Migraines during pregnancy: what usually changes, and what needs a doctor

Short answer

For most women with migraine, pregnancy brings fewer attacks: reviews report that about 60–70% find their migraine eases or stops, mostly in the second and third trimesters, while attacks often come back in the first weeks after birth (5, 4). But a headache in pregnancy is not always "just your migraine": a severe headache, vision changes, pain below the ribs, vomiting or sudden swelling can be signs of pre-eclampsia and need checking the same day (2).

If your attacks did not settle, or got worse, you are not doing pregnancy wrong and it is not your fault. About a quarter of women with migraine without aura keep having attacks through pregnancy, and migraine with aura improves less often (4).

Note: This article explains research and guidelines. It is not medical advice. Talk to your OB, midwife or doctor before taking any medicine, supplement or herbal remedy in pregnancy or while breastfeeding. Call emergency services for a sudden, extremely painful headache, weakness on one side of the body or face, trouble speaking, vision loss or a seizure (1). This guide is published by Welltory, which makes one of the apps mentioned.

If you live with migraine and want to work through it with other women who get it, Welltory runs a paid peer-support program: join Migraine Lab here (what Migraine Lab is, who it is for and what it costs). It is education and peer support, not medical care.

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Headache warning signs in pregnancy: when it is not just a migraine

Start here, because this is the part that matters most. Pregnancy changes which headaches doctors worry about. The American College of Obstetricians and Gynecologists (ACOG) guideline on headaches in pregnancy and postpartum says that a new headache with red-flag features should be evaluated promptly, because a secondary cause is found on imaging in more than 25% of such cases (3).

Call your maternity unit, OB, midwife or doctor the same day if you have (2):

• a severe headache;

• problems with vision, such as blurring or seeing flashing lights;

• pain just below your ribs;

• vomiting;

• a sudden increase in swelling of your face, hands, feet or ankles.

NHS notes that any of these could be signs of pre-eclampsia, which usually starts after 20 weeks of pregnancy (2). ACOG adds that pre-eclampsia should be considered in anyone with a headache and high blood pressure from 20 weeks of pregnancy until 6 weeks after birth (3).

Seek medical care immediately, according to the CDC's list of urgent maternal warning signs, for a headache that won't go away or gets worse over time — one that feels like the worst headache of your life, lasts even after medicine and fluids, starts suddenly like a clap of thunder, or comes with blurred vision or dizziness (8). The CDC applies these signs to pregnancy and the year after delivery.

Call emergency services for a sudden, extremely painful headache; problems speaking or remembering; loss of vision or double vision; drowsiness or confusion; a seizure; a very high temperature with signs of meningitis; weakness on one side of the body or face; or a headache after a head injury (1).

Why the familiar migraine still deserves a call

A review by the European Headache Federation lists a change in a previously stable headache pattern as a red flag in pregnancy, alongside a headache that peaks in less than five minutes, raised blood pressure and new neurological symptoms (4). In plain words: if this headache is not like your usual attacks, say so. NHS also advises urgent advice for any migraine attack if you are pregnant or have just had a baby (1).

A practical habit: take your blood pressure if you have a home cuff and your care team has asked you to, and tell them the number when you call. Write down when the headache began and what came with it.

What usually happens to migraine during pregnancy, trimester by trimester

Most studies follow women who had migraine before pregnancy. Their stories tend to follow a shape.

• First trimester — 46.8% of women with migraine without aura were better, and only 10.6% were attack-free (6)

• Second trimester — Most women improve; in one prospective study, 83% of women with migraine without aura were better (6)

• Third trimester — Improvement often deepens; 87.2% better and 78.7% attack-free in the same study (6)

• First week after birth — Attacks returned in 34% (6)

• First month after birth — Attacks returned in 55.3% (6)

The numbers come from a 2003 study that gave headache diaries to 49 women in Italy, so they are a small sample. Larger reviews agree with the overall pattern. The European Headache Federation review pooled the data for migraine without aura: about 67% improved, about 26% stayed the same and about 8% got worse (4). A 2012 study in Japan found remission rates of 63%, 83% and 85% across the three trimesters (7).

