Headaches are common during pregnancy, affecting many individuals as their bodies undergo significant changes. Navigating pain relief requires careful consideration for both the expectant mother and the developing baby. Understanding which medications are safe, which to avoid, and non-pharmacological approaches is important.
Generally Permitted Medications
For headache relief during pregnancy, acetaminophen, known by brand names like Tylenol, is the primary recommended over-the-counter option. Most pregnant individuals can safely use acetaminophen for occasional headaches. This medication works by blocking nerve impulses that signal pain in the brain.
Acetaminophen is typically taken at a dose of 325 to 650 milligrams (mg) every four to six hours as needed. For extra strength formulations, a dose of 500 mg per caplet can be taken, with two caplets every six hours. Do not exceed a total of 3,000 mg within a 24-hour period to minimize risks. Always use the lowest effective dose for the shortest duration necessary. Consult with a healthcare provider or pharmacist before taking any medication during pregnancy.
Medications to Avoid
Certain medications should be avoided during pregnancy due to risks to the developing fetus. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (e.g., Advil, Motrin), naproxen (e.g., Aleve), and higher doses of aspirin, are not recommended.
Taking NSAIDs after 20 weeks of pregnancy can lead to serious complications, including kidney problems in the baby and low levels of amniotic fluid. This reduction can impair lung and kidney development. NSAIDs may also cause premature closure of the ductus arteriosus, a blood vessel in the baby’s heart. Studies have also suggested an increased risk of miscarriage with NSAID use in early pregnancy.
Triptans, a class of prescription drugs for migraines, require caution. While studies on sumatriptan, the most studied triptan, have been reassuring regarding birth defects, concerns exist about their vasoconstricting action affecting fetal blood vessels. Other triptans have less safety data. Ergot derivatives, an older class of migraine medications, are not recommended due to their strong vasoconstrictive effects and ability to stimulate uterine activity.
Opioid painkillers, including those prescribed for severe pain, carry risks when used during pregnancy. Opioids can cross the placenta and have been linked to problems such as premature birth, poor fetal growth, and specific birth defects, including heart conditions and abdominal wall defects. Opioid exposure in the womb can also lead to neonatal abstinence syndrome (NAS) in newborns, a withdrawal condition characterized by tremors, irritability, feeding difficulties, and respiratory problems.
Non-Pharmacological Strategies
Many drug-free methods can help manage headaches during pregnancy. Rest and optimizing sleep can alleviate tension headaches and migraines. Applying a cold compress to the forehead or neck can help reduce inflammation and constrict blood vessels, while a warm compress or shower may relax tense muscles. Maintaining proper hydration by drinking plenty of water is also beneficial, as dehydration can trigger headaches.
Regular meals and a balanced diet can help prevent headaches by maintaining stable blood sugar levels. Avoiding known headache triggers, such as certain foods or odors, is also a preventive measure. Managing stress through techniques like deep breathing, meditation, or yoga can contribute to headache prevention and relief. Physical activity, such as a daily walk or moderate aerobic exercise, can also be helpful. For some, biofeedback, a technique that teaches control over body functions, may assist in preventing or easing headache pain.
When to Consult a Doctor
While many headaches during pregnancy are benign, certain symptoms warrant immediate medical attention. Contact a healthcare provider if a headache is severe, sudden in onset, or persistent and does not improve with home remedies. Headaches accompanied by changes in vision, such as blurred vision or flashing lights, are concerning. Other red flags include sudden swelling in the face, hands, or feet, pain below the ribs, nausea, vomiting, dizziness, or fever.
New or worsening headaches, especially after 20 weeks of pregnancy, could indicate more serious conditions like preeclampsia. Preeclampsia is a pregnancy complication characterized by high blood pressure and organ damage, which can pose risks to both the mother and the baby. Prompt consultation ensures proper diagnosis and management of any underlying issues.