Headaches During Pregnancy: Relief, Medicines and Preeclampsia Signs

Are headaches normal during pregnancy?

Headaches are common in pregnancy, especially early on, and the NHS says they usually improve as pregnancy goes on and do not harm your baby. Cleveland Clinic says headaches and migraines tend to increase in the first trimester.

Migraines and other primary headaches, the kind not caused by another condition, often ease as pregnancy goes on. ACOG's 2022 headache guideline, as summarized in American Family Physician, says up to 80% of pregnant patients with primary headaches have them less often by the second trimester.

After 20 weeks, a headache can also be a sign of preeclampsia, a high blood pressure disorder of pregnancy. The NHS says preeclampsia usually starts after 20 weeks, and ACOG says it often develops in the third trimester and can also appear in the weeks after birth.

What causes headaches in pregnancy?

Hormones, the rise in blood volume in the first trimester, and triggers such as not drinking enough water, lack of sleep and stress can all cause headaches in pregnancy, according to Cleveland Clinic. Its list of triggers also includes foods that set off migraines, poor nutrition and an upset stomach.

Some headaches are secondary, meaning another condition causes them. ACOG's guideline says secondary headaches are common in pregnancy and names preeclampsia and infection among the causes, and Cleveland Clinic adds sinus infections and blood clots in the brain.

How can you relieve a headache while pregnant?

The NHS suggests drinking plenty of fluids, getting enough sleep, and resting and relaxing, for example in a pregnancy yoga class. Cleveland Clinic suggests lying in a dark room or putting a cold cloth over your head, and keeping a headache diary to spot your triggers and any change your doctor should know about.

Cleveland Clinic says poor posture, especially late in pregnancy, can lead to headaches, and that physical therapy to strengthen the neck and shoulder muscles can help, along with prenatal massage.

ACOG's guideline says relaxation techniques, sleep hygiene, stress management, hydration and cognitive behavioral therapy have limited evidence of benefit but are safe in pregnancy, as are acupuncture and biofeedback. Cleveland Clinic advises talking to a physician before using any natural remedy.

What headache medicine can you take while pregnant?

Acetaminophen, called paracetamol in the UK, is the first-choice painkiller for headaches in pregnancy in both US and UK guidance, but check with your doctor, midwife or pharmacist before you take it or anything else. ACOG's 2022 headache guideline recommends acetaminophen as the first treatment for an acute migraine in pregnancy, and the NHS says paracetamol is the first choice of painkiller, taken for the shortest possible time.

In September 2025 the FDA began the process of changing acetaminophen's label to say that its use in pregnancy may be associated with an increased risk of neurological conditions such as autism and ADHD in children. The FDA's announcement also says a causal relationship has not been established. ACOG responded that acetaminophen remains the painkiller of choice in pregnancy, used at the lowest effective dose for the shortest necessary time with your OB-GYN's advice. The NHS, citing the UK's medicines regulator, says there is no evidence it causes autism. Tylenol during pregnancy goes through that evidence.

ACOG says not to take ibuprofen or naproxen in pregnancy unless your OB-GYN recommends them. According to ACOG, they may be suggested for migraines that don't improve with acetaminophen, but only in the second trimester and for 48 hours or less at a time. The NHS says to avoid ibuprofen and other NSAIDs, and painkillers containing codeine, unless a doctor prescribes them.

ACOG says low-dose aspirin may lower the risk of preeclampsia for some people, and that you should not start taking aspirin on your own without talking to your OB-GYN.

When is a headache in pregnancy a sign of preeclampsia?

A headache that will not go away is one of the preeclampsia symptoms ACOG lists, and ACOG says to call your OB-GYN right away if you have any of them, especially in the second half of pregnancy. The others on ACOG's list are swelling of the face or hands, seeing spots or changes in eyesight, pain in the upper abdomen or shoulder, nausea and vomiting in the second half of pregnancy, sudden weight gain, and difficulty breathing.

The NHS lists these as possible signs of preeclampsia that need checking immediately: a severe headache, vision problems such as blurring or flashing lights, pain just below the ribs, vomiting, and a sudden increase in swelling of the face, hands, feet or ankles. ACOG's guideline says preeclampsia should be considered in anyone 20 or more weeks pregnant who has a headache and raised blood pressure, and that the headache is commonly severe and felt on both sides of the head.

Preeclampsia can also start after birth. ACOG's guideline says it should be considered for up to six weeks after birth in anyone with a headache and high blood pressure. Preeclampsia symptoms covers the condition in full.

Which headaches need urgent care?

The CDC lists a headache that won't go away or gets worse over time as an urgent maternal warning sign, and says to seek medical care immediately. The CDC describes it as feeling like the worst headache of your life, lasting even after medicine and fluids, starting suddenly with severe pain like a clap of thunder, throbbing on one side of your head above your ear, or coming with blurred vision or dizziness.

ACOG's guideline lists the red flags that mean a headache in pregnancy should be checked promptly: a rapid onset or a change from your usual headaches, severe or thunderclap pain, raised blood pressure, fever, being in the third trimester, signs of a problem with nerve or brain function in one part of the body (focal neurological deficits), and changes in consciousness.

When should you call your doctor or midwife?

• A severe headache (NHS), or one that won't go away or gets worse, even after medicine and fluids (CDC).
• A sudden, severe headache that starts like a clap of thunder, or one that throbs on one side of your head above your ear: get medical care immediately (CDC).
• A headache with blurred vision, flashing lights or spots, pain below the ribs or in the upper abdomen, vomiting, or sudden swelling of the face, hands or feet (NHS, ACOG).
• Headaches that are getting worse, are different from your usual ones, or don't respond to home remedies such as fluids, sleep or a dark room (Cleveland Clinic).
• A headache with a fever (ACOG).
• A headache that won't go away or gets worse in the year after giving birth (CDC).

In the UK, the NHS says to call your maternity unit, GP or NHS 111. The CDC says to tell whoever you speak to that you are pregnant or were pregnant within the last year.