22 March, 2022
Migraines can be horrifically debilitating or a mild inconvenience on other occasions. They vary dramatically in their presentation, triggers and patterns. Some people have severe throbbing headaches, while others have atypical migraines without headaches. Some can push on through the day, while others are locked in a dark room avoiding all stimulation.
However they present, migraines are a drain.
Combine that with all the changes occurring during pregnancy. Your belly and chest expand. Your blood volume increases by 50%. Your hormones rapidly rise. Your heart changes size and shape. You need to eat and drink more.
So how do migraines change during pregnancy? Do migraines change how the pregnancy will progress? How can migraines be managed drug-free when trying to conceive through to breastfeeding?
How Pregnancy Affects Migraines?
For many migraine sufferers, migraines improve during pregnancy. This is especially true for those who get migraines "without aura" - meaning without extra symptoms like dots in the vision.
With pregnancy there’s changing hormone levels which can trigger some types of migraines. The changing oestrogen levels during pregnancy may set off migraines for some women.
There’s also the postural changes, tight muscles and strained neck & back as your belly gets bigger and the waddle more prominent. You might suddenly cut caffeine and change your diet when you find out you're pregnant - around a quarter of pregnancies are unplanned so the dietary changes can be sudden and extreme.
Half of the increased blood volume occurs in the first 2 months of pregnancy. The extra blood coursing around your body can contributing to a pulsating headache.
How Migraines Affect Pregnancy?
Migraineurs have a slightly higher risk of developing pre-eclampsia during pregnancy (Aukers et al. 2019). Pre-eclampsia is a combination of high blood pressure and other symptoms, which can be similar to migraines like spots in your vision.
Women who suffer migraines are also more likely to be diagnosed with gestational diabetes (EAN 2021). This is where your blood sugar levels rise during pregnancy and return to normal levels after pregnancy. You might then go on to develop type two diabetes later in life after being diagnosed with gestational diabetes.
Anxiety and depression are more common in migraineurs (Welander et al. 2021). It's important to know this to be aware of how you are feeling. Maybe you have a history of mental health. When you are pregnant, this is a time to nourish yourself and be responsive to how you are feeling.
Being a migraine suffering doesn't mean you'll get pre-eclampsia, gestational diabetes or anything else. It just means you need to be aware you are at a very slightly higher risk than someone who doesn't have migraines.
It provides a great opportunity to be proactive. As the old adage says: prevention is the best cure! So eat healthy, exercise regularly and monitor your stress levels. These are helpful for anyone, especially pregnant women, regardless of migraine status.
You can find out more about exercising during pregnancy or healthy eating during pregnancy here. Otherwise you can speak directly with your dual qualified pregnancy chiros / pilates instructors or women's health dietitian.
Migraine Treatment Options while Pregnant
Many medications are considered safe during pregnancy however all medications should be checked with your obstetrician, neurologist or GP. Sometimes medication and dosage needs to be changed during pregnancy and breastfeeding - or stopped all together.
Experts disagree how safe painkillers are during pregnancy. Some research suggests that panadol shouldn’t be taken during pregnancy (Bauer et al. 2021).
Stress is a common trigger for migraine sufferers. Falling pregnant, pregnancy and early parenthood are frequently stress inducing due to the sheer magnitude of changes occurring.
Finding time each day to do something that calms and soothes your nervous system is important. During pregnancy, it can also be a nice way to connect with your baby. For example, you might focus on breathe work. As you take a deep breathe in, your belly expands, giving baby the beautiful oxygen it needs to grow and thrive. As you breath out, gently engaging your core muscles, you hug baby close to you.
Getting adequate sleep
Fatigue is another common trigger for migraines.
Sleep during pregnancy can be tough! Finding a comfortable position, battling pains, stress, nausea, toilet runs, heartburn. There’s so many changes throughout pregnancy that can impact sleep.
Maybe the medications or supplements that you previously used to help drift off can’t be used during pregnancy.
An entire post could be written regarding sleep during pregnancy! It’s a big topic.
