Headaches caused by migraines can be debilitating and severely interfere with day-to-day activities. For some, migraines may begin during pregnancy, while chronic migraine sufferers find relief from their symptoms.
Migraines can last for approximately 4 to 72 hours and occur with or without an aura.
During pregnancy, migraines often improve for chronic sufferers while some may experience a migraine for the first time.
There are several risks of migraines during pregnancy that can affect you and your developing baby.
There are many non-medication options that can bring migraine relief.
Medication options for migraine treatment are limited during pregnancy; but there are many natural ways that can bring a migraine relief.
What is a migraine?
Migraines are severe headaches characterized by severe throbbing or pulsing within the head on one or both sides. Anyone, including children, can experience migraines. Generally, there are four stages to a migraine attack, although every sufferer may not experience every stage.
- Prodrome. Symptoms may occur a few days before a migraine attack. Possible symptoms include constipation, mood changes, food cravings, neck stiffness and fluid retention;
- Aura. An aura is gradual onset warning sign that can occur before or during a migraine. Often auras are visual symptoms such as seeing shapes, bright spots or flashes of light;
- Migraine attack. The length of time and frequency of migraines can vary between individuals but an attack generally lasts 4 to 72 hours. Often a migraine can be accompanied with nausea and vomiting and noise, light and sound sensitivities;
- Postdrome. Migraine attacks can leave you feeling exhausted and confused. A postdrome period may last up to a day.
Pregnancy hormones and migraines
Pregnancy causes a major hormonal shift within the body. While 50-80% of people may report an improvement in their chronic migraines during pregnancy, others may experience migraines for the first time. Women’s naturally cycling estrogen levels are thought to impact migraines.
During pregnancy and breastfeeding, estrogen levels remain high and stable. This stability may decrease the severity and frequency of migraines. Unfortunately for others, pregnancy can worsen migraine attacks, especially during the first 12 weeks. This worsening may be associated with changes in a medication regimen used to manage migraines that are not considered safe while pregnant or breastfeeding.
It is important to keep open communication with your obstetrician or midwife. A person suffering from migraine sand feeling no symptom relief during pregnancy should be closely monitored for blood pressure increases and the development of pre-eclampsia — a serious pregnancy-related high blood pressure complication.
Risks of migraines during pregnancy
The risks of migraines for developing babies have not been well studied. Yet, there have been some studies that have found correlating risks for a developing infant and for the pregnant parent that experience migraines.
The identified risks for infants include the following:
- Low-birth weight;
- Pre-term birth;
- Intensive care admission for baby;
- Respiratory distress syndrome;
- Febrile seizures;
A study also found a relationship between migraines and cardiovascular diseases during pregnancy, such as:
- Heart attack or a heart disease;
- Pulmonary embolus or venous thromboembolism;
- High blood pressure;
- Pre-eclampsia or gestational hypertension.
However, more research on these associations is needed.
Managing the migraine pain
Suffering from a migraine can be frustrating, especially if you're pregnant. However, there are ways how you can safely achieve a relief.
Here's how to manage the pain from a migraine without medication:
- Find a dark room. Try to rest there during a migraine attack;
- Try alternative medicine therapies. Acupuncture, massage, reflexology, and aromatherapy may be used under the guidance of a qualified practitioner, as there are several acupuncture points, trigger points, and certain essential oils that should be avoided in pregnancy;
- Get enough sleep. Good sleep habits are always essential but especially during pregnancy. Your body is doing tremendous work creating a human;
- Stay hydrated. Dehydration can be a migraine trigger. During pregnancy, your body’s water needs are substantially higher. Be sure that you are drinking enough water, at least 8-12 cups a day.
The risks versus benefits must be considered with medications during pregnancy. Migraine-induced vomiting can cause dehydration and electrolyte imbalances, and relief becomes necessary for the migraine sufferer and the developing baby.
Limited information exists on the safety of migraine medications because of the inability to conduct clinical trials that include pregnant and lactating people. Any medications must be used under the guidance of your obstetrician or midwife. Some pharmacologic solutions can include:
- Acetaminophen (Tylenol);
- Diphenhydramine (Benadryl);
- Intranasal lidocaine;
- Metoclopramide (Reglan, anti-nausea).
There are second-line medications that may also be considered if migraine attacks require further treatment. Opioid medications, aspirin, indomethacin, and ergots are generally not recommended in pregnancy.
When a migraine could be something more
It is especially important to speak with your obstetrician or midwife if you are experiencing a migraine for the first time while pregnant. It is essential to rule out other possible causes, such as:
- High blood pressure and pre-eclampsia (especially, if accompanied by visual changes and pain in the area of the liver);
- Cerebral aneurysm;
- Intracranial venous sinus thrombosis.
More often than not, migraines are not a worrisome part of pregnancy, but it is important to talk to your obstetrician or midwife about any concerns that you may have.