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Pregnancy and Headache

Headache is a frequent cause of missed work, lost joy, and fractured interpersonal relationships. The common refrain “not tonight honey, I’ve got a headache” is not just a sitcom punch line, but a frequent reason why we are less likely to get on the floor and play with our children, laugh at our husband’s dumb jokes, or offer a pleasant smile at work. This is even true for those of us lucky enough to have a caring doctor.


During pregnancy, the issue is especially acute since pregnant women are appropriately reluctant to take medicines that may carry risk to their baby, and doctors are hesitant to offer treatment for fear of being sued. In addition, most women will suffer an increased number of headaches during the first trimester. Complicating the issue further is that most pregnant women will wait as long as possible before treating their head pain in the hope of avoiding medicine. This is often a mistake, as headache studies demonstrate that once pain has been present for several hours, it is much more difficult to eliminate.


In fact, oral pain medicines are less well absorbed in the midst of a prolonged headache, and therefore higher doses of medicines that were being avoided are then necessary. As the headache worsens, nausea and vomiting become more likely and the opportunity to use oral medicines disappears. Additionally, the after-effects of having a prolonged headache can be as uncomfortable as the headache itself. An already tired pregnant woman can feel wiped-out for days.


There are essentially no medicines considered by the FDA to be safe and effective for headache during pregnancy. Still, there are several medicines and interventions that are commonly employed. A few of these are listed below.


To prevent headaches:

1) Stay well hydrated.

2) Maintain a regular sleep pattern (both too much and too little sleep can trigger headaches).

3) Avoid strong odors such as cleaning agents and perfumes.

4) Take a daily walk.

5) Learn stress reduction techniques.

6) Avoid foods that are triggers for you.


For treatment (discuss all options with your doctor before proceeding):

1) Copious fluid intake.

2) Acetaminophen, and/or caffeine.—(Tylenol and a Mountain Dew)

3) Ice packs or cooling chemical pads.

4) Acupuncture, massage, biofeedback.

5) Emetrol (otc), phenergan, or holistic wristbands for nausea.

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