If you have migraine and you get pregnant, your symptoms may change. Many women find their symptoms improve during pregnancy. But some women’s symptoms stay the same or get worse.
It’s important to talk to your doctor about changes in your migraine patterns during pregnancy so you can make a treatment plan.
On this page, find out how to manage migraine with safe treatments during pregnancy and after giving birth.
Migraine changes during pregnancy
Managing migraine during pregnancy
Migraine changes after giving birth
Managing migraine after giving birth
Caffeine and migraine during pregnancy and breastfeeding
If you have migraine, your triggers and symptoms may change during pregnancy. You may also need to try different treatments at this time.
Tell your doctor if your experience of migraine changes. They will ask about your health history, check your general health and work with you to make a treatment plan.
See your doctor straight away if:
For a small number of women, pregnancy is the first time they experience a migraine attack. This is more likely to be migraine with aura.
Talk to your doctor if you experience migraine symptoms for the first time while you’re pregnant.
Research suggests that migraine improves for most women during pregnancy. This often happens in the second and third trimesters, when female hormones are more stable.
Also, during pregnancy you have more natural painkillers called ‘endorphins’ in your body that help to relax your muscles and improve your blood sugar balance.
Some research suggests migraine with aura is less likely to improve or go away during pregnancy. In one small study of women with menstrual migraine, some women found their headaches got more intense during the first trimester but eased later on. Another small study showed if you have menstrually-related migraine you may be less likely to see improvements in the first and third trimesters.
A small number of women find their symptoms get worse or change during pregnancy. Also, triggers can be more intense during the first trimester. For example, if you have nausea, you might not eat regular meals or stay hydrated, which can cause migraine.
We need more research to see if migraine attacks during pregnancy cause health risks.
Some studies suggest women with migraine before their pregnancy may have increased risk of problems during pregnancy. For example:
If you’re concerned about migraine symptoms during pregnancy, see your doctor.
If you’re planning to get pregnant, talk to your doctor about your migraine symptoms and how to manage them. Depending on your situation, your doctor may recommend:
Migraine attacks can make you feel ill and stressed, so it’s important to consider the benefits and risks of taking medicine during pregnancy.
Two-thirds of women who have migraine take medicine for migraine during pregnancy, especially during the first trimester.
Talk to your doctor about the right treatments for you. They’re likely to recommend using the least number of medicines at the lowest doses during pregnancy. This will be different for everyone.
If you take medicines for migraine, make sure they are recorded in your pregnancy notes.
Your doctor will recommend you try pregnancy-safe medicines for migraine during pregnancy.
Ask them about the benefits and risks of using different medicines, including:
There are many things you can do to manage your migraine triggers during pregnancy.
When you’re pregnant, it’s especially important to look after yourself. Make sure you find time to relax, sleep, exercise, eat well and drink plenty of water. You can also ask family and friends to help with household tasks and other activities.
Nerve block injections are considered safe in pregnancy, particularly in the second and third trimesters. The medical name for this treatment is ‘greater occipital nerve block’ (GON).
Your doctor will inject a small amount of local anaesthetic and steroid into the back of your head to target a large nerve that is associated with migraine.
The injections can be used repeatedly during pregnancy and can provide weeks of relief.
You can try different natural therapies for migraine during pregnancy, including:
You can also try using a neuromodulation device to block the pain signal from nerves to brain. Ask your doctor to recommend a device.
After giving birth, hormonal changes and triggers, such as stress and fatigue, can cause migraine to return.
You might experience migraine again when your periods come back. Breastfeeding may delay the return of periods and migraine.
You may have migraine after giving birth, even if you have never experienced migraine before. But this is rare.
Talk to your doctor about concerns about migraine and ask them to help you make a post-birth treatment plan.
It’s important to prioritise your health after giving birth. When you’re feeling well, you’re more likely to be able to care for your baby.
Managing migraine triggers is one way to look after yourself during this time. You can also ask people to help with meals and chores to reduce the likelihood of stress triggering an attack.
Depending on your situation, you can:
If you’re breastfeeding, ask your doctor which medicines and doses you can use for migraine.
If you were using the Pill before pregnancy, ask your doctor when it’s safe to start taking it again.
Some people find that caffeine triggers migraine attacks. Others use caffeine to help prevent and treat attacks. Caffeine can be found in coffee, sports or energy drinks, soft drink, tea and some medicines.
If caffeine is helpful, you don’t have to give it up during pregnancy or when breastfeeding. But it’s a good idea to gradually reduce the amount of caffeine to 200 mg per day.
Pay attention to how caffeine affects you and your baby, and talk to your doctor if you have any concerns.
Read a fact sheet about migraine in pregnancy and breastfeeding on the Royal Hospital for Women’s website.
This information was developed in partnership with Migraine & Headache Australia.
This content has been reviewed by a group of medical subject matter experts, in accordance with Jean Hailes policy.
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