The Myth-Busting Guide to Migraines and Pregnancy

If you’re reading this article, you’ve probably already heard some of the common myths about migraines and pregnancy. Some of these myths include:

• Headaches during pregnancy are normal and nothing to worry about.
• Your migraine attacks will go away when you get pregnant.
• You can’t use medications for migraine when you’re pregnant.
• You can take “painkillers” during pregnancy, but not migraine meds.

Let’s take a look at these myths and find some solutions.

Do Migraine Attacks Disappear During Pregnancy?

This is a difficult question because the statistics vary depending on the source – and depending on the trimester. You can read more details in Migraine During and After Pregnancy, but the short answer is that things probably do improve for some (more than half of) women during pregnancy and even up to a year after the birth of the baby (especially if the baby is breastfed). The biggest improvement is during the second and third trimester.

However, a significant number of women either experience no change, and a few actually get worse. For some women, the medication they have always relied on for migraine no longer works. You’re probably reading this article because you’re one of the many women struggling with migraine during pregnancy.

Are Headaches During Pregnancy Normal?

Common, yes. Normal, no.

Headaches can be dangerous, and that includes migraine headaches and other migraine symptoms (for example, migraine during pregnancy may increase your risk of stroke). In a moment we’ll discuss what to do, but for now let’s remember that your suffering actually can affect both you and your baby. Ignoring your pain because you think it will somehow help your baby is a strategy which probably won’t work well.

Drugs During Pregnancy

There are all kinds of myths about drugs during pregnancy. So let’s be honest. Prescribed medications for migraine may be an excellent choice for both you and your baby. However, not all “painkillers” are perfectly safe.

Also, many non-drug options have good scientific evidence behind them. If you choose not to use medications, you are most certainly not doomed to use “inferior” options.

What to do about Migraines and Pregnancy

Migraine and headaches should not be ignored. Although you have many other things to think about, including so many changes in your body, it is very important that you pay attention to your pain and what it may be telling you. (This actually includes more than just head pain – migraine itself can lead to pain in various parts of the body. Read more about the importance of identifying non-headache pain related to migraine: Warning Flag: Do you have non-headache pain?)

• Keep a journal of any pain and other symptoms that you’re experiencing. Make a note of how long a symptom such as headache lasts, how severe it is, what treatment you had for it (if any). For tips on using a simple page-a-week option, check out A Migraine Diary: The Lazy Way. You can also use an app on your phone, a document on your computer – whatever works for you. Your doctor may recommend an option especially for your pregnancy.
• Talk to your doctor. If your headache symptoms are new, see a doctor as soon as possible. Some headaches can be a signal of immediate danger. For example, some women with cerebral venous thrombosis may have headache as their only symptom. Neurological conditions, which may include headache as a symptom, are now a significant cause of death among pregnant women. (For more, read Headaches during Pregnancy: Not What You Think?) Even the pain of a tension-type headache or the symptoms of migraine may be dangerous – it’s worth it to check things out and find treatment as soon as possible.
• Talk to your doctor before taking “painkillers”. Some people still think that taking Tylenol or Advil is completely safe. We now know that there are risks (see for example this information about anti-inflammatory medications such as ibuprofen, and this research on acetaminophen / paracetamol). Although most doctors still consider acetaminophen/paracetamol to be low risk, these medications may not be the best for migraines and pregnancy anyway, as we’ll see in a moment.
• Weigh the risks of medications with your doctor. Going through severe migraine attacks during pregnancy is not good for you or your baby. Of course you do not want to take a medication that will harm your baby, but there are low-risk options available. For example, recent research has shown that triptan medications, abortive drugs that specifically target migraine, are safe for the baby during pregnancy (read more here), though they still may pose some risk to the mother. (See also Triptans are the first line migraine drugs in pregnant women) Your doctor will recommend medications based on your own situation and medical history, but don’t be afraid to consider these options.
• Consider non-drug treatments. There are excellent non-drug treatments, and some of them may work better for you than medications. In cases of a severe attack, intravenous magnesium will often stop the pain cycle. Magnesium supplements are also one of the best preventative treatments for migraine overall (more information here). Other excellent treatments include biofeedback, feverfew (particularly in combination supplements such as MigreLief), massage, the SootheAway device, and trigger point therapy, to name just a few. Do talk to your doctor – non-drug options sometimes carry risks as well.
• Find support. Although there are many excellent treatments available, they often take time. Don’t be afraid to ask family and friends for support during this time. When you’re experiencing so many changes, with headache or migraine symptoms on top of it all, you’re not going to be able to continue “life as usual”. Be patient, and ask for help if you can.

Finally, here are four things NOT to do when you’re struggling with migraines in pregnancy:

1. Don’t expect that everything will go as expected: You’ve read 27 books, talked to your friends and gotten advice from your Mom – and this is your 4th baby – but things may still not go as planned. You’re unique, and your baby is unique, and you’ve changed even over the past year.
2. Don’t panic! Yes, migraine is serious. Yes, you need to talk to your doctor. But you’re probably going to be all right. The above information is supposed to encourage you to pay attention and seriously consider treatment, it’s not supposed to make you panic about every headache. Many many women have made it through pregnancy just fine, and have even had some really happy times, in spite of headaches.
3. Don’t ignore what your body is telling you: It might seem like it’s just sending too many messages at times, but do your best to pay attention.
4. Don’t focus on the challenges and problems: Oh, easier said than done! Who does this writer think he is – emphasis on the he?! Yes, there’s no doubt it can be hard. You may need to get more help and support than you expected you would ever need. But you also need to make the choice to see the good things that are happening, if you possibly can. As I have said before, it is possible to experience happiness even when you’re plagued by migraine and/or headache. We can be realistic about the suffering that migraine can cause, and still encourage one another to be thankful for the good around us.

There is good help available for migraine. Following the steps above will give you a higher than average change of finding the treatment you need.

For more information, read about natural solutions for migraines and pregnancy from the Mayo Clinic, and this overview of migraines during pregnancy from WebMD.