Nearly 40% of women experience headaches after pregnancy (1). Postpartum headache is termed as a pain in the head and neck or shoulder in the first six weeks after delivery.
It could happen due to various hormonal and biological changes that occur during and after pregnancy. But a headache can interfere with the new parenting responsibilities, and make your routine painful.
In this MomJunction post, we tell you about the reasons for a headache after pregnancy, and ways to manage it effectively.
Causes Of Headaches After Pregnancy
Any of the following factors can cause primary headaches (including migraines and tension headaches):
- A history of migraines
- The drop in estrogen levels
- Weight loss due to a drop in hormonal levels
- Lack of sleep
Secondary headaches are causedby some underlying health conditions, such as.
- Preeclampsia or eclampsia
- Spinal headaches
- Cortical vein thrombosis
- Caffeine withdrawal
Regional anesthesia also could lead to a headache in some women.
Not all the causes mentioned above are common. A study performed on a sample group of 95 women has found that.
- 47% of women had migraine and tension headaches
- 24% had a headache associated with preeclampsia
- 16% had a headache related to regional anesthesia (4)
We cover them in detail in the next section.
Most Common Types Of Postpartum Headaches
Explained below are the most common causes of a headache after pregnancy.
- Tension headache: It is a mild to moderate pain that starts from the neck and radiates through the entire head. It makes you feel like something is tied around the head. The pain lasts for 30 minutes or longer. Sometimes it can be for as long as a week. Stress, muscle tension, dehydration or lack of sleep could cause tension headaches (5).
- Migraine: The severe headache can occur on one or both sides of your head. It can have symptoms such as nausea, vomiting, and sensitivity to sounds and lights. These headaches also cause visual disturbances such as blind spots, and numbness.
- Postpartum preeclampsia: The condition happens when you have high blood pressure and excess protein in your urine after the childbirth. It could lead to severe headaches, along with abdominal pain, nausea, vision changes, seizures and a decrease in urination.
Headaches, in this case, will develop on both sides of the head, and worsen with physical exertion (8).
- Postdural puncture headache: This is one of the side effects of using regional anesthesia. It might develop after you receive spinal or epidural anesthesia that might puncture the dura before the delivery.
It could cause a severe headache within 72 hours of the surgery and radiate especially when you sit or stand upright. The other symptoms include nausea, vomiting, neck stiffness, and vision and hearing changes (9).
Does Breastfeeding Cause Postpartum Headaches?
Some women might have a lactation headache while for some breastfeeding could be a remedy for their headache. The body releases oxytocin hormone while breastfeeding and this hormone could trigger a headache. You may also get a headache when your breasts become full, hard and swollen. This headache could be relieved with feeding (3).
Ways To Get Relief From Postpartum Headaches
If you develop mild or moderate headache with no serious symptoms, your doctor will treat it just like a typical headache. They would suggest some self-care measures that could be effective in most cases.
- Cold compress: If you develop a migraine, apply an ice pack on the forehead. You can make the ice pack by placing some ice cubes in a towel or using a bag of frozen peas. Do the cold compress for about 15 minutes. This would constrict the blood vessels, and reduce the pressure on sensitive nerves, thus reducing the headache (10).
- Hot compress: It works in the case of a tension headache. Place a hot pad on your forehead or back of the neck. The heat relaxes the tensed and tightened muscles in that area, and relieves a headache.
- Get enough sleep: Deprivation of sleep is also one of the reasons for postpartum headaches. You need to sleep for seven to nine hours every day not only to be active but also to treat a headache (11).
- Stay in a dim or quiet room: Bright and flickering light from computers and televisions could cause a headache. Use anti-glare screens or use drapes over the windows to dim the outside light. Transform to softer lighting systems at home.
- Have a little caffeine: Sipping on some tea, coffee or any other caffeine drinks will give relief from a headache. Caffeine constricts blood vessels and enhances your alertness and mood, which, in turn, reduce your headache. They also improve the effectiveness of headache medications (ibuprofen and acetaminophen) (12).
- Try massage or acupuncture: Massage your neck and temple region for a few minutes. It eases the tension headache that you get from stress. You can also use acupuncture technique at the point LI-4 (located between the index finger and the thumb of the left hand). This area is linked to the part of the brain where headaches emanate (13).
