Prepare For Migraine During Pregnancy: 4 Tips To Get You Ready
This post contains affiliate links. If you click on one and make a purchase, I may earn a small commission at no additional cost to you.
I did not prepare for migraine during pregnancy, although I really wish I did. I had episodic migraine for most of my life, and after unsuccessfully trying multiple treatments, I learned to live with it. So when my husband and I began discussing having children, I assumed there were no safe migraine treatment options during pregnancy. A headache specialist confirmed my suspicions once I became pregnant. When I was in agonizing pain and reached out for advice, she told me my only options were to “take Tylenol and drink more water.” These “treatments” never offered relief before, let alone when my hormones raged during pregnancy. I did not make a plan to manage my migraine during pregnancy, and that was a big mistake I hope you can avoid.
What to Expect: Migraine During Pregnancy
My two pregnancies were challenging and ultimately led me to a chronic migraine diagnosis complicated by medication-overuse headache. But I want to start with some genuinely encouraging news: for many people, migraine actually improves during pregnancy.
A 2024 review of migraine during pregnancy found that 60% to 70% of people with migraine reported that their attacks resolved during pregnancy, with improvement most common during the second and third trimesters. Improvement was also more common in people with migraine without aura. Of course, everyone is different. Some people experience no change, worsening attacks, or migraine for the first time during pregnancy.
Even if your migraine does not improve, there are treatment options and management strategies that you can discuss with your healthcare team. I wish I had known that when I was pregnant. I may have experienced less pain and felt far less stressed about how I would manage migraine throughout my pregnancy.
Although pregnancy can feel like an especially vulnerable time when you live with migraine, you are not helpless or alone. If you are looking for a safe space to connect with other parents and parents-to-be who understand, exchange information, and feel supported, join our Parenting With Migraine Facebook support group.
Now, let’s make a plan. Here is a to-do list for anyone living with migraine who is pregnant or planning to become pregnant:
1. Assemble A Team Of Doctors To Help You Manage Migraine During Pregnancy
It is so important to know that you have options for managing migraine during pregnancy. Finding the right healthcare providers is the first step. If possible, meet with them before pregnancy to review your current treatments and develop a migraine management plan that considers your needs and the available pregnancy safety information.
Depending on your medical history, your healthcare team may include:
An obstetrician or OB-GYN: This doctor oversees your pregnancy, monitors your health and your baby’s development, and coordinates your general pregnancy care.
Headache specialist or neurologist - This healthcare provider can help you manage your migraine during pregnancy. A headache specialist focuses on headache and migraine disorders and may be certified in Headache Medicine. A 2024 systematic review estimated that approximately 40 million U.S. adults live with migraine. Yet the UCNS reported only 859 physicians certified in Headache Medicine across the United States and Canada.
Maternal-Fetal Medicine (MFM) physician - An MFM physician specializes in higher-risk and medically complex pregnancies. Not everyone with migraine needs to see an MFM specialist, but one may be helpful if your migraine is severe, you have additional pregnancy risks, or your medication plan is complicated.
Your doctors can work together to develop an individualized migraine management plan that considers your disability, medical history, pregnancy, and available safety information.
Consider an Appointment With A Maternal-Fetal Medicine Physician
If your migraine is severe, you have other pregnancy risks, or you take medications that require additional consideration, ask your OB-GYN or headache specialist whether you should meet with an MFM physician before getting pregnant.
During the appointment, you can review your medical history, migraine treatments, medications, and supplements. Your healthcare team can help you decide what may be continued, what may need to be changed, and what options you could consider for treating or preventing migraine attacks during pregnancy.
Some medications and supplements may need to be adjusted well before pregnancy. According to current recommendations for managing migraine during pregnancy, CGRP monoclonal antibodies, including Aimovig, Ajovy, Emgality, and Vyepti, should generally be stopped six months before pregnancy because pregnancy safety data remain limited.