Migraines in early pregnancy

The first trimester is often the hardest stretch. Hormone levels are rising fast, nausea and vomiting can make it hard to eat and drink regularly, and sleep is often broken. The 2003 study found that having menstrually related migraine before pregnancy was linked with less improvement in the first and third trimesters, and that hyperemesis (severe pregnancy sickness) was linked with less improvement in the second (6).

Is a migraine a sign of pregnancy?

On its own, no. Headaches are common in early pregnancy, and NHS notes that they do not harm your baby (2). But a headache is not a reliable pregnancy sign, because migraine has many other triggers. If you think you might be pregnant, a pregnancy test is the way to find out — and it is worth knowing before you take any medicine.

Why pregnancy changes migraine: hormones and the drop after birth

Migraine in women is closely tied to estrogen, and especially to estrogen falling. Before pregnancy, many women notice attacks around their period, when estrogen drops at the end of the cycle (see our guide to menstrual migraine).

Pregnancy removes those monthly swings. Estrogen rises during pregnancy and stays high, without the monthly drop. Reviews link the improvement to this hormonal stability, and the return of attacks after birth to the sudden drop in estrogen that follows delivery (5). That is why the pattern so often looks like a "holiday" in the middle of pregnancy, followed by a hard landing a few days or weeks after the baby arrives.

Hormones are not the whole story. Sleep, regular meals, fluids and stress all matter too, and pregnancy changes every one of them. Our overview of migraine triggers covers the everyday ones.

Migraine with aura and new migraines in pregnancy

Migraine with aura — where visual or other neurological symptoms come before or with the headache — behaves differently.

• It improves less often. Nearly half of women with migraine with aura continue to have attacks during pregnancy (4).

• It can start in pregnancy. In studies collected by the European Headache Federation review, migraine with aura began during pregnancy in 10.7% to 14% of cases (4). Migraine without aura can also start in pregnancy, in 1% up to 10% of pregnant women (4).

• First-time aura needs a doctor. Visual symptoms in pregnancy can also be a pre-eclampsia warning sign (2). If you have never had aura before, or the aura feels different, do not assume it is migraine — call your care team. Aura that lasts longer than 1 hour needs urgent advice (1).

If your first ever migraine-like attack happens in pregnancy, it is worth getting it diagnosed rather than self-labeled. Doctors can tell migraine apart from other causes only with an exam, your history and sometimes tests.

Work out your early warning signs with women who get it

Welltory Migraine Lab is a paid, moderated online community for women 18 to 65 living with migraine. Opens December 1, 2026. Peer support and education, not medical care.

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Migraine and pregnancy health: what the risk studies mean

You may have read that migraine is linked with pregnancy complications. This part can be scary, so here is what the research actually says.

• Pre-eclampsia. Pooled studies link migraine with about a twofold increase in the odds of pre-eclampsia (pooled odds ratio 2.05) (5).

• Preterm birth. A smaller increase, with a pooled odds ratio of 1.26 (5).

• Stroke. Stroke in pregnancy is rare, but migraine has been associated with up to a 15-fold higher risk of maternal stroke in a large US case-control study (4, 5).

• Mental health. Maternal migraine was associated with higher odds of peripartum mental illness (odds ratio 1.75) (5).

Three things help keep this in proportion. First, these are associations: they do not prove that migraine causes the complication, and most pregnant women with migraine have healthy pregnancies. Second, a doubling of a rare risk is still a small absolute risk. Third, and most useful: this is exactly why your OB or midwife should know you have migraine. Some care teams check blood pressure more closely in women with migraine, especially with aura. The European Headache Federation authors call migraine an important risk factor for hypertensive and vascular disease in pregnancy (4).

What can I take for a migraine while pregnant?

This is the question people search most, and the honest answer is: ask your OB, midwife or doctor before taking anything, including over-the-counter pills, supplements and herbal remedies. The choice depends on the trimester, your health and what you have taken before. Here is what the guidelines say in general terms, so you know what to ask about.

