Headache Symptoms In Pregnancy | What’s Normal, What’s Not

Headaches can pop up early, vanish for weeks, then swing back near the end. That’s common. What’s not fun is the guessing game: “Is this just pregnancy stuff, or is it a warning sign?”

This article breaks down the symptom patterns most people notice, what tends to trigger them, and the fast-call signs that maternity teams want you to report right away.

Headache Symptoms In Pregnancy With Trimester Clues

Pregnancy shifts hormones, blood volume, sleep, appetite, and posture. Those shifts can change how your head feels, even if you’ve had headaches for years. Use the timing as a clue, then pair it with how the pain acts and what shows up with it.

First Trimester Headache Signs

Early pregnancy headaches often track with nausea, fatigue, and disrupted routines. Skipped meals, low fluids, and caffeine cutbacks are common triggers. Migraine patterns can also flare when hormones swing.

• Dull, steady pressure on both sides of the head
• One-sided pulsing pain with nausea or light sensitivity
• Headache after a long gap without food or water

Second Trimester Headache Signs

Many people feel better in the middle months. If headaches keep coming, they often link to repeat triggers like screen time, tight shoulders, dry air, or not drinking enough.

• Band-like pressure across the forehead after a busy day
• Head pain with dry mouth, dark urine, or dizziness
• Migraine with aura: brief visual zigzags or a blind spot, then headache

Third Trimester Headache Signs

Late pregnancy can bring headaches back as sleep gets choppy and muscle strain builds in the neck and upper back. Treat a brand-new severe headache differently than a familiar tension pattern, mainly after 20 weeks.

• Ache at the base of the skull after long sitting or standing
• Face pressure with stuffy nose that worsens when leaning forward
• Headache plus vision trouble, swelling, upper belly pain, or shortness of breath

What Different Pregnancy Headaches Usually Feel Like

Head pain during pregnancy often falls into a few buckets. The labels aren’t the goal. The goal is to match the feel, timing, and add-on symptoms so you pick the right next step.

Tension-Type Headache

Steady pressure, often on both sides, with tight shoulders or a stiff neck. It tends to build through the day. Long screen sessions, jaw clenching, and posture strain are common culprits.

Migraine

Pulsing pain, often one-sided, with nausea, vomiting, light sensitivity, or sound sensitivity. Some people get aura symptoms first, like flashing spots or tingling that clears within an hour.

Sinus Pressure

Face pain, tooth ache, and pressure that worsens when you lean forward. Pregnancy can swell nasal tissue, so congestion can happen even without an infection. Fever or thick colored mucus can mean infection and is worth a call.

Red Flag Headache Symptoms That Need Same-Day Care

Some headache symptoms in pregnancy line up with conditions that need quick evaluation, including hypertensive disorders like pre-eclampsia. If you’re unsure, call anyway.

Call Now If You Notice Any Of These

• Sudden “thunderclap” headache that peaks fast
• Headache with blurred vision, new blind spots, or visual changes that don’t clear
• Headache with new swelling of the face or hands
• Headache with upper belly pain, chest pain, or shortness of breath
• Headache with fever, stiff neck, confusion, fainting, or a seizure
• New headache after 20 weeks that keeps worsening or won’t settle

These signs show up in many clinical warning lists. The WHO pre-eclampsia fact sheet lists severe headache and visual disturbances among symptoms seen in severe disease.

Blood Pressure And Headache

High blood pressure can trigger a headache that feels new, stubborn, or more intense than your usual pattern. If you have a home cuff, follow your clinician’s advice on when to check and when to call. If you don’t have a cuff, your symptom combo still matters.

Table Of Common Headache Patterns During Pregnancy

This table is a pattern matcher. It can’t diagnose you, but it can point you toward sensible self-care or a faster call.

Pattern	Typical Feel	What Often Sets It Off
Tension-type	Steady pressure, tight neck or shoulders	Posture strain, jaw clenching, long screen time
Migraine	Pulsing pain, nausea, light or sound sensitivity	Hormone shifts, missed meals, dehydration, strong smells
Migraine with aura	Brief visual changes or tingling, then headache	New aura in pregnancy warrants a call
Caffeine withdrawal	Dull ache within a day of cutting caffeine	Tapering often feels easier than stopping overnight
Low fluids	Headache with thirst, dark urine, dizziness	Vomiting, hot rooms, long gaps between drinks
Low blood sugar	Headache with shakiness or “crash” feeling	Long gaps between meals; a snack plus water may help
Sinus pressure	Face pressure that worsens when leaning forward	Nasal swelling; fever can suggest infection
Hypertensive disorder	New severe headache with vision changes or swelling	More common after 20 weeks and postpartum; needs medical review

First Steps That Often Ease A Typical Headache

If your symptoms fit a familiar tension headache or a migraine you’ve had before, start here. These steps also give you useful details to share if you end up calling.

