Extreme headache after a C-section: what to know

A headache that becomes worse when you sit or stand and improves when you lie flat can happen after a spinal or epidural anaesthetic. This pattern may be accompanied by nausea, neck discomfort, light sensitivity or changes in hearing, and it can need specific treatment. A headache that is severe, persistent, unusual for you, or not eased by recommended medicine has other possible causes too.

Postpartum pre-eclampsia is a condition that can develop after birth, including after a caesarean delivery. It may present with a severe headache, vision changes, pain beneath the ribs, sudden swelling, shortness of breath or feeling very unwell. The headache itself does not establish the cause, so checking blood pressure and having a clinical examination matter.

Contact the maternity unit, obstetric team or anaesthesia team promptly and describe when the headache began, whether position changes it, and any medicines you have taken. If you are still in hospital, tell your nurse or doctor immediately. Resting in a comfortable position and drinking fluids may help while you arrange advice, but do not delay assessment to see whether the pain settles.

Tell the clinician whether you had a spinal or epidural, whether your blood pressure was raised during pregnancy or after birth, and whether you have fever, weakness, confusion, seizures or visual symptoms. Do not take additional medicines beyond the discharge instructions without checking what is suitable after delivery and while breastfeeding.

Seek emergency help now for a sudden or rapidly worsening headache, fainting, seizure, confusion, weakness or numbness on one side, trouble speaking, severe vision changes, chest pain, serious breathing difficulty, or a high temperature with a stiff neck. Urgent assessment is also needed for a severe headache with raised blood pressure, pain under the ribs, or marked swelling of the face or hands.

These warning signs can indicate a serious postpartum problem and should not be judged by how common a cause is. If you are unsure whether the symptoms are severe, call emergency services or ask someone to take you for assessment; do not drive yourself if you feel faint, confused or have visual symptoms.

Ask: Could this pattern be related to my spinal or epidural anaesthetic? Should my blood pressure, urine and neurological symptoms be checked? Which pain relief is appropriate for me, and what symptoms mean I should return urgently? If a post-dural puncture headache is suspected, ask what treatment options and follow-up are available.