Migraine and pregnancy 

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 relax your muscles and improve your blood sugar balance.

Studies suggest that certain types of migraine, for example, migraine with aura and menstrual migraine, are less likely to improve during pregnancy. But more research is needed to better understand this.

A small number of women find their symptoms get worse or change during pregnancy. Triggers can be more intense during the first trimester, especially if nausea makes it hard to eat and stay hydrated.

Some studies suggest women with migraine before their pregnancy may have increased risk of problems during pregnancy. For example:

• pre-eclampsia (a serious condition that can affect mother and baby)
• heart (cardiovascular) changes
• miscarriage
• caesarean section
• giving birth to a child with low birth weight.

But more research is needed to understand this.

If you’re concerned about migraine symptoms during pregnancy, see your doctor.

If you’re planning a pregnancy, ask your doctor about a migraine treatment plan. Depending on your situation, they may recommend:

• different ways to manage hormonal migraine after your stop using the Pill
• good trigger management habits that you can continue during pregnancy
• new medicines that are safe to use during pregnancy.

Migraine attacks can make you feel unwell, 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 your doctor records them 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:

• painkillers
• anti-nausea medicine
• migraine-prevention medicines.

After giving birth, hormonal changes and triggers, like 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 if you have concerns about migraine and ask them to help you make a post-birth treatment plan.

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
• 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.

Tell your doctor if your experience of migraine changes during pregnancy. 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:

• you experience new symptoms, such as visual changes, weakness, numbness, tingling or changes to speech or swallowing
• your head pain changes, for example, the type, location and frequency of pain
• you get high blood pressure during pregnancy
• you get unusually severe or sudden head pain.