Migraines and Pregnancy

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No one is exempt from migraines and women are especially prone so it’s just a matter of averages to expect that migraines will affect pregnancies.  Women should naturally be concerned about taking medications during pregnancy, whether over the counter or prescription, and since most people turn automatically to medication to treat the severe headaches caused by migraines, it’s doubly important to be aware of the consequences of taking migraine medication during pregnancy. 

Unfortunately, the plain fact of the matter is that the effects of most headache medications on pregnant women and their unborn children still remains in the dark.  Because of this uncertainty, women who suffer from migraines really need—when possible, of course—to work their migraine relief into their pregnancy plan right from the beginning, even before conception. Most experts in migraine prevention and relief strongly advise a slow tapering off medication prior to attempting to conceive.   A slow tapering off means about a week, by the way, not several months.

Of course, many women suffer from headaches far too extreme to even consider tapering off their medication.   If this is the case with you, it is highly recommended that before attempting to become pregnant you make an appointment with your doctor and to talk over the risks of sticking with your medications while pregnant.   It’s been well established that some medications such as Depakote have caused birth defects, but many other preventative medications such as beta-blockers and tricyclics have been proven relatively safe.  If you’re taking drugs by injection, like Imitrex, you’ll definitely have to stop taking it because there just simply isn’t enough evidence of its safety during pregnancy.  

Since most birth defects occur during the first few months of life, often before the mother even realizes she is pregnant at all, it is not a good idea to wait until confirming the pregnancy before making decisions on medication and pregnancy.

Of course, there is more to pregnancy and migraines than just being careful with medication.  Pregnancy means food cravings and food cravings means eating things you don’t normally eat, or least eating them in a bulk you don’t normally eat them in.  Food and food additives are major league triggers of migraines so when pregnant, be sure to be careful about what you eat.  In particularly, avoid foods high in MSG and stay away from strong aged cheeses, which are well known triggers for migraine attacks.  It couldn’t hurt to avoid low blood sugar by eating complex carbohydrates rather than refined sugars.  On the other hand, when using sugar substitutes be sure to stay away from aspartame (NutraSweet).

Generally speaking, a woman who doesn’t have any other health problems besides migraines probably doesn’t run any special risk.  On the other hand, if your first migraine onsets during pregnancy, it is vitally important to get to a doctor so that he can rule out any other dangerous conditions such brain hemorrhage, meningitis, or even tumors. Further testing may be needed to determine the cause of the headache.

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Migraine treatment during pregnancy tends to be of the medical alternative variety such as the use of cold packs, darkened room, and sleep.  Although caffeine is one of the trickiest of all food-related migraine triggers to deal with, taking it in small doses during the first trimester is usually safe, as is the use of acetaminophen in small doses.

When it comes to both pregnancy in general and migraines in general, one of the best thing you do to is to relieve the amount of stress in your life.  Yes, it’s very easy to say you’re going to reduce stress and it’s altogether something else to actually do it, but if you can take small steps here and there to reduce or eliminate tension-causing elements from your life, you’ll be surprised at the effect it has on your migraines.  Not to mention the effect it will have on your pregnancy.

One last thing to be aware of concerning pregnancy and migraines.  Patients are often giving hormones to induce labor and this frequently causes migraines.  Labor is painful enough without adding migraine pain to it so be sure your delivery care person knows you are prone to migraines before the decision is made to induce labor.

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