Obstetrics FAQs

What if I am pregnant and have a headache?

Headache is a very common complaint, and a very difficult problem to deal with via the internet, or any "call-in" type scenario. The vast majority of headaches in reproductive aged women are going to be benign and self-limited. First, one must clarify what type of headache you have. In clarifying the type of headache, we must be mindful of danger signs that mandate presentation to an emergency room. Some of these might be:

  • First time headache. The patient has never had headaches before.
  • High intensity headache. Described as the worst headache of a person's life.
  • Severe persistent headache which reaches maximal intensity within a few seconds.
  • Altered mental status or seizure accompanying the headache.
  • Concomitant infection ie sinus infection, fever.
  • Visual changes.
  • Headache with exertion.
  • Patients being followed for high blood pressure especially in the third trimester. May have swelling, visual changes and even abdominal pain.

If the patient has a history of migraines and the headache is typical, then we usually conclude that this is a migraine though many patients will notice an improvement in migraines during pregnancy. Tension headaches are very common during pregnancy. Typically, we recommend Tylenol 1000mg and before 32 weeks gestation, ibuprofen (ie advil,motrin) 800mg. We also recommend drinking a caffeinated beverage such as 12 oz. soda. Though we don't advocate regular caffeine consumption, episodic use is not contraindicated in this situation. We do not recommend using your midrin, or imitrex. If you call the on-call physician, you will likely be told to go to the emergency room for evaluation and pain medications.