Terrible headache during pregnancy: what to know

Hormonal change, poor sleep, missed meals, visual strain, stress or withdrawal from caffeine can trigger head pain. A blocked nose or facial pressure may accompany allergic rhinitis, a cold or sinus disease. Fever, vomiting, diarrhoea, heat exposure or difficulty keeping fluids down can point toward dehydration or heat exhaustion. A new, severe or persistent headache can also occur with high blood pressure disorders of pregnancy, so its timing, quality and associated symptoms matter.

Rest in a quiet, dim room and sip fluids regularly. Eat a small meal if you have gone without food, and use a cool cloth on your forehead or neck. Record when the pain began, where it is, how intense it feels, and whether light, movement, nausea or visual symptoms change it. Do not start, stop or combine pain medicines without checking with your maternity clinician; some medicines are unsuitable in pregnancy.

Seek urgent assessment for a sudden explosive headache, a headache that is severe and unlike your usual pattern, fainting, confusion, weakness, trouble speaking, a seizure, stiff neck, fever, repeated vomiting, chest pain, shortness of breath or new vision changes. Contact your maternity team promptly if the pain does not settle with rest and fluids, returns repeatedly, or comes with swelling, upper abdominal pain or a known high blood pressure reading.

Ask whether your blood pressure and urine need checking, which pain reliever is appropriate for your pregnancy stage, and whether your symptoms fit migraine, sinus illness or dehydration. Mention every medicine, supplement and recent illness.