Headaches during Pregnancy: Not What You Think?

Your girlfriends have given you lots of ideas about what to expect during pregnancy, including what to expect regarding headaches.  This will especially be true if headaches made a significant impact on your life before you were pregnant.

All this advice can be very useful.  But it can be dangerous if you don’t do two key things that you should be doing.

Specialists Kirsty Revell and Paul Morrish recently teamed up to look at the data regarding headaches and pregnancy.  Their findings were published in the journal The Obstetrician & Gynaecologist this spring (see “Headaches in pregnancy“).

First, and as expected, 90% of headaches experienced during pregnancy were from tension-type headache and migraine.  “Tension-type” headache, so called because we used to think it came from muscle tension (now we know it’s a more complex neurological headache), and migraine which may improve or get worse during the course of the pregnancy, though it tends to improve during the last trimester.

These headaches, though common, may be quite serious for a number of reasons.  Doctors are rethinking how we approach headache in pregnant patients.  There are good drug and non-drug options for pregnant women.

Some headaches can be more immediately dangerous for pregnant women, especially if not recognized and treated properly by a doctor.  For example, patients with cerebral venous thrombosis may have headache as their only symptom.  If the headache is ignored, the blood clot could lead to stroke, or even be fatal.

Neurological conditions, which often show themselves as various types of headache, are now the third most common cause of death in pregnant women.  And sometimes it takes a neurologist to properly diagnose and treat the issue.

So what are the two key things you must do in order to stay safe during pregnancy, when it comes to headache conditions?

First, pay attention to the symptoms you’re experiencing, especially when they’re related to headache.

The changes you experience during pregnancy may seem overwhelming, and it could be tempting to just say that it’s “normal” (after all, your friend said this would happen), or just a minor thing among the 289 other things you need to mention to your doctor.

But headache is not normal, and can be dangerous.  Especially if it changes or gets worse.  If you notice any unusual symptoms, or your headaches get worse, pay attention to what your body is telling you.  If possible, write down the details.

If you already have migraine, you may notice that the headaches improve, but you still experience visual aura, or that the aura changes.  Pay attention.

The second thing you need to do should be obvious – talk to your doctor.  She may simply tell you to keep an eye on the symptoms, or to take advantage of a treatment for the pain.  And that may be all you need.  But she also may refer you to a specialist for further testing.

It may seem like just another thing to worry about for such a “small” thing like a headache.  But the referral could save you serious problems in the future.

Watch for changes.  Talk to your doctor, even if the changes are small.  And if symptoms continue to worsen or have a major impact on your life, make sure your doctor is listening and finding you the treatment you need.