Nausea with headache during pregnancy

By trimester

Weeks 1–13

1st trimester

Early on, the usual drivers are hormonal shifts, fluid loss from vomiting, low blood sugar from skipped meals, and broken sleep. Work the simple things first: fluids spread across the day, small frequent food, and a steady bedtime. Ask your clinician what you can take for the headache before you are in the middle of one.

Weeks 14–27

2nd trimester

Migraine patterns often quiet down in the second trimester. If yours is doing the opposite, or a headache arrives that is unlike any you have had before, report it rather than absorbing it. Nausea that first appears after 9 weeks also deserves a second look.

Weeks 28–birth

3rd trimester

From 20 weeks on, a persistent headache with nausea is a reason to call, not to wait. ACOG lists both among preeclampsia symptoms, along with vision changes, swelling of the face or hands, sudden weight gain, and pain in the upper abdomen or shoulder.

What does the evidence show for nausea with headache?

• Preeclampsia symptoms include a headache that will not go away and nausea and vomiting in the second half of pregnancy, alongside vision changes, facial or hand swelling, and upper abdominal or shoulder pain, and any of these warrant calling your ob-gyn right away. 1
• Nausea connected to migraine carried more than three times the odds of severe nausea and vomiting of pregnancy, and nausea with other kinds of headache nearly double the odds of moderate symptoms, in a cohort of 2,411 women. 2
• Among 37 women with migraine headache, 27% had experienced hyperemesis gravidarum, and among 16 women with hyperemesis gravidarum, 37% had migraine, a pattern the authors read as a shared underlying mechanism. 3
• Nausea and vomiting that first appears after 9 weeks of pregnancy, or that arrives with headache, fever, or abdominal pain, can point to a cause other than ordinary morning sickness. 4
• Acetaminophen at recommended doses has not been shown to increase the chance of birth defects, and the guidance is to use only as needed at the lowest effective dose unless your provider has said otherwise. 5
• NICHD lists headache, blurred vision, and right upper quadrant abdominal pain alongside high blood pressure, protein in the urine, and swelling of the face and hands as preeclampsia findings, and names severe headache, vision problems including temporary blindness, upper right abdominal pain, nausea and vomiting, and reduced urine output under eclampsia. 6

When should I call my provider about nausea with headache?

The combination on this page is the same combination that matters in preeclampsia, so the bar for calling should be low after 20 weeks. NICHD puts headache, blurred vision, and pain in the upper right abdomen next to swelling of the face and hands as preeclampsia findings, and adds severe headache, vision problems including temporary blindness, upper right abdominal pain, nausea and vomiting, and urinating much less than usual under eclampsia. A headache that will not shift with rest and fluids, with nausea riding alongside it, is worth same-day contact rather than another dose of anything. Seizures put it straight into emergency territory. Whatever the pattern, any symptom that feels beyond your usual range is a reason to call: obstetric teams expect these questions and would rather hear early than late.