headaches.
last revised · reviewed 2026-07-05
Headaches are common in pregnancy, especially the first trimester, driven by hormone shifts, increased blood volume, tiredness, and often caffeine withdrawal. Most are harmless tension-type headaches — but a severe headache in the second half of pregnancy needs same-day review, as it can signal pre-eclampsia.
what it feels like
Most pregnancy headaches are tension-type: a dull, steady ache or band of pressure around the forehead or the back of the head, often building through the day. Women with migraine may find pregnancy changes its pattern — often better after the first trimester, occasionally worse.
why it happens
The steep hormonal changes of early pregnancy affect blood vessels and neurotransmitters much as the menstrual cycle can. Add expanded blood volume, disrupted sleep, first-trimester fatigue, hunger from nausea, and abruptly quitting caffeine, and the first trimester becomes prime headache territory. Levels stabilising usually brings relief by mid-pregnancy.
what helps
- Rest in a quiet, dark room with a cold flannel on the forehead
- Keep blood sugar steady — small regular meals prevent hunger headaches
- Drink water consistently through the day; dehydration is a leading trigger
- Taper caffeine gradually rather than stopping dead
- Prioritise sleep and short daytime rests
- Gentle neck and shoulder stretches, or a warm shower, ease tension-type pain
- Paracetamol is generally considered safe in pregnancy at the recommended dose — confirm with your midwife; avoid ibuprofen unless a doctor specifically advises it
when to call your midwife or doctor
- A severe headache after 20 weeks, especially with vision changes (flashing lights, blurring), swelling of the face or hands, or pain under the ribs — possible pre-eclampsia; call your midwife or doctor immediately
- A sudden, explosive 'worst headache of my life'
- Headache with fever, stiff neck, rash, confusion, or drowsiness
- A headache that persists for more than a couple of days despite paracetamol, or keeps returning — call your midwife or doctor
This page is general information, not a diagnosis. When in doubt, call — no midwife has ever minded a careful question.
common questions
Are headaches normal in early pregnancy?
Yes — headaches are one of the most common first-trimester complaints, caused by hormone surges, extra blood volume, tiredness, and often caffeine withdrawal. They usually improve as hormone levels settle from around weeks 12 to 16.
What can I take for a headache while pregnant?
Paracetamol at the standard dose is generally considered safe throughout pregnancy and is the first-choice painkiller — confirm with your midwife. Avoid ibuprofen and aspirin unless a doctor has specifically prescribed them, particularly in the third trimester.
When is a headache in pregnancy an emergency?
Seek same-day help for a severe headache after 20 weeks with visual disturbance, sudden swelling, or pain below the ribs — classic warning signs of pre-eclampsia. A sudden thunderclap headache, or one with fever and stiff neck, also needs urgent assessment. Call your midwife, doctor, or maternity unit straight away.
read it in context
Headaches tends to show up around these weeks of pregnancy:
related symptoms
- Cramping in early pregnancy
Mild, period-like cramping is common and usually normal in early pregnancy — the womb is growing and its supporting ligaments are stretching.
- Braxton Hicks contractions
Braxton Hicks are irregular 'practice' tightenings of the uterus that can start from mid-pregnancy and become more noticeable in the third trimester.
- Morning sickness
Morning sickness is nausea, with or without vomiting, that affects around 7 in 10 pregnant women.
know what's normal, week by week
elara tracks your symptoms alongside your weeks.
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