• Acetaminophen (paracetamol). NHS calls paracetamol the first choice of painkiller in pregnancy and advises taking it for the shortest possible time; ask a pharmacist, midwife or doctor about dose and duration (2). ACOG also names acetaminophen as initial therapy (3).

• Ibuprofen and other NSAIDs. NHS advises avoiding them in pregnancy unless prescribed by your doctor (2). ACOG says to avoid them in the first and third trimesters (3).

• Codeine. NHS lists it among painkillers to avoid unless prescribed (2). ACOG says to avoid opioids, ergot medicines and products containing butalbital (3).

• Triptans, such as sumatriptan. ACOG lists sumatriptan as a second option for headaches that do not respond to first-line treatment — a prescription decision for your doctor (3).

• Combination products for migraine. Many contain several ingredients, such as a painkiller plus caffeine. Check every ingredient with your pharmacist or OB rather than going by the brand name.

• Preventive medicines. If you took a daily preventive before pregnancy, ACOG advises reviewing it before pregnancy or early in it (3). Do not stop a prescribed medicine suddenly without talking to the doctor who prescribed it.

If you are planning a pregnancy, the best time to have this conversation is before you conceive. If you are already pregnant and took something before you knew, tell your OB or midwife — do not panic, and do not hide it.

For a general picture of migraine medicines outside pregnancy, see our guide to migraine treatment.

How to get through a migraine while pregnant without medicine

Non-drug steps are the base of care in pregnancy. ACOG notes that lifestyle measures have limited evidence but are safe, and that acupuncture and biofeedback are also considered safe (3). Reviews add trigger avoidance, stress management, sleep, hydration, regular meals and exercise, with mindfulness and cognitive behavioral therapy as further options (5).

When an attack starts, a simple sequence many women find workable:

1. Check the warning signs first. If anything in the list above applies, call before trying home steps.

2. Drink something and eat a small snack, especially if you have been sick or have gone a long time without food.

3. Lie down in a dark, quiet room. Lying on your side is often more comfortable later in pregnancy.

4. Use cold or warmth. A cool cloth on the forehead or back of the neck helps some people; others prefer warmth on the shoulders.

5. Rest your eyes and turn off screens for a while.

6. Note the time and what you felt, so you can tell your care team later.

7. If your OB has agreed on a medicine plan, follow that plan rather than improvising.

Everyday habits that lower the load

• Regular meals. Small, frequent snacks help if nausea makes big meals hard.

• Fluids through the day. NHS advises drinking plenty to prevent dehydration (2).

• Sleep and rest. NHS suggests getting enough sleep and finding ways to rest and relax, such as pregnancy yoga (2).

• Caffeine. If you drink coffee, ask your OB or midwife how much is right in pregnancy, and change your intake gradually — sudden cuts can bring on headaches.

• Gentle movement, as your care team allows.

Postpartum migraines: the first weeks after birth

For many women, the hardest part comes after the baby arrives. In the 2003 study, migraine came back in the first week after birth for 34% of women and in the first month for 55.3% (6). The European Headache Federation review notes that headache after birth is common for all women — about 30–40%, not only those with migraine — and that the pre-pregnancy pattern returns within 1 month in 55% (4).

Why this happens:

• Estrogen falls sharply after delivery (5).

• Sleep becomes broken for weeks or months.

• Meals and fluids get irregular when you are feeding and caring for a newborn.

• Stress and anxiety are common, and the review notes that these postpartum changes are migraine triggers in their own right (5).

Not every postpartum headache is a migraine

ACOG lists several postpartum headaches that need medical attention, including pre-eclampsia (which can appear up to 6 weeks after birth) and a headache after an epidural, which happens in up to 1.5% of people who have one (3). A headache that gets much worse when you sit or stand up and eases when you lie down is worth mentioning to your care team if you had an epidural or spinal. The CDC urges immediate care for a headache that won't go away or gets worse at any point in the year after birth (8).

If you are also struggling with sleep and recovery, our guide to postpartum recovery after 35 covers the broader picture.

