Headaches During Pregnancy
Medically reviewed by Dr. Lisa Okafor, MD, FACOG · Board-Certified OB-GYN
Content reviewed against published ACOG, NIH, March of Dimes guidelines
Last reviewed:
Your health matters just as much as your baby's. If you are dealing with headaches during pregnancy, here is what you need to know.
The short answer
Headaches are common during pregnancy, especially in the first and third trimesters. They are often caused by hormonal changes, increased blood volume, stress, fatigue, caffeine withdrawal, or dehydration. Most pregnancy headaches are tension-type and harmless, but severe or persistent headaches, especially in the third trimester, should be evaluated to rule out preeclampsia.
Key takeaways
- Headaches are common during pregnancy, especially in the first and third trimesters. They are often caused by hormonal changes, increased blood volume, stress, fatigue, caffeine withdrawal, or dehydration. Most pregnancy headaches are tension-type and harmless, but severe or persistent headaches, especially in the third trimester, should be evaluated to rule out preeclampsia.
- Usually normal when: Mild to moderate tension-type headache that responds to rest, hydration, or acetaminophen
- Call your doctor if: Sudden severe headache, the worst headache of your life, or a headache different from any you have had before
- Varies by age — see the age-by-age breakdown below
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What Parents Should Know
According to ACOG, NIH, March of Dimes guidelines, headaches are common during pregnancy, especially in the first and third trimesters. They are often caused by hormonal changes, increased blood volume, stress, fatigue, caffeine withdrawal, or dehydration. Most pregnancy headaches are tension-type and harmless, but severe or persistent headaches, especially in the third trimester, should be evaluated to rule out preeclampsia. At First trimester, headaches are common in the first trimester due to surging hormones, increased blood volume, and caffeine reduction. Rest, hydration, cool compresses, and acetaminophen (Tylenol) at your provider's recommended dose are generally safe. Avoid ibuprofen (Advil/Motrin) and aspirin unless specifically prescribed by your provider. It is generally considered normal when mild to moderate tension-type headache that responds to rest, hydration, or acetaminophen. However, you should contact your pediatrician promptly if sudden severe headache, the worst headache of your life, or a headache different from any you have had before.
Normal vs. Concerning
By Age
What to expect by age
First trimester
Headaches are common in the first trimester due to surging hormones, increased blood volume, and caffeine reduction. Rest, hydration, cool compresses, and acetaminophen (Tylenol) at your provider's recommended dose are generally safe. Avoid ibuprofen (Advil/Motrin) and aspirin unless specifically prescribed by your provider.
Second trimester
Many people find headaches improve in the second trimester as hormones stabilize. If headaches persist, try maintaining regular sleep, eating frequent small meals, staying hydrated, and managing stress. If you need medication, acetaminophen remains the safest option.
Third trimester
New-onset headaches in the third trimester or headaches that are different from your usual pattern should always be reported to your provider. Severe, persistent headache that does not respond to acetaminophen, rest, and hydration can be a warning sign of preeclampsia, especially if accompanied by visual changes, upper abdominal pain, or swelling.
What to Tell Your Pediatrician
- Describe when you first noticed headaches during pregnancy and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if frequent headaches that are not responsive to safe home treatments.
- Mention if headaches that are interfering with work or daily activities.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Mild to moderate tension-type headache that responds to rest, hydration, or acetaminophen
- Headaches related to fatigue, hunger, stress, or caffeine changes
- Headaches similar to ones you experienced before pregnancy
- Headaches that occur in the first trimester and improve in the second
- Frequent headaches that are not responsive to safe home treatments
- Headaches that are interfering with work or daily activities
- A change in headache pattern or new type of headache during pregnancy
- Sudden severe headache, the worst headache of your life, or a headache different from any you have had before
- Headache accompanied by vision changes, seeing spots, severe swelling, or upper abdominal pain - these are potential signs of preeclampsia
- Headache with fever, stiff neck, confusion, or seizures
What You Can Do at Home
- Keep track of when you notice headaches during pregnancy — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that mild to moderate tension-type headache that responds to rest, hydration, or acetaminophen — this is generally within the range of normal.
- At First trimester, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Prioritize your own rest and nutrition. Accept help when offered, and do not hesitate to reach out to your healthcare provider.
- While monitoring at home, seek immediate care if sudden severe headache, the worst headache of your life, or a headache different from any you have had before.
Related Conditions
Migraines During Pregnancy
Migraines affect about 25% of women of reproductive age. Many people with migraines find they improve during pregnancy, especially in the second and third trimesters, due to stable estrogen levels. However, some experience worsening or new-onset migraines. Management during pregnancy requires careful medication selection under your provider's guidance.
Preeclampsia Warning Signs
Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of organ damage, usually after 20 weeks of pregnancy. It affects about 5-8% of pregnancies and can range from mild to severe. With regular prenatal monitoring, preeclampsia can be detected early and managed to protect both you and your baby.
Related Resources
Postpartum Recovery Guide
Week-by-week postpartum recovery timeline and warning signs.
Medicine Dosage Calculator
Calculate correct Tylenol and Motrin doses by your baby's weight.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is headaches during pregnancy normal?
When should I call the doctor about headaches during pregnancy?
When is headaches during pregnancy normal?
What causes headaches during pregnancy?
What should I mention to my pediatrician about headaches during pregnancy?
Is headaches during pregnancy normal at First trimester?
Is headaches during pregnancy normal at Second trimester?
Should I go to the ER for headaches during pregnancy?
Does headaches during pregnancy go away on its own?
References
- [1]American College of Obstetricians and Gynecologists. Headaches in Pregnancy. ACOG, 2022. ACOG
- [2]National Library of Medicine. Headache in Pregnancy. StatPearls, 2023. NIH
- [3]March of Dimes. Common Discomforts of Pregnancy. March of Dimes, 2023. March of Dimes
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Headaches During Pregnancy.
Things to mention
- Describe when you first noticed headaches during pregnancy and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if frequent headaches that are not responsive to safe home treatments.
- Mention if headaches that are interfering with work or daily activities.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- Frequent headaches that are not responsive to safe home treatments
- Headaches that are interfering with work or daily activities
- A change in headache pattern or new type of headache during pregnancy
Urgent signs to report immediately
- Sudden severe headache, the worst headache of your life, or a headache different from any you have had before
- Headache accompanied by vision changes, seeing spots, severe swelling, or upper abdominal pain - these are potential signs of preeclampsia
- Headache with fever, stiff neck, confusion, or seizures
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
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Related Resources
Bottom line
Most cases of headaches during pregnancy are normal. Talk to your pediatrician if sudden severe headache, the worst headache of your life, or a headache different from any you have had before.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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Migraines During Pregnancy
Migraines affect about 25% of women of reproductive age. Many people with migraines find they improve during pregnancy, especially in the second and third trimesters, due to stable estrogen levels. However, some experience worsening or new-onset migraines. Management during pregnancy requires careful medication selection under your provider's guidance.
Preeclampsia Warning Signs
Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of organ damage, usually after 20 weeks of pregnancy. It affects about 5-8% of pregnancies and can range from mild to severe. With regular prenatal monitoring, preeclampsia can be detected early and managed to protect both you and your baby.
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