Migraines in pregnancy

Most of us get headaches in pregnancy but having a migraine is another matter entirely. And even if you’ve not had one in the past you might now, especially in those first few months.

A migraine is triggered by disruption to the blood flow to your head. When this flow is upset, you’ll probably start feeling wobbly - think nausea, blurred vision, sensitivity to noise - and a short time after the throbbing head pain arrives.

Migraine symptoms are pretty nasty and can include blurred vision and sensitivity to light, sickness, diarrhoea, or simply feeling very tired. There are two type of migraine - migraine with aura and migraine without aura. They can last from between four and 72 hours.

Celeb mum Holly Willoughby suffered during her second pregnancy with baby Belle. The This Morning and Dancing on Ice presenter suffered from such bad migraines that she was forced to take time off work for a while.

The head pain is either localised on one side of the head, or moves across the whole head. Other symptoms are aching arms and legs, buzzing or ringing in your ears and feeling spaced out, or dislocated from what’s going on around you.

“I would go a day without one then all of a sudden I’d get another which could easily last 5 days, was so painful I had to go sit in a dark room,” says Kay, a member of our MadeForMums community.

Why am I getting migraines now that I’m pregnant?

“Migraine in women is linked to the effects of oestrogen,” says Professor Anne MacGregor, a specialist in headache and women's health.

During pregnancy the levels of oestrogen and progesterone in your body are thrown out of whack. One result of this is that around 16 percent women get migraines for the first time when they're pregnant (most often in the first trimester).

Professor MacGregor adds, “Migraine with aura is more likely to occur at times when oestrogen levels are high, such as pregnancy”

That said, some people find that they actually get fewer migraines when they’re pregnant. According to the Migraine Trust, this is because pregnancy causes a surge of the natural pain-killing hormones (endorphins). Research suggests that if you normally get menstrual migraine without aura there is a 60 to 70% chance that you will have few or no migraines when you’re pregnant.

Professor MacGregor explains, “The natural drop in oestrogen around menstruation can trigger migraine without aura. During pregnancy, oestrogen levels become more stable and so many women with a history of menstrual migraine without aura find that their migraine is better while they are pregnant and breastfeeding, only to return as their periods return”.

What sets them off?

There are many things that can trigger a migraine. Common kick-starters are dehydration, glaring and flickering lights (like the ones you find in many in offices), loud noises, extremes of temperature and strong smells. So as long as you don’t work in a loud, glary, smelly office you’ll be ok!

Some foods are also known to trigger migraines, in both pregnant and non-pregnant women and these include:

• Aged cheese
• Alcohol
• Cold foods
• Citrus Fruits
• Red Wine

That said, simply avoiding certain foods doesn’t always prevent migraines; triggers come together over a period of time, like pieces of a jigsaw, to cause the problem.

Make them go away!

Paracetamol can be used to treat migraines. And whilst using aspirin and ibuprofen is generally not recommended during pregnancy, especially in the last trimester, your doctor may consider the benefits to outweigh the risk if they are taken infrequently and if they bring relief.

“Paracetamol is the safest drug to use during pregnancy but is rarely effective for migraine. Drugs such as ibuprofen and aspirin are safe to take in the first two trimesters but should be avoided during the third trimester. Anti-sickness drugs such as metoclopramide and prochlorperazine (only available on prescription) are also OK,” says Professor MacGregor.

Preventative medication is sometimes prescribed for suffers of severe migraines and this can continue in pregnancy if your doctor thinks it’s necessary. “[The] Safest ones during pregnancy are propranolol or amitriptyline,” says Professor MacGregor

A drug called sodium valproate, which is occasionally used to treat acute migraines should not be used in pregnancy. According to Professor MacGregor, “There is clear evidence of harm and sodium valproate should not be used for migraine in women who are pregnant, planning a pregnancy, or not using effective contraception”.

Are there natural remedies I can try?

Yes. Acupuncture has been shown to be particularly useful for mums-to-be who suffer from migraines and some people find essential oils and massage very helpful. Be aware though that some essential oils (like rosemary) need to be avoided in pregnancy.

Sleep and lying in a dark room can also help and many mums-to-be recommend cooling packs:

Christine, who is a member of our MadeForMums community says: "If you fold up a wet tea towel lengthways and put it in the freezer for a bit (put 2 in so you've got one ready once the first goes warm) you can use this on your forehead."

A relaxation technique called Biofeedback has been used to help relieve migraines. Biofeedback is a way of learning to control your body's functions, such as your heart rate. You’re connected to electrical sensors that give you information (feedback) about your body (bio).

According to the Mayo Clinic, “This feedback helps you focus on making subtle changes in your body, such as relaxing certain muscles, to achieve the results you want, such as reducing pain”.

Do I need to tell my midwife?

If you start experiencing migraines, tell your midwife at your next antenatal appointment and if you start getting them frequently see your doctor.

Migraine Action offers support for migraine sufferers and have a helpline 08456 011 033 (10-4pm week days)