Headaches in pregnancy

Headaches are common in pregnancy, particularly in the first trimester, and they’re usually harmless — often driven by the surge of hormones, plus everyday triggers like tiredness, dehydration, hunger, stress, and cutting back on caffeine. For most people they ease off as the pregnancy settles, especially by the second trimester.

There’s a lot you can do to prevent and ease them without reaching for medication. Many pregnancy headaches respond to the simple things: drinking enough water (dehydration is a sneaky trigger), eating regular meals so your blood sugar doesn’t dip, getting enough rest, and managing stress with gentle movement, fresh air and a bit of downtime. If you’ve suddenly reduced your caffeine, a gradual cut-down rather than going cold turkey can spare you the withdrawal headache. A cold or warm compress on your head or neck, resting in a dark quiet room, and gentle neck and shoulder stretches can all help in the moment.

If you do need pain relief, paracetamol is generally considered safe in pregnancy at the recommended dose — but it’s worth checking with your pharmacist, GP or midwife, especially about how much and for how long. Importantly, avoid anti-inflammatory painkillers like ibuprofen in pregnancy (particularly later on) unless your doctor has specifically advised them, and don’t take any other headache or migraine medications without checking they’re safe. If you have migraines, tell your care team, as your usual medications may need reviewing.

Here’s the part that matters most. From around the middle of pregnancy onwards, a headache can occasionally be a warning sign of pre-eclampsia (a condition involving high blood pressure), so it’s important to know when a headache needs prompt attention. Contact your midwife or maternity unit straight away if you have:

• A severe headache, or one that won’t go away with rest and paracetamol
• A headache with vision changes — blurring, flashing lights or spots
• A headache with sudden swelling of your face, hands or feet
• A headache with pain just below your ribs, or feeling suddenly unwell

These, especially together, warrant a check rather than waiting. It’s also worth seeing someone for a headache that comes with a fever and a stiff neck, or one that feels suddenly and unusually intense (“the worst headache of your life”).

It’s worth keeping a mental note of your own triggers, because they’re often predictable once you look — a skipped meal, a poor night’s sleep, too little water, a stressful day, or a screen-heavy afternoon. Heading those off is easier than treating a headache once it’s taken hold. Many people find gentle neck and shoulder massage, a walk in fresh air, or simply lying down in a cool, dark room for twenty minutes does more than any tablet. And if headaches are becoming frequent, or are new for you, mention it at your next appointment even if none of the red flags apply.

For the everyday tension or hormone headache, though, rest, water, food and a little paracetamol if needed usually do the trick. Keep an eye on the warning signs, look after the basics, and don’t hesitate to call if a headache feels different from your normal.