Extreme headache postpartum: what should you know?

Broken sleep, missed meals, dehydration, blood loss, muscle tension, migraine, infection, and medication effects can all contribute after birth. A headache following spinal or epidural anaesthesia may be worse when upright and ease when lying down; tell the maternity team about this pattern.

Postpartum pre-eclampsia can occur after delivery, so a new severe headache with visual symptoms, swelling, breathlessness, chest discomfort, or upper abdominal pain needs urgent assessment. The symptom pattern guides care; the headache itself does not identify one cause.

Ask another adult to stay with you if possible. Rest, drink fluids, eat a small meal if tolerated, and write down when the pain began, its position, and what changes it. Measure blood pressure only if you have a reliable monitor and know how to use it; do not delay care to obtain a reading.

Call your maternity unit, obstetric clinician, or urgent care service for a severe or unfamiliar headache. Mention an epidural or spinal procedure, heavy bleeding, fever, breast infection symptoms, and every medicine you are taking, including medicines used while breastfeeding.

Call emergency services for a sudden explosive headache, seizure, collapse, confusion, new weakness, trouble speaking, severe breathlessness, chest pain, sudden vision loss, or a stiff neck with fever. Seek urgent review for persistent pain, repeated vomiting, a high blood pressure reading, or pain that is worse when standing after neuraxial anaesthesia.

Do not drive if you are dizzy, confused, or having visual symptoms. Bring your discharge information and medicine list, and tell staff that you recently gave birth.

Ask whether your blood pressure, neurological examination, blood tests, or treatment for a post-dural puncture headache is needed. Confirm which options are compatible with breastfeeding and what follow-up timing is appropriate.