Very bad headache during pregnancy: what to know

Pregnancy can overlap with familiar headache triggers such as poor sleep, dehydration, stress, heat, congestion or migraine. Allergic Rhinitis, Chronic Sinusitis, a Common Cold or COVID-19 may also cause head pain. Dengue Fever is a concern after relevant mosquito exposure and fever. A severe or new headache can also signal a pregnancy complication, particularly when it comes with raised blood pressure, visual disturbance, upper abdominal pain or sudden swelling, so the symptom deserves individual assessment.

Stop strenuous activity, rest somewhere cool and quiet, and sip fluids if you are able. Contact your maternity team, obstetric clinician or urgent-care service for advice rather than choosing a new medicine yourself. Tell them how far along the pregnancy is, when the pain began, whether it is worsening, and whether you have checked your blood pressure. Keep a list of medicines, supplements, fever, vomiting, visual symptoms and reduced urine.

Seek emergency care for a thunderclap headache, seizure, fainting, confusion, weakness, difficulty speaking, new vision loss, stiff neck with fever, repeated vomiting or a head injury. Contact maternity care urgently for severe persistent pain, flashing lights or blurred vision, pain beneath the ribs, sudden swelling of the face or hands, or a blood-pressure reading that concerns your clinician. Do not drive yourself if you feel unwell.

Could this be migraine, infection, dehydration or a pregnancy-related complication? Should my blood pressure and urine be checked? Which pain relief is suitable at this stage of pregnancy, and what change means I should attend hospital?