Severe headache after childbirth: what to know

The first days after delivery can involve fluid loss, missed meals, broken sleep, muscle tension, and changing hormones. Headache may also occur with infection, high blood pressure, or a spinal headache after an epidural or spinal anaesthetic. A spinal headache often changes with posture, becoming worse when sitting or standing and easing when lying down. Fever, cough, or congestion may suggest [Common Cold](/conditions/common-cold/) or [COVID-19](/conditions/covid-19/), while heat and fluid loss can contribute to [Dehydration](/conditions/dehydration/).

Tell your maternity unit, doctor, or midwife about a severe postpartum headache, particularly if it is new or unlike previous headaches. While arranging advice, rest, drink fluids if you can, and eat a light meal if you have not eaten. Check before taking medicine if you are breastfeeding, have high blood pressure, or take other treatments. Note whether the pain changes when upright, and record fever, vision symptoms, blood-pressure readings if available, and any medicines used.

Seek emergency help for sudden explosive pain, weakness, numbness, confusion, seizure, fainting, difficulty speaking, vision loss, chest pain, or severe breathlessness. Get urgent assessment for a severe headache with high blood pressure, fever, stiff neck, repeated vomiting, heavy bleeding, or pain that is worsening or not settling. Do not delay because the headache follows an epidural; a posture-related headache still needs review.

Ask whether your blood pressure, neurological examination, hydration, and recent anaesthetic need review, and which treatment is compatible with breastfeeding. Mention when delivery occurred, whether you had an epidural, the posture effect, fever, bleeding, sleep, fluid intake, and any history of [Heat Exhaustion](/conditions/heat-exhaustion/) or [Dengue Fever](/conditions/dengue-fever/).