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Headaches during pregnancy: What is a safe treatment?

It can be tough to navigate all the pains of pregnancy with medication restrictions.
/ Source: TODAY

It can be tough to navigate all the aches and pains of pregnancy while also keeping your growing baby safe. Here's what to know when your head is throbbing and you're desperately searching for relief.

What could be causing your headache

“It’s absolutely essential to figure out the cause of the headache before attempting to treat it,” said Dr. James Bernasko, Director of the Regional Perinatal Center at Stony Brook Children's Hospital. Pregnancy headaches can range from "the merely inconvenient to the actually life-threatening,” so context is particularly important, Bernasko added.

Possible causes include:

  • Fatigue
  • Stress
  • Eye strain
  • Dehydration
  • Nasal congestion
  • Hormonal fluctuations
  • Caffeine withdrawal
  • Migraine
  • Preeclampsia

If you have a family history of high blood pressure, stroke, or aneurysms, or you are experiencing the "worst headache of your life," call your provider immediately, Bernasko said.

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What could help your headache

Non-pharmacological options

"Sometimes, something as simple as chocolate can trigger a headache" during pregnancy, so it's worth testing out a few non-pharmacological remedies first, Bernasko said. If you're suffering from chronic headaches, consider acupuncture or biofeedback, a technique that allows you to channel and dissipate your pain.

Things to try:

  • Warm compress on the face (sinus headache)
  • Cold compress on the back of the neck (stress headache)
  • Meditation
  • Massage

Over-the-counter medication options


Tylenol, sold as the generic acetaminophen, is "the safest headache medication" during pregnancy and is not associated with any known birth defects, according to Bernasko. However, you should avoid taking more than 1500 milligrams within 24 hours as overuse can damage your liver.

Ibruprofen, aspirin, naproxen (NSAID)

This group of pain relievers is known as NSAIDs (non-steroidal anti-inflammatory drugs). They should only be taken after consulting with your doctor, as prolonged use can irritate the stomach and affect blood flow in the baby’s heart, Bernasko said.

However, “if Tylenol hasn’t worked for you in the past... you can take one pill of any of [the above] and then reach out to your provider," Bernasko said. The bottom line: NSAIDs are "not something you should take multiple times without your provider knowing.”


"During some types of headaches your blood vessels enlarge... Caffeine can help stop this action" because it constricts your blood vessels, wrote Dr. Talia Gates, an OB/GYN in Jasper, Alabama, in an email to TODAY. Gates recommends combining Tylenol and a caffeinated drink for dual relief.

Yet as Bernasko points out, caffeine withdrawal or overdose could have caused your headache in the first place, so make sure to factor in how much you've already consumed.

Prescription options

Narcotics, also known as opioids, are "everywhere now," Bernasko said, so it can be tempting to pop one for a headache. However, these medications can be addictive and "should only be taken under direct medical supervision," Bernasko explained. Additionally, prolonged use of narcotics can cause your baby to develop neonatal abstinence syndrome and undergo a painful withdrawal process after birth.

Narcotic analgesic combinations, which contain acetaminophen or an NSAID in addition to an opioid, pose similar risks. Yet if your over-the-counter options are falling short, your doctor may suggest one of the "safe medications" within this group, said Gates.

Triptans (migraine medication)

If you've already been prescribed a triptan for migraines, it's safe to continue using during pregnancy, Bernasko said. Otherwise, consult your doctor to find the right medication for your symptoms.