Can you get a pregnancy migraine?

Pregnancy causes a variety of changes in the body, and shifts in hormone levels and body shape can lead to many unexpected symptoms. For some women, migraine headaches may be part of a pregnancy, but there also may be treatments available to provide safe relief. Migraine is a health condition that can have many different symptoms in addition to headache.

Generally, headaches are common during pregnancy, and the most common types experienced by pregnant women are usually tension  and migraine headaches. However, 50% to 80% of women who experienced migraine headaches prior to pregnancy report fewer episodes while pregnant. This is likely due to increased levels of estrogen.

Among women who do experience migraine headaches during pregnancy, the frequency often declines during the second and third trimesters, but then they may increase during the postpartum period when estrogen levels decline.

During pregnancy, the symptoms of a migraine attack are similar to those that people who aren't pregnant experience, and include:

• Throbbing or pulsating pain on one or both sides of the head
• Sensitivity to sensory stimuli, like light, noise and smells
• Digestive problems, like vomiting, abdominal pain and nausea
  
• Sweating
• Chills
• Loss of appetite
• Scalp tenderness 

These symptoms may continue for a few hours or up to a few days. At the beginning of a migraine attack or shortly before, you may experience sensory symptoms called an aura. Around 15% to 25% of migraine sufferers experience aura symptoms, which may include:

• Temporary loss of vision or blind spots
• Seeing bright spots, flashes of light, waves or jagged lines
• Ringing in the ears
  
• Changes in sense of taste or smell
• Pins and needles sensation in the arms or legs
• Numbness or tingling of the skin
• Muscle weakness on one side of the body or face
  
• Trouble recalling words or inability to speak
• Slurred speech

During the hours or days before a migraine attack, you may experience a prodrome phase, marked by the following symptoms:

• Irritability and mood swings
  
• Sensitivity to noise and light
• Food cravings
• More frequent urination
• Stiff muscles
  
• Problems concentrating or reading
• Insomnia and fatigue
• Yawning

About 80% of migraine sufferers have symptoms after an attack during what's called the postdrome phase. Some people experience feelings of elation, while others describe being depressed or extremely fatigued. Brain fog and trouble concentrating are also common post-migraine symptoms. 

It's important to report any symptoms you are experiencing to your healthcare provider. Symptoms of migraine can mimic more serious conditions during pregnancy that need treatment, such as hypertension and preeclampsia.

Some common migraine treatments may pass through the placenta and pose risks to a baby. As a result, medical providers exercise caution when recommending treatments. Not all medications and treatments are ideal for all pregnant women, making it important that you talk to your healthcare provider before taking any medication.

Trigger tracking and avoidance

• Many things can trigger migraines, such as:
• Alcohol
• Aged and processed foods
• Aspartame
• Bright lights
• Too much caffeine or a lack of caffeine
• Changes in sleep patterns
• Exercise
• Loud noise
• Monosodium glutamate (MSG), a food preservative
• Sex
• Skipping meals
• Stress
• Strong odors
• Weather

Healthcare providers may recommend that pregnant women keep a migraine journal, recording their activities, diet and fluid intake for each day and noting when they experience migraines. Over time, this may help you identify triggers, and you can then take steps to avoid these triggers during pregnancy.

If you never had a migraine attack before you were pregnant, they may subside within a few months of delivery. However, migraine may persist in some women. Your healthcare provider can continue to adjust your migraine treatment plan during the postpartum period and beyond as needed to manage pain and potentially decrease the frequency of attacks.

Whether you're a long-time sufferer of migraine attacks or experiencing the issue for the first time, talking to your healthcare provider about your symptoms is important during pregnancy. Any headache that’s accompanied by vision loss, one-sided numbness or weakness, or other neurological symptoms should be reported to your provider immediately. They can also help you explore over-the-counter migraine pain relief products and prescription medications for migraine relief that are safe for you and your baby. In addition, you can discuss lifestyle changes and other nonmedicinal interventions that can help you deal with migraines during pregnancy.

Updated by Julie McDaniel, MSN, RN, CRNI, February 2025.