Headaches in pregnancy 20 weeks and over

There are many reasons why you might have a headache; most of these are unrelated to your pregnancy. Dehydration is one of the commonest reasons for developing a headache. It is important that you remain well hydrated during pregnancy and avoid dehydration, especially in hot weather  (6-8 medium glasses or 1.6L throughout the day). Try taking simple paracetamol at home; it is safe to take 2x 500mg tablets (1g) of paracetamol every 4 to 6 hours, not exceeding 4g in 24 hours. (Do not take NSAIDS such as Ibuprofen during pregnancy).

Severe headache:

  • Always there and so bad it's hard to think or talk

  • You can't sleep

  • Makes daily life difficult to manage

Moderate headache:

  • Always there

  • Makes it hard to concentrate

  • You can manage to get up, wash or dress

Mild headache:

  • Comes and goes

  • You can manage to sleep

  • Is annoying but doesn't stop you doing things like going to work

Call 999 if you/ the pregnant woman has any of the following

  • Having a seizure (fit)

  • Unable to speak

  • Sudden onset of severe headache reaching maximal pain within seconds

  • Any loss of consciousness

  • Neck stiffness/ pain or develop a rash that does not disappear with pressure (the ‘Glass Test’)

  • Numbness or weakness in your arms and/ or legs

  • Drowsiness or confusion

Contact your GP or NHS 111 out of hours today if you have any of the following

  • Persistent moderate headache which is not relieved within 12 hours of taking regular paracetamol (2x 500mg tablets 4-6 hourly)

  • Visual or hearing disturbance, double vision

  • Temperature 38°C or over (or feel hot to touch)

Contact your maternity unit within 1 hour if you have a headache with any of the following:

  • Epigastric pain (under your ribs on the right side not related to your baby’s movements)

  • Visual disturbances- these are usually “flashing lights” seen in front of the eyes- not related to standing up

  • Persistent or sudden swelling particularly around the face

  • Reduced baby movements

  • Pre eclampsia in a previous pregnancy

  • Previous concerns about your blood pressure at your midwife or doctor’s appointment

  • You are taking any medication for your blood pressure

  • Your headache settles when taking paracetamol.

  • Your headache improves when drinking enough fluids. (6-8 medium glasses or 1.6L throughout the day) or after a sleep.

  • Swelling in your hands and feet that improves when lying down

  • If you suffer with migraine and you are experiencing a typical migraine headache

For more information on pre eclampsia click here

For more information on sepsis click here

Self care

Contact your maternity unit if you are still concerned. And speak to your community midwife at your next appointment.

Pain relief

Paracetamol 2x 500mg tablets (1g) 4-6 hourly not exceeding 4g in 24hours. Do not take NSAIDS such as Ibuprofen whilst pregnant.

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