Drink, Then Add A Little Salt If You’ve Been Sick

Start with water. If you’ve been vomiting or sweating, pair fluids with a salty snack, broth, or an oral rehydration drink so you hold onto what you drink.

Eat On A Schedule, Not On Hunger

In early pregnancy, hunger cues can be weird. Set a timer for small meals and snacks. Pair carbs with protein or fat to steady energy.

Calm The Neck And Jaw

Drop your shoulders, tuck your chin slightly, and roll the shoulders back a few times. Let your teeth separate and relax the tongue. A warm shower on the neck can ease muscle-driven pain.

Try Cold Or Warm Packs

Cold can calm migraine pain. Warmth can loosen tension headaches. Try one for 10 to 15 minutes, then switch if nothing changes.

Medicine Options Many Clinicians Use In Pregnancy

Medicine choices depend on trimester and your health history. Follow your own clinician’s plan, even if a friend swears by something else.

The ACOG FAQ on headaches and pregnancy lists common triggers like dehydration, caffeine withdrawal, and low blood sugar, plus general relief options. For many people, acetaminophen is a first-line pick when used as directed. ACOG also restated its view on acetaminophen safety in 2025 (ACOG acetaminophen news release).

Label Checks Matter

Acetaminophen is inside many cold and flu products. Don’t stack products without reading labels, so you don’t exceed the daily limit printed on the package.

NSAIDs Need Clinician Timing

Ibuprofen and naproxen have pregnancy timing limits and can be unsafe late in pregnancy. Don’t self-start them.

Table Of “Call Today” Versus “Monitor” Headache Patterns

Use this triage map as a quick check. If you’re torn, call. That’s what triage lines are for.

What You Notice	How Soon To Get Seen	What To Do Next
Sudden severe “worst ever” headache	Emergency care now	Ask someone else to drive if you feel faint; bring pregnancy notes if you can
Headache with blurred vision or visual changes that don’t clear	Same day	Call maternity triage; note swelling, belly pain, or shortness of breath
Headache with new face or hand swelling	Same day	Call your prenatal team; check blood pressure if you have a cuff
New headache after 20 weeks that keeps building	Same day	Rest on your left side, sip water, don’t take new meds without advice
Fever with head pain and stiff neck	Urgent care now	Head in; share temperature, rash, confusion, or neck stiffness
Familiar tension headache that improves with fluids, food, and rest	Monitor	Track triggers, stretch neck, use warm pack, keep meals regular
Familiar migraine that follows your plan and improves	Monitor	Rest in a dark room, small snack, cold pack, follow clinician-approved meds

Postpartum Headaches Still Deserve Respect

Headaches don’t stop after delivery. Sleep loss, hormone shifts, and dehydration can keep them going. High blood pressure disorders can also appear or worsen after birth. If you’re postpartum and you have severe headache with vision changes, chest pain, or breathing trouble, get checked.

The CDC urgent maternal warning signs list covers pregnancy and the year after delivery, with symptoms that should trigger immediate care.

A Simple Way To Track Triggers

If headaches keep returning, a tiny log can pay off. Keep it basic: time, what you ate and drank, sleep length, and where the pain sat. After a week or two, patterns often pop out.

When To Bring It Up At A Prenatal Visit

Bring headaches up at your next visit if they’re frequent, changing, or pushing you to use pain medicine often. Ask what your safe medication plan is for your trimester, what symptoms should trigger a same-day call, and whether home blood pressure checks make sense for you.

Next Step Checklist

Use this quick sequence when a headache hits:

1. Check for red flags: vision changes, swelling, fever, severe sudden pain, chest pain, breathing trouble, weakness, seizure.
2. If red flags are present, call triage or seek emergency care.
3. If it matches a familiar pattern, drink water, eat a snack, rest, and use cold or warm packs.
4. If it isn’t improving, or it feels new after 20 weeks, call the same day.