Postpartum Headache

What are postpartum headaches?

Headaches are common after having a baby. In the six weeks after a pregnancy ends (postpartum), your body goes through all kinds of changes as it returns to its pre-pregnancy state. Some of these changes increase your headache risk.

On top of the physical changes, you’re dealing with the stressors of caring for a newborn: The late-night feedings, the crying, the diaper changes. The new demands can make your head pound.

Typically, headaches become less frequent after the postpartum period. In the meantime, there are steps you can take to manage postpartum headaches.

Types of postpartum headaches

The most common types of postpartum headaches are the most common types in general: tension headaches and migraines. Cluster headaches are less common postpartum, but you can get them, too. The painful throbbing, pulsing or squeezing in your head may feel unpleasant, but it’s usually not serious.

You may get a spinal headache if you had an epidural for pain during delivery. Most people can manage them at home, but in some cases, you may need treatment.

Sometimes, headaches are a warning sign of a rare but serious medical emergency called postpartum preeclampsia. Symptoms include a severe (usually throbbing) headache and vision changes that typically start within 48 hours of giving birth. But symptoms can start as late as six weeks after delivery. This headache doesn’t get better with pain medication, like acetaminophen (Tylenol®).

Get to an emergency room immediately if you’re experiencing symptoms of postpartum preeclampsia. This condition can lead to life-threatening complications without timely treatment.

How common are postpartum headaches?

Approximately 40% of people get headaches in the weeks after they’ve given birth. Usually, they’re unpleasant but not serious.

About half of people with a history of migraines before pregnancy get them postpartum. This includes people who get menstrual migraines. Symptoms usually improve during the second and third trimesters only to return after having your baby.

What are the symptoms of a postpartum headache?

Symptoms include:

• Mild to moderate pain that may feel like squeezing on both sides of your head (tension headache).
• Severe, throbbing or pounding pain that feels more pronounced in a particular area of your head (migraine).
• Burning or piercing pain that feels centered behind one eye and also spread out in the nearby area (cluster headache).
• Dull or throbbing pain that worsens when you sit or stand but gets better when you lie down (spinal headache).

When should I worry about postpartum headaches?

The most common postpartum headaches — tension headaches and migraines — aren’t serious. But severe, sudden headache pain alongside other unusual symptoms may be a sign of postpartum preeclampsia or a blood clot in your brain.

Red flags to look out for include:

• Blurred vision or sensitivity to light. People sometimes see spots or floaters.
• Mental changes, like confusion or brain fog.
• Swelling of your face, hands, feet or limbs.
• Nausea and vomiting.
• Pain, usually near your ribs.
• Shortness of breath.
• Seizure.

Get to an ER immediately if you have these symptoms.

What causes headaches postpartum?

Postpartum headache causes include:

• Hormone levels dropping: Levels of pregnancy hormones (like estrogen) return to pre-pregnancy levels in the six weeks after pregnancy ends. Many people who normally get headaches experience fewer headaches in the second and third trimesters when estrogen levels increase. The dip in estrogen in the weeks after having your baby can cause headaches. This is especially the case with migraines, which are sensitive to hormone fluctuations.
• The demands of caring for an infant: The demands of caring for your baby can cause you to skip meals, forget to drink enough water and lose sleep. The stress of hearing your newborn cry and anticipating their needs can make your head pound.
• Having an epidural: Spinal fluid can leak out when you get an epidural injection. The lost fluid can change the pressure of the cerebrospinal fluid surrounding your brain. The end result is a headache. If this happens during your epidural, your healthcare providers should tell you that you’re at higher risk for this side effect.

Changes in your body during pregnancy also put you at risk of serious conditions where a headache is a symptom — not the primary condition. Changes in your blood vessels that allow enough blood to flow to the fetus during pregnancy can increase your risk of postpartum preeclampsia. Stroke risk is highest in the period shortly after giving birth. Headache is a common symptom of both conditions.

How are postpartum headaches diagnosed?

Your healthcare provider will determine whether you have a primary headache — like a tension headache or migraine — or if your headache is secondary to a more serious condition. They’ll ask about your symptoms, including when your headaches start, where you feel the pain and how long they last.

If they’re concerned your headache is a sign of a serious condition, they may perform a neurological exam or imaging tests. They may order blood tests.

How do you get rid of postpartum headaches?

Treatment for postpartum headaches is similar to treatment for any other headaches. Options include:

• Taking headache medicine: Medications like acetaminophen (Tylenol) and over-the-counter NSAIDs (ibuprofen and naproxen sodium) can help ease headache symptoms. Ask your healthcare provider about what’s safe to take while breastfeeding (chestfeeding). For example, both aspirin and triptans are pain relievers that can be transferred through breast milk. Depending on the dose, they may be unsafe for your baby. Your provider can advise you.
• Trying hot or cold therapy: Applying cold compresses or using a heating pad can soothe headache-related pain. Experiment to find which temperature works best for you.
• Attending to your basic needs: Prioritize caring for your health after delivery. This includes eating regular, healthy meals, drinking at least eight glasses of water daily and getting at least seven hours of sleep. If that sleep goal seems impossible, aim to sleep whenever the baby’s sleeping.
• Managing stress: Learn what techniques work best when it comes to managing stress. For some people, relaxation techniques — like massages, mindfulness and yoga — help. Often, the issue is that you need extra help. Now’s the time to reach out to your support network.

Treatment for spinal headache

You may need an epidural blood patch to treat a spinal headache. This procedure creates a blood clot over the hole from the epidural puncture that’s leaking fluid. The clot stops the leak.

Can postpartum headaches be prevented?

Not always. There’s nothing you can do about the hormone changes that increase your headache risk. But you can prevent headaches from lifestyle-related things, like setting aside your own health while caring for an infant.

Still, this is often easier said than done.

Sometimes, the best strategy is to plan ahead. Have a snack handy in case you feel a hunger headache coming on. Have provider-approved pain relievers nearby, in case you feel your head start to throb or ache.

What can I expect if I have postpartum headaches?

For most people, headaches are most frequent the first week after giving birth. Most people get them less frequently after the first six weeks. The key is giving your body (and mind) a chance to adjust to the major changes you’re experiencing.

What questions should I ask my healthcare provider?

Questions to ask include:

• What’s likely causing my headaches?
• What type of headache do I have?
• What treatments would you recommend?
• What types of headache medicines should I try first?
• How can I recognize and avoid things that may be triggering my headaches?

A note from Cleveland Clinic

It can be hard to prioritize your own health when caring for a newborn. But doing so can prevent aches and pains that make it harder to care for your baby. While you can’t always prevent postpartum headaches, you can manage them by getting a handle on stress. You can be prepared by having medications on hand that are safe for both you and, if you’re breastfeeding, your baby. If you’re experiencing a severe headache alongside symptoms of postpartum preeclampsia, seek care immediately.