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Migraine And Pregnancy

Pregnancy also influences migraine. Some women with migraine find their attacks disappear completely, occur less often, or are milder during pregnancy. Attacks either worsen or remain unchanged in others.

If you're planning pregnancy, be sure to tell your health-care provider. He or she will work with you to manage your migraines, including reviewing medicines that are safe for you and your baby. It makes sense to avoid taking medicine during pregnancy. However, if your migraines are very bad, there are medicines and non-drug treatments that have been used safely during pregnancy which should be discussed with your doctor. The Food and Drug Administration has a system for coding the suitability of medicines for women during pregnancy, and your healthcare provider can explain it to you.

Increased estrogen levels early in pregnancy can protect against migraine. As many as 7 out of 10 women gain relief of migraines during pregnancy. Even if headaches persist during the first trimester, they usually disappear after that. Menstrual migraine is the type most likely to improve during this time. One medical expert has noted that during pregnancy, migraine in women:

  • improves or disappears in 69%
  • remains unchanged in 8%
  • varies in 5%
  • worsens in 7%
  • appears for the first time in 11%

Research has shown that migraines do not harm the baby. There was no difference in pregnancy outcomes between mothers who had migraines and those who did not.

However, if migraines are associated with nausea, vomiting and dehydration, pregnant women should ask their healthcare providers about potential risk to the fetus and treatment for these symptoms.

Treating Migraine During Pregnancy

Non-drug treatments — relaxation techniques, regular sleep, massage, ice packs and biofeedback — should be tried first. A medical study has shown these treatments can be very effective: symptoms improved in 79% of women, with an overall 72.9% reduction in headaches.

If drug treatment is required, the following may be considered by your healthcare provider:

  • Acetaminophen (alone or with codeine)
  • Aspirin (not during last trimester)
  • Ibuprofen (not during the last trimester)
  • Prochlorperazine, chlorpromazine, trimethobenzamide, promethazine (during pregnancy)
  • Metoclopramide (for gastric symptoms)
  • Triptans (but only with caution)

If pregnant, you should only use a medicine that has been prescribed or recommended by your health-care provider. Do not self-medicate, even with over-the-counter medicines.

Excerpted and used with permission of the National Headache Foundation

Last updated March 6, 2009