Migraine while breastfeeding

Breastfeeding may help a little. In the 2003 study, breastfeeding seemed to protect against migraine coming back after birth (6). In the 2012 study from Japan, recurrence was lower in breastfeeding mothers than in bottle-feeding mothers up to 6 months after delivery (7). Other studies have not found a clear link, so this is a possible bonus, not a promise (4). However you feed your baby, a return of migraine is not a sign you did something wrong.

Treatment options usually widen while breastfeeding: the 2024 review notes that there are significantly more treatment options than in pregnancy, with a few exceptions (5). ACOG also advises limiting caffeine, because babies process it slowly (3). Which specific medicine is right for you is a question for your doctor, pediatrician or a pharmacist — many people ask about popular over-the-counter migraine combinations, and the answer depends on the ingredients and your baby's age.

How to track your migraine through pregnancy and after birth

A simple record makes every appointment easier and helps your care team tell a familiar migraine from something new.

1. Write down your usual pattern now: how often attacks come, how long they last, whether you have aura, what usually helps.

2. Log each attack in 30 seconds: date, start time, how bad (0–10), aura yes or no, anything unusual.

3. Add context: hours of sleep, meals skipped, vomiting, stress, how much you drank.

4. Record what you took and whether it helped, including the time.

5. Note blood pressure readings if your care team has asked you to check at home.

6. Flag anything new: a different kind of pain, first-time aura, swelling, vision change. New means call, not log.

7. Keep going after birth. The first 6 weeks are when the pattern often changes again.

Our migraine headache diary guide has a template you can adapt.

Living with migraines during pregnancy: the questions people ask next

Can migraines hurt my baby?

NHS says headaches in early pregnancy do not harm your baby (2). The concern is not the pain itself but the link between migraine and conditions such as pre-eclampsia, which is why your care team should know about your migraine (5).

Why are my migraines worse in the first trimester?

Hormones are rising fast, nausea and vomiting make meals and fluids irregular, and sleep is often broken. Improvement is most often seen from the second trimester onward (6, 5).

How do I get rid of a migraine while pregnant fast?

There is no reliable fast fix. Many people find rest in a dark room, fluids, a snack and cold or warmth make an attack easier to get through, and any medicine should be one your OB or midwife has agreed. If the headache is severe or comes with vision changes, swelling or vomiting, call your care team instead (2).

Can I get Botox or other preventive treatment for migraines while pregnant?

Preventive treatment in pregnancy is usually reserved for severe cases and decided case by case with your doctor. ACOG advises reviewing preventive medicines before or early in pregnancy (3). Ask your neurologist and OB together.

Will my migraines go back to normal after the baby?

Often yes, and sometimes quickly: in one review, the pre-pregnancy pattern returned within 1 month of delivery in 55% of women (4). Sleep, feeding and stress in the first months can make attacks harder for a while.

Before you blame yourself

Pregnancy comes with a lot of quiet pressure to "do it right." When attacks continue, it is easy to think you are eating wrong, resting wrong or failing to cope. The research suggests a kinder reading: a quarter or more of women with migraine keep having attacks in pregnancy, and the first trimester and the weeks after birth are hard for reasons you cannot fully control — rising and falling hormones, nausea, broken sleep (4, 5).

Before you blame yourself, look at what your days already show. Was the attack after a night of 4 hours' sleep? After a morning of vomiting with nothing to drink? After a long gap without food? Pick one lever your care team agrees with — for example, a snack and a glass of water every 3 hours, or a protected rest window in the afternoon — and keep it for 1–2 weeks. Then look back at your log. One change at a time is how you learn what matters for you.

When to see a doctor

Same day or urgently: any headache with the pre-eclampsia warning signs — a severe headache, vision problems such as blurring or flashing lights, pain just below the ribs, vomiting, or sudden swelling of the face, hands, feet or ankles (2). NHS also advises urgent advice for a migraine attack if you are pregnant or have just had a baby, if an attack lasts longer than 72 hours, or if aura lasts more than 1 hour (1).

