Headaches during pregnancy

By trimester

Weeks 1–13

1st trimester

A sudden change in caffeine, whether cutting back or quitting cold, is a frequent trigger now. Cut back gradually instead of stopping all at once to avoid withdrawal headaches. Dehydration from nausea is another common cause.

Weeks 14–27

2nd trimester

Some people notice their migraines ease up in the second trimester as hormone levels steady out. Others notice new patterns instead. Keep track of your triggers and mention any new pattern to your provider.

Weeks 28–birth

3rd trimester

This is the trimester to watch most closely. Call your provider the same day for a new severe headache, vision changes, upper-abdominal pain, or sudden swelling in your face or hands: these can be signs of preeclampsia.

What does the evidence show for headaches?

• Common headache triggers in pregnancy include caffeine withdrawal, dehydration, poor sleep, and low blood sugar, and acetaminophen is considered an appropriate over-the-counter option. 1
• Doctors use a specific evaluation framework to tell an ordinary headache apart from one caused by something that needs urgent attention. 2
• A severe or unrelenting headache, especially with visual changes, upper-abdominal pain, or new swelling, is a red-flag symptom that needs same-day evaluation because of preeclampsia risk. 3
• Occasional, short-term acetaminophen use is supported for pregnancy-related pain and fever, at the lowest dose that works for the shortest time needed. 4
• A severe headache together with vision problems such as temporary blindness, pain in the upper right area of the belly, or a marked drop in how often you're urinating are warning signs of preeclampsia or eclampsia. 5

When should I call my provider about headaches?

Call your provider the same day for a headache that is severe, sudden, or different from your usual pattern, especially alongside vision changes like blurred vision or temporary vision loss. Pain in the upper right side of your belly, new swelling in your face or hands, or a noticeable drop in how often you're urinating alongside the headache are additional preeclampsia and eclampsia warning signs that call for prompt evaluation rather than a wait-and-see approach. None of these lists replace your own judgment: if this symptom worries you, that on its own is enough reason to check in with your healthcare provider.