Migraine in pregnancy: when to worry and when not

The headaches, sensitivity to light, and nausea that accompany migraines are very annoying, and when you’re pregnant, the pain and discomfort can be amplified.

Although migraine in pregnancy is usually not a cause for concern, sometimes it can be an early warning of some pregnancy complications that could put the mother and the baby she is carrying at risk.

Migraine in pregnancy: things to know how to find relief and when to call the doctor

About 4 out of 10 women experience migraines in their lifetime and most before the age of 35, right around the time women are trying and experiencing pregnancy.

Women who suffered from migraines before pregnancy may notice changes during pregnancy: migraines may occur more frequently,

increase in intensity or be accompanied by new symptoms never experienced before becoming pregnant.

For example, you might experience a migraine attack with aura, with visual disturbances and flashes of light, or nausea and vomiting. These changes are likely triggered by the high levels of estrogen present in pregnancy.

In other cases, however, estrogens ensure that women who normally suffer from migraine during pregnancy are exempt from it. This is because estrogen remains high during pregnancy and does not decrease as it does before menstruation, when it decreases quickly causing attacks.

It may also happen that even women who do not suffer from migraine can experience the first episodes during pregnancy. They usually begin in the first trimester and then subside as the pregnancy progresses.

Migraines can also be triggered by lack of sleep and stress, situations that can occur frequently in pregnancy.

Why migraines are a cause for concern

There are some recent studies that have associated migraine in pregnancy with even serious complications of the same.

A study published in the journal Neurology showed that women who had high blood pressure and severe headaches were 17 times more likely to experience pregnancy complications, such as preeclampsia.

Preeclampsia , which affects 4 to 5 percent of pregnancies, can lead to preterm birth and low birth weight babies. Another study presented in April at the American Academy of Neurology found that women who suffer of severe migraines are more likely to have pregnancy complications, including preeclampsia, premature birth, and low birth weight babies. The study also found that women aged 35 and older are seven times more likely to experience these complications.

Robbins, an author of both studies and an associate professor of clinical neurology at the Albert Einstein College of Medicine in New York, explained that the increase in complications can have various causes. One of these is that migraine can be associated with other cardiovascular diseases such as arterial hypertension or psychiatric diseases such as anxiety and depression.

However, it is not clear why age over 35 can increase the likelihood of complications.

When to call the doctor

Call your doctor if you have never experienced migraines or severe headaches in the past, if the migraine has lasted for several hours, or if it is associated with nausea and vomiting.

Preeclampsia can come on very quickly. Even within 24 hours.

You should talk to your doctor if your migraines are accompanied with aura and you have never experienced it before, or if you experience numbness or tingling in your face or arms.

In addition to headaches, vision changes, nausea and vomiting, signs of preeclampsia can include pain in the upper right side of the abdomen and increased bloating.

How to deal with migraine

There are several things that can be done to manage migraines and prevent an attack.

  • Have a plan of action before pregnancy: If migraines are a problem, try to prepare yourself before pregnancy on how to deal with them. Talk to your neurologist and gynecologist to understand which drugs you can take and in which dosages you can use them during pregnancy.
  • Rest : Moving to a rather dark room to rest or take a nap can help reduce pain and other symptoms. It may also help to place a handkerchief moistened with cold water over the eyes.
  • Attention at the table : skipping meals and dehydration can trigger migraines.
  • Avoid certain foods : coffee, tea and chocolate can all be “migraine carriers”. But be careful because even eliminating caffeine when you discover that you are expecting a child can trigger migraines. If you are used to drinking coffee in the morning to start the day, perhaps it is appropriate to continue taking that cup even during pregnancy
  • What drugs ? We refer you to your doctor. Paracetamol is usually considered safe and effective in pregnancy but you shouldn’t overdo it, so define the doses with him.
  • Sleep must become a priority: sleeping little and/ or badly can promote migraines. Get help so you can dedicate the right time to sleep and rest.
  • Manage stress : While pregnancy is a happy time in a woman’s life, it can also be a source of worry about work, fear of childbirth, fear of not being good enough, and so on. It is very important to cope with these anxieties in order to manage stress and thus avoid migraines. Sign up for a yoga class for pregnant women, plan a second honeymoon with your partner or simply take time out every day to do something that relaxes you: a walk, a bath, a swim, reading a good novel they can do wonders in managing stress.

Kathryn Barlow is an OB/GYN doctor, which is the medical specialty that deals with the care of women's reproductive health, including pregnancy and childbirth.

Obstetricians provide care to women during pregnancy, labor, and delivery, while gynecologists focus on the health of the female reproductive system, including the ovaries, uterus, vagina, and breasts. OB/GYN doctors are trained to provide medical and surgical care for a wide range of conditions related to women's reproductive health.

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