Postpartum headaches are natural complaints that can occur anytime after delivering a baby. However, according to the American Migraine Foundation, one in four new mothers encounter postpartum headaches within two weeks of childbirth, while others face migraine attacks within the first month.
Postpartum headaches are caused by chemical and physiological bodily changes. These headaches might subside once the hormone levels drop. However, consult your doctor when the condition persists even after the stipulated period (1) (2).
Learn about the types, causes, triggers, and management of postpartum headaches.
Causes Of Postpartum Headache
Postpartum headaches are self-limiting and benign in most cases. However, some possible causes that may trigger these headaches include
- Hormones: The levels of estrogen and endorphins (pain-killing hormones) increase sharply during pregnancy, reducing the symptoms of pre-existing migraine headaches. However, post-delivery, these hormone levels return to normal, leading to the return of headaches (3).
- Exhaustion: After childbirth, mothers tend to focus solely on nurturing their babies. However, the fatigue, stress, and physical changes during and after pregnancy can lead to exhaustion, causing headaches.
- Breastfeeding: Even though breastfeeding does not directly contribute to postpartum headaches, the changes in the hormonal levels due to breastfeeding could lead to headaches.
Furthermore, a personal or family history of migraines could increase the risk of developing postpartum headaches.
Types Of Postpartum Headache
Postpartum headaches can be divided into two groups, namely, primary headaches and secondary headaches.
1. Primary headache syndromes
They include migraines, tension headaches, and cluster headaches, which aggravate after childbirth due to hormonal imbalances, high-stress levels, or sleep deprivation and fatigue (1). Though they can be managed with paracetamol or low-dose aspirin, you should consult your doctor whether any medication is safe to use while breastfeeding (2).
2. Secondary postpartum headaches
A prospective cohort study’s results reveal that, after childbirth, most women suffer from secondary headaches (4). They usually act as an initial symptom pointing to an underlying disease or condition. Certain factors that may cause secondary headaches are as follows:
- Postdural puncture headache (PDPH): PDPH is a side effect of using regional anesthesia during childbirth. It affects the front and back parts of the head and worsens while sitting or standing (5). It can be managed with paracetamol with caffeine and by lying down till the pain subsides, or even require an intervention such as an epidural blood patch when there is no response to conservative treatment.
- Preeclampsia: Postpartum preeclampsia is a rare condition leading to high blood pressure and high protein levels in the urine (6). It is a serious condition leading to complications such as eclampsia (seizures) if not diagnosed and treated promptly.
Possible Triggers Of Postpartum Headaches
Certain factors that may trigger acute postpartum headaches are (1)
- A drop in the estrogen and progesterone levels
- Skipping meals
- Sleep deprivation
- High-stress levels
- Changes in serotonin and oxytocin levels
Management And Prevention Of Postpartum Headaches
Certain over-the-counter pain relievers such as Ibuprofen or Tylenol can help manage postpartum headaches without interfering with breastfeeding (2). Additionally, you can prevent postpartum headaches with the following tips for a healthy lifestyle:
- Get enough sleep
- Stay hydrated
- Take time to relax and de-stress
- Avoid known triggers
- Follow a healthy diet rich in proteins, carbohydrates, and minerals
- Engage in regular physical activity
- Avoid straining your eyes
- Correct your posture
Signs To Call The Doctor
Postpartum headaches often resolve by themselves with proper rest and food. In case the headache persists for more than 24 hours and aggravates, or accompanies other signs as follows, consult your doctor
- Neck stiffness
- Vomiting tendency
- Blurred vision
- Shortness of breath
Postpartum headaches are a fairly common, non-serious issue among women that usually resolves within five to six weeks from childbirth. Certain over-the-counter medications that are safe to use while breastfeeding can help deal with the pain. However, in case of a severe headache that aggravates over time, contact your doctor.
- Postpartum headaches are usually harmless and self-limiting.
- They are classified as primary or secondary based on their occurrence before or after pregnancy.
- Skipping meals, lack of sleep, hormonal imbalances, and stress are some factors that may cause acute postpartum headaches.
- Maintaining a healthy lifestyle and taking OTC pain relievers such as Tylenol can help manage postpartum headaches.
- Marina Boushra and Kimberly M. Rathbun; (2021); Postpartum Headache.
- New Moms with Migraine: Understanding Postpartum Headache.
- Migraine during pregnancy.
- A Hospital Based Retrospective Study of Acute Postpartum Headache.
- Headache After ASpinal Or Epidural Injection.
- Postpartum Preeclampsia.