Immediately: a headache that feels like the worst of your life, starts suddenly like a clap of thunder, does not go away after medicine and fluids, or comes with blurred vision or dizziness — at any time in pregnancy or the year after birth (8).

Call emergency services for a sudden, extremely painful headache; problems speaking or remembering; vision loss or double vision; drowsiness or confusion; a seizure; a very high temperature with signs of meningitis; weakness on one side of the body or face; or a headache after a recent head injury (1).

Book a routine appointment if attacks are getting worse, happen more than once a week or are hard to control (1), or if you are planning a pregnancy and take migraine medicines.

How to bring this up with your doctor

• Tell your OB or midwife early that you have migraine, whether it is with or without aura, and what you usually take.

• Bring your log for the last 4–8 weeks: attack dates, how long they lasted, aura, what you took and blood pressure readings if you have them.

• Ask by name: "What can I take for a migraine at this stage of pregnancy, and what should I avoid?" "Should we review my preventive medicine?" "Does my migraine change how often my blood pressure should be checked?" "What can I take while breastfeeding?"

• Describe what is new. "This headache is different from my usual migraine because…" is the most useful sentence you can say.

• If you feel dismissed, say: "I have migraine and I know the warning signs of pre-eclampsia. I would like my blood pressure checked and this headache assessed today." You can also ask for a referral to a neurologist or headache specialist who works with pregnant patients.

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How Welltory helps — and what it cannot do

What it cannot do. Welltory is a general wellness product, not a medical device. It does not diagnose migraine or pre-eclampsia, it does not measure blood pressure from your phone camera, and it cannot predict an attack — our review of whether a smartwatch can predict a migraine explains why no wearable can yet. It is not a replacement for prenatal care, and nothing in the app should delay a call to your care team.

What it can do is help you keep the everyday context around your attacks in one place:

• A quick heart rate and HRV reading with your phone camera. It is a spot reading, not continuous monitoring; follow the measurement guide and the tips for accurate HRV readings. Pregnancy changes many body signals, so compare readings with your own recent weeks rather than with how you were before pregnancy.

• Sleep, resting heart rate and activity from your watch or ring. You can connect Apple Health, Health Connect and other sources.

• Tag what happened. If you use an iPhone with an Apple Watch or Oura ring, the Today screen flags stress stretches and asks "What happened?" — tap a tag or type a few words: "migraine," "vomited all morning," "3 hours' sleep," "night feeds."

• Looking back at patterns. On iOS, My Patterns shows how your measurements relate to what you log.

• A log for your appointments. You can export your data as a CSV file from the web app and bring it to your OB, midwife or neurologist. Patterns are things to discuss with them, not proof of a trigger.

Working this out with other women. Welltory Migraine Lab is a paid, moderated online community for women aged 18 to 65 living with migraine; you do not need a diagnosis to join. It opens on December 1, 2026; you can book your place now, and your paid period starts on the opening day. Members get a personal strategy built on their own data, a community of women with similar symptoms, and a medical board that explains what is happening in the body. It is education and peer support, not medical care, and it does not replace your OB, midwife or doctor. Join Migraine Lab or read what Migraine Lab is, who it is for and what it costs.

How we made it

We based this article on the American College of Obstetricians and Gynecologists guideline on headaches in pregnancy and postpartum (as summarized by the American Academy of Family Physicians), NHS guidance on migraine and on headaches in pregnancy, the CDC's urgent maternal warning signs, a systematic review by the European Headache Federation, a 2024 review in Life, and prospective studies from Italy and Japan. Every number was checked against the source we cite on November 10, 2026. We do not give medicine doses; those belong to your OB, midwife or doctor. Search questions came from what people in the United States most often ask about migraines during pregnancy, after birth and while breastfeeding. For the product section, we checked every function against the Welltory Help Center on November 10, 2026.

Made with AI tools, then edited and fact-checked by the Welltory team. See our Editorial & AI policy.

Jane Smorodnikova, co-founder of Welltory, built the methodology behind how we read physiological data.

Written by Tatsiana Yashyna.

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