- Drink more water: Dehydration causes irritability and impairs concentration that could make the headache worse. Have water and sugar-free juices, and eat water-rich fruits and vegetables.
- Ginger tea: The ginger root contains antioxidants and anti-inflammatory components that could reduce headaches. It is found to be as effective as sumatriptan therapy for migraines. You can take ginger as a freshly brewed tea or in the form of a supplement (14).
These measures are mostly safe but you may want to consult your doctor for an assurance from them. However, these home remedies may not work in some cases.
When To See A Doctor?
See a doctor if the remedies are not giving you any relief or the headache is recurring. Consider seeing a doctor if the headache:
- Is severe
- Is accompanied by fever, nausea, vomiting, neck stiffness, cognitive problems or visual changes
- Peaks in intensity after sometime
- Disturbs your sleep
- Changes when you move into a different position
- Develops from a physical activity
Your doctor will diagnose the cause depending on the symptoms. They might suggest a treatment if they think it is necessary.
Treatment For Postpartum Headaches
If you develop a headache while you are still in the hospital after delivery, your doctor might suggest a CT or MRI scan and treat the condition depending on the type.
- Primary headaches (tension and migraine) are treated with over-the-counter medications such as ibuprofen (Advil), naproxen (Aleve), diclofenac sodium (Voltaren) and eletriptan hydrobromide (Relpax) (15).
They do not recommend aspirin, opioids, atenolol, zonisamide, tizanidine, and atenolol as they are not compatible with breastfeeding.
- Secondary headaches need an intensive treatment plan, and they are treated with much care. Your doctor would suggest further tests before initiating the treatment.
Headache, even if it is mild, could be a hindrance in your day-to-day activities, especially because your baby needs your complete attention and frequent feeding. In this situation, you would just want the headache to subside at the earliest.
How Long Does A Postpartum Headache Last?
Irrespective of the cause, most postpartum headaches go away within six weeks after childbirth. However, secondary headaches might take longer than this as they need proper treatment.
Postpartum headaches happen due to the internal changes and there is nothing much you can do to avoid them. However, you may be extra careful with your routine.
Ways To Prevent Postpartum Headaches
Self-care can help prevent primary headaches. Here are some measures you can take :
- Get proper rest by taking naps whenever your baby sleeps.
- Drink more water and remain hydrated.
- Consume healthy and nutritious foods.
- De-stress yourself by reading a book, taking a walk, talking to your dear ones, etc.
If you experience frequent headaches, consult your doctor. However, if the headaches are mild or infrequent, you may take the above-mentioned self-care measures to get relief from them. Remember that headaches are not a cause of concern in the majority of cases. It is just a matter of weeks (if not days) before they disappear.
Do you have a postpartum headache? Do share your experience in the comments section below.
2. Vgontzas, A. and Robbins, M. S; Classifying postpartum headache; American Headache Society (2018)
3. Alison MacArthur; Differential diagnosis of postpartum headaches; Revista Mexicana de Anestesiología (2009)
4. Sabharwal; Postpartum headache: Diagnosis and management; Continuing Education in Anaesthesia Critical Care & Pain; ScienceDirect Journals (2011)
5. Anne Fetterman et al.; Tension headaches; University of Rochester Medical Center (2019)
6. Luc Jasmin et al.; Migraine; NIH (2017)
7. Hoshiyama E et al.; Postpartum migraines: A long-term prospective study; Intern Med (2012)
8. John D. Jacobson et al.; Preeclampsia; NIH (2018)
9. Kyung-Hwa Kwak; Postdural puncture headache; Korean J Anesthesiol (2017)
10. Serap Ucler et al.; Cold therapy in migraine patients: Open-label, non-controlled, pilot study; Evid Based Complement Alternat Med (2006)
11. Nathaniel F. Watson et al.; Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society; Sleep Research Society (2015)
12. Richard B. Lipton et al.; Caffeine in the management of patients with headache; J Headache Pain (2017)
13. Acupressure for pain and headaches; Memorial Sloan Kettering Cancer Center
14. Maghbooli M et al.; Comparison between the efficacy of ginger and sumatriptan in the ablative treatment of the common migraine; Phytother Res (2014)
15. John F. Rothrock; Non-steroidal anti-inflammatory drugs (nsaids) for acute migraine treatmenthead; American Migraine Foundation