Simple sleep tips include:
- Avoid screen time prior to bed. Add night shift or blue-light reducing software on your phone, tablet and computers if you must use them prior to sleep.
- Drink plenty of water during the day and tapper off after dinner time. Bubs will push up against the bladder but it’ll less frequently interrupt your sleep if your bladder not full.
- Have a consistent bedtime and wind-down routine.
- Use calming essential oils. Lavender and orange are frequently used together for sleep.
- Avoid caffeine in the afternoon and evening. In fact, during pregnancy, you should be limiting your caffeine intake regardless. Find out more here about how much caffeine is safe during pregnancy.
- Sleep with pillows around you for support. As your belly grows, it may be more comfortable to have a pillow under the belly. Many women enjoy a pillow between their legs to take the strain off the pelvis. We’d suggest having a pillow between the knees and feet to keep the pelvis from twisting.
Releasing Body Tension
More than that, more and more people see their chiropractor or osteopath to create space for baby to grow and then descend in labour. Being active and flexible during labour helps the birth process and eases the healing journey.
Diet for Migraines
Many foods that can trigger migraines are limited during pregnancy. Alcohol and soft cheeses being two big examples.
During pregnancy and breastfeeding, your water requirements increase. Being dehydrated can trigger or exasperate migraines. It’s recommended to have 3-4 extra cups of water a day during pregnancy (RANZCOG 2018).
Acupuncture for Migraines
Acupuncture can help reduce the intensity and frequency of migraines (Ou et al. 2000). More than that, acupuncture is safely used by many pregnant women to ease their back pain, nausea and assist their preparation for birth.
About the Author
Dr Cassie Atkinson-Quinton - Chiropractor, Neuro-Rehabilitation Therapist, Women's Health Lover
Women are complicated and beautiful creatures. Our unique physiology makes us more susceptible to migraines, chronic pain, autoimmune conditions, Alzheimer's, gut issues, anxiety and more. Our hormonal changes through puberty, menstrual cycle, pregnancy, breastfeeding and menopause can all upset the fine balance in the body & brain. This is what fascinates Dr Cassie and has driven her to study clinical neuroscience in depth and continues to learn at University of NSW with a Graduate Certificate in Women's Health Medicine. Her approach to practice incorporates the body-brain-hormone connections.
Similar articles you'll enjoy:
- Aukes AM, Yurtsever FN, Boutin A, Visser MC, de Groot CJ. Associations between migraine and adverse pregnancy outcomes: systematic review and meta-analysis. Obstetrical & gynecological survey. 2019 Dec 1;74(12):738-48.
- Bauer AZ, Swan SH, Kriebel D, Liew Z, Taylor HS, Bornehag CG, Andrade AM, Olsen J, Jensen RH, Mitchell RT, Skakkebaek NE. Paracetamol use during pregnancy—a call for precautionary action. Nature Reviews Endocrinology. 2021 Sep 23:1-0.
- Bronfort G, Haas M, Evans R, Leininger B, Triano J. Effectiveness of manual therapies: the UK evidence report. Chiropractic & osteopathy. 2010 Dec;18(1):1-33.
- Clinical Practical Guidelines: Pregnancy Care [Internet]. RANZCOG; 2018 [cited 28 November 2021]. Available from: https://ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-MEDIA/Women's%20Health/Patient%20information/Pregnancy-Care-Guidelines.pdf
- Migraine in pregnancy and post partum- epidemiological and clinical characteristics. Presented at the EAN Congress 2021
- Ou MQ, Fan WH, Sun FR, Jie WX, Lin MJ, Cai YJ, Liang SY, Yu YS, Li MH, Cui LL, Zhou HH. A systematic review and meta-analysis of the therapeutic effect of acupuncture on migraine. Frontiers in neurology. 2020 Jun 30;11:596.
- Welander NZ, Mwinyi J, Asif S, Schiöth HB, Skalkidou A, Fransson E. Migraine as a risk factor for mixed symptoms of peripartum depression and anxiety in late pregnancy: A prospective cohort study. Journal of Affective Disorders. 2021 Dec 1;295:733-9.