Pregnancy and Breastfeeding with Migraine – Assessing Risk

A study from Norway, published last month in BMJ Open, raised some interesting questions about women with migraine who are pregnant and breastfeeding. In this case, though, it wasn’t a study about treatment options, but a general investigation about what women think about treatments.

Here’s a quote from the study abstract that says it all: “Women with migraine severely overestimated the risk associated with migraine pharmacotherapy in pregnancy.”

In other words, in the opinion of the authors, women are overestimating just how potentially dangerous pharmaceutical drugs are for the baby.

First of all – I think it’s actually good that mothers “overestimate” the risk, because doctors and researchers may often “underestimate” the risk. We should all be thankful for picky, “paranoid” mothers who have saved us from a lot of troubles in life.

Philosophy aside, however, it’s not necessarily a good thing that women “severely” overestimate the risk. Why?

First, because overestimating the risk of medications probably means you’re also underestimating the risk of migraine. Yes, migraine itself carried a risk. It’s not simply a matter of “enduring pain for the sake of the baby”. That pain may do damage beyond the momentary, and may lead to other health issues, not to mention impacting your ability to mother. Migraine treatment is important, both in the short term and in the long term, for both you and your baby.

Second, you may be suffering through the pain needlessly. There may be good treatments available to you that you are avoiding based on outdated information.

Also, we need to recognize that prescription migraine drugs are not necessarily riskier for the baby than over-the-counter painkillers. So don’t run to the local drugstore assuming that will be safer than your doctor’s prescription. Talk to your doctor – and then weigh the risks. If possible, talk to a migraine specialist.

It’s wise to be extra-cautious for the sake of your baby. But be sure you’re not making assumptions that are going to make your health worse, when you can actually get some good treatment. And don’t stop taking preventative medication without talking to your doctor.

For more on migraine and pregnancy, check out The Myth-Busting Guide to Migraines and Pregnancy.

The study abstract is here (with a link to the full text): Risk perception, beliefs about medicines and medical adherence among pregnant and breastfeeding women with migraine