in the weather and barometric pressure, which you may be more sensitive to as a result of your condition
• Differences in your diet caused by cravings and the effort to adapt to a healthier lifestyle

A migraine diary is very helpful for determining your particular triggers. Your diary should include the date and time of your headache attack, the duration, and the food and drinks you consumed before the pain began. Include the location of the pain and other migraine symptoms, and record the weather and your state of mind in the 6 hours before the onset of the attack. By determining your triggers, you may be able to avoid the things that cause your pain.

Getting Tested for Pre-Eclampsia

If you are pregnant and have migraines, your doctor may want to perform tests to ensure you are not suffering from pre-eclampsia. He or she will check for elevated protein levels in your urine, as well as swelling in your face and ankles. If tests reveal you are free of pre-eclampsia, then he will rely on your medical history and migraine diary to make a diagnosis.

Treating Your Pain

Finding effective treatment for your specific migraines can be difficult enough under regular circumstances, but during pregnancy you’re required to be extra-careful about taking medication or consuming certain foods and drinks. Most people cut alcohol, smoking, and caffeine out of their diet, and doctors usually advise against eating certain foods, such as sushi.

Medication

Acetaminophen is usually safe for most patients, and sufferers should take it as soon as they feel the first indications of pain for it to be effective. It may not be sufficient for severe headaches, though, and while some triptans are considered safe to take during pregnancy, it might be necessary to supplement your treatment with a comprehensive preventive effort.

Water Therapy and Hydration

Apply a cool compress to your forehead or the back of your neck, or take a cool shower or a warm bath. Make sure you take in sufficient water too, because it’s easy to forget to drink when you are busy and active. Being hungry or thirsty could trigger a stress reaction followed by a migraine episode, so it’s critical for pregnant women to remain properly hydrated.

Nerve Block Therapy

A report published in the Journal of Obstetrics and Gynecology shows that peripheral nerve block therapy might be an ideal option for pregnant migraine sufferers. While patients who took oral or intravenous migraine medication had no relief, 80% of those who had nerve block therapy did experience relief.

Exercise and Massage

If you don’t get enough exercise during pregnancy it could lead to stress, which can definitely trigger major migraine episodes. The best gentle exercises for pregnant women are yoga, Pilates, and walking.  Massage is also a good way to both relax and stimulate your blood flow, and can be beneficial for treating a migraine attack.

Complications to Watch Out For

While migraines are less common, but mild or tension headaches are more frequent during pregnancy, women should pay close attention if they experience a headache along with any of the following:

• A fever or body temperature higher than 100 F
• Blurry vision
• Severe nausea that does not go away

When any of these symptoms are combined with a headache they signal a potentially more serious condition, which might need emergency medical attention to protect the lives of mother and child. 

Monitoring Migraines during Pregnancy

Although many women have relief from their migraines while they are pregnant, you should take note of whether that lucky statistic includes you or not. Document whatever you think might have caused a migraine episode during your pregnancy. Keep a migraine diary and record any tension headaches along with the information listed above.

Preventing Pregnancy Migraines

Expectant mothers usually take steps to ensure they are living the healthiest lifestyle possible, but for migraine patients this is particularly important. Manage your risks for a migraine attack by paying attention to (and avoiding) your known triggers and getting enough sleep. Avoid stress with massage therapy, practice meditation, yoga, or other calming techniques and drink enough fluids to ensure your body doesn’t become dehydrated. Watch the news, and plan accordingly if you expect significant changes and active weather that could trigger your headaches.

If you're pregnant and experiencing headaches for the first time, or are a regular migraine sufferer, consult with your migraine specialist for help in identifying treatment and prevention strategies that are safe for your baby.