It's not unusual to get tension headaches when you're pregnant, especially in the first trimester. Tension headaches — the most common kind of headache — can feel like a squeezing pain or a steady dull ache on both sides of the head or the back of the neck. If you've always been susceptible to tension headaches, pregnancy can make the problem worse.
Experts don't know exactly why carrying a child tends to make your head ache more often, but one good guess is the hormonal free-for-all that's taking place in your body. Going cold turkey on caffeine can also make your head pound.
Other potential culprits include lack of sleep or general fatigue, sinus congestion, allergies, eyestrain, stress, depression, hunger, and dehydration.
For most pregnant women, headaches tend to diminish or even disappear during the second trimester, when the flood of hormones stabilizes and the body grows accustomed to its altered chemistry. What about migraines?
Migraines are another common type of headache. Experts estimate that about one in five women has a migraine headache at some time in her life, and about 15 percent of migraine sufferers get migraines for the first time when they're pregnant (most often in the first trimester).
Migraine headaches cause moderate to severe throbbing pain, typically on one side of the head. They last from four to 72 hours (if untreated) and are aggravated by physical activity. They are also accompanied by other symptoms, such as nausea, vomiting, or sensitivity to light and noise.
Some migraine sufferers have what are known as migraines with aura — that is, headaches that are preceded by symptoms that may include visual changes (such as bright flashing lights or blind spots), sensations of numbness or "pins and needles," weakness, and speech disturbances. These symptoms may start as long as an hour before a migraine and may last up to an hour.
Fortunately, about two thirds of women who are prone to migraines notice that they improve during pregnancy. (This is more likely if your migraines tended to be worse around your periods or started when you first began menstruating.) Others notice no change or find that their headaches become more frequent and intense.
Even if you're part of the unlucky minority whose migraines don't improve during pregnancy, you can at least take some solace in the fact that migraine sufferers don't appear to have a higher risk of pregnancy complications than other women.
Most headaches during pregnancy are unpleasant but harmless, but a headache can be a sign of a more serious problem. If you're having a migraine or other severe headache for the first time ever, you'll need a full medical evaluation to be sure nothing else is going on.
In the second or third trimester of pregnancy, a headache could be a sign of severe preeclampsia, a serious pregnancy-induced syndrome that includes high blood pressure, protein in the urine, and other changes. Preeclampsia can come on suddenly, so it's very important to be aware of the symptoms.
Call your midwife or doctor right away if you notice swelling in your face or puffiness around your eyes, more than slight swelling of your hands, or excessive or sudden swelling of your feet or ankles.
Sudden swelling is caused by water retention that can also lead to rapid weight gain, so let your caregiver know if you gain more than 4 pounds in a week.
Be aware, though, that not all women with preeclampsia have obvious swelling or dramatic weight gain — and not all women with swelling or rapid weight gain have preeclampsia.
With more severe preeclampsia, you may experience other symptoms. Call your caregiver immediately if you have any of these warning signs:
Severe or persistent headache
Vision changes, including double vision, blurred vision, seeing spots or flashing lights, sensitivity to light, or temporary loss of vision
Intense pain or tenderness in your upper abdomen
Nausea and vomiting
Symptoms can vary from woman to woman, and preeclampsia can occur without any obvious symptoms, particularly in the early stages.
Some symptoms of preeclampsia, such as swelling and weight gain, may seem like normal pregnancy complaints, so you might not know you have the condition until it's discovered at a routine prenatal visit. This is one of the reasons it's so important not to miss your appointments.