What to Know About Headaches During Pregnancy

"I love being pregnant. I like it more than not being pregnant. But the headaches, my god the headaches. Someone...please help. Don't say water. Or Tylenol. Or iron. Or magnesium. I need witchcraft."

Yes, Chrissy Teigan told it straight, back when she was pregnant with baby Miles in December 2017. Pregnancy headaches can make you want to slap the man sitting next to you. It's a bitter irony that pregnancy headaches happen at the same time as pregnancy, so, no you can't have any Advil. But if knowledge is power, here's why they happen and what you can do.

When you are pregnant, what you had previously thought of as your body gets remodeled into something like a single bedroom apartment with a giant waterbed. The waterbed houses a new roommate who stretches your ligaments, pushes your organs up into your chest, pumps you full of hormones, tugs on your back, eats up your food, drinks your water, and uses up lots of energy. And all of these things can cause headaches. Most of the time pregnancy headaches are normal, but it's also good to make sure your headaches aren't a symptom of something more serious.

According to Sarah Prager, M.D., an associate professor in the Department of Obstetrics and Gynecology at the University of Washington, dehydration is probably the most common cause of pregnancy headaches. "Women need to hydrate more than usual, and this is worse if they have significant nausea or vomiting," she says.

Let's recap: you are tired, you might feel ill, you are running around trying to gather the approximately five gazillion things you will need for a tiny new human, and now you need to drink EVEN MORE than normal? Yes. Your new roommate needs water too, and when you don't drink enough for the both of you, a headache is often the unpleasant reminder.

Here the treatment is simple: drink more fluids. And maybe consider something that helps you remember to drink throughout the day. The Fitbit has a fluid intake tracker, there are apps for your phone, and you can even buy a water bottle that reminds you to drink. Though Fitbit and other companies still lack "pregnancy mode," another benefit of health trackers while pregnant is that you can see just how hard your body is working. As one woman who posted her results online wrote, "It is a test of strength and endurance simply to carry a child to term and give birth." Don't forget to hydrate during your marathon.

Another likely cause is muscle stress. Especially in the third trimester, your baby is pushing things around. The organs that normally occupy your torso are literally squeezed up into your chest cavity, you have something about the size and weight of a bowling ball pulling on you, and your ligaments have gotten stretchier. These headaches are tension headaches, so anything that helps with muscle tension can help relieve the pain. That could include massage, warm or cool compresses, relaxing music, meditation, herbal tea, relaxing scents like lavender or botanical oils, a warm rice sock, or a bath. (Just make sure the bath is not too hot, and no, nobody knows exactly how hot that would be.)

There are a dozen other reasons. Some of these are sleep deprivation, stress, hormone fluctuations, low blood sugar, not enough protein, iron, magnesium, or calcium in your diet, food sensitivities, and caffeine withdrawal. If you can, try to determine the trigger. Do you get headaches when you are hungry or go too long without eating? You might need to even out your blood sugar by eating smaller meals, more often.

Migraines are a special form of headache hell. Severe, pulsing pain on both sides, migraines can build over minutes or hours and make you sensitive to light and even throw up. Some women get fewer migraines while pregnant, while others find that pregnancy brings them on. Pregnancy migraines generally have the same causes as less debilitating headaches, but hormone changes are especially to blame.

Virginia Christian, 38, who is pregnant with her third child, says the migraines that began early in this pregnancy were so bad she missed work. "I would get massive headaches and get sick and try to rehydrate and get sick. I lost weight. They were just really making me ill." Now in her last trimester, Christian says her headaches are less frequent, but nothing she tried really helped. Her pregnancy has been so rough that she never wants to do it again. "This one will definitely be the finale," she says.

Christy Batts was 25 and having her third baby when she started getting migraines. "Before when I had a headache it was something I could point to and say, 'yes, this is the cause, and it is temporary,'" she says. Her midwife suggested teas and tinctures, homeopathic treatments, herbs, heat, and ice, but nothing worked. Finally, in desperation, she tried a chiropractor. "I didn't think I was one of those people who went to chiropractics," Batts says, "but I had two other kids and I wasn't ready to be bed-bound with the lights off." The chiropractor made minor adjustments on Batts' hips and massaged a pulled ligament, and she says her headaches stopped.

Anthony Noya of Noya Chiropractic in Washington, D.C., is not surprised. "There are a whole lot of postural changes that happen during pregnancy," he says. And according to Noya, if the structure of the body is off, it can't function properly. As you can imagine, pregnancy can throw a body off-center. "The spine and the human frame is really this complex game of Jenga," he says.

As he explains it, the brain sends messages down the spinal cord, which connects to nerves and tissues in the body, and these guide hormones and other processes. If there is something putting pressure on these highways, the messages don't work the way they should, and headache can be a result. "It's not necessarily treating headaches, it's how do we get the body back to normal," Noya explains of chiropractic treatment.

Most of the time, pregnancy headaches are a normal, if painful and irritating, part of pregnancy. But sometimes they can signal something more serious. Blood pressure spikes can also cause headaches, so severe headaches in the last trimester can be a sign of preeclampsia. Prager says pregnant women should pay attention to "headaches that don't go away with hydration and rest; visual changes; and anything that feels really different."

Fortunately, pregnancy headaches often get better with time or treatment. No matter what the cause, if you have pregnancy headaches, try to rest and be kind to yourself. Pregnancy is both a totally normal and totally extraordinary process — and, as you may have heard, some aspects of it may hurt a little.

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