ACOG’s pregnancy headache guidance, summarized by The ObG Project, also identifies valproate and topiramate as medications that should not be used during pregnancy because of the potential for fetal harm.
If you take one of these medications, do not stop it on your own. Make an appointment with your neurologist or headache specialist to discuss how to stop or change it safely and which alternatives may be appropriate for you.
What If I Am Already Pregnant?
First, congratulations! Ideally, these conversations would happen before pregnancy, but it is never too late to ask about migraine treatment options and find ways to get some relief.
If your headache specialist or neurologist tells you there are no treatment options during pregnancy, ask your OB-GYN whether a referral to an MFM physician or a second opinion from another headache specialist would be appropriate.
When to Seek Urgent Medical Care
A new, sudden, severe, or significantly different headache during pregnancy should not automatically be assumed to be migraine. Contact your OB-GYN or seek urgent medical care if a headache is accompanied by high blood pressure, vision changes, weakness, numbness, confusion, fever, persistent vomiting, or other unusual symptoms. These symptoms may indicate preeclampsia or another condition that requires prompt evaluation. You can learn more from the American College of Obstetricians and Gynecologists’ guide to headaches during pregnancy.
Need Better Access to a Headache Specialist?
If you cannot find a local headache specialist, are facing a long wait for an appointment, or need another opinion about managing migraine during pregnancy, virtual neurology may be an option.
Neura Health is a virtual neurology clinic I have been using since 2022 that offers video visits with board-certified neurologists and access to a headache care team through online messaging. Services, appointment availability, insurance participation, and pricing vary by location, so check the website for current details. You can use my code parenting15 for $15 off your initial membership.
2. Build S.E.E.D.S. Habits for Migraine Before Pregnancy
Focus on lifestyle changes that may help support your migraine management before, during, and after pregnancy. S.E.E.D.S. is an acronym that can help you remember several lifestyle habits that may support migraine management.
S is for Sleep - Keep consistent sleep. Try keeping your bedroom dark, cool, and quiet to improve sleep hygiene.
E is for Exercise - Exercise regularly. Start slowly, even if it’s 5 minutes once a week!
E is for Eating - Develop consistent eating patterns and avoid dehydration.
D is for Diary - Tracking your migraine attacks can help you and your physicians identify patterns, recognize possible triggers, and evaluate whether your treatments are helping.
S is for Stress Management - Find ways to manage stress through meditation, deep breathing or gentle movement. The Danielle Foundation’s free Wellness for Migraine program offers yoga, mindfulness practices, and migraine-friendly nutrition resources to support your overall well-being.
Of course, pregnancy and life with a new baby are not exactly known for consistency or glamorous self-care. Eating regularly, staying hydrated, sleeping well, and finding time to move your body can all become more difficult. If you are planning to become pregnant, it is a good idea to start building these habits beforehand. This gives you time to figure out what works for you before pregnancy symptoms and life with a new baby make consistency even harder. You do not have to do any of it perfectly. S.E.E.D.S. simply gives you a practical framework for supporting your health and managing migraine before, during, and after pregnancy.
3. Explore Non-Medication Options for Migraine During Pregnancy
Non-medication tools and strategies can be helpful additions to your migraine management plan during pregnancy. Here are some of my recommendations:
Neuromodulation Devices
Neuromodulation devices such as CEFALY, Nerivio, or gammaCore may be considered for use during pregnancy as non-medication options for treating or preventing migraine attacks.
I regularly use my CEFALY to treat migraine attacks and it is usually my go-to migraine relief treatment when I feel an attack coming on. CEFALY is an FDA-cleared wearable device for the acute and preventive treatment for migraine. CEFALY offers a 90-day satisfaction guarantee, so if it is not effective for you, you can return the device to get your money back. Use code parentingwithmigraine to get 15% off the device.
Acupuncture
I used acupuncture during both of my pregnancies and found it helpful. ACOG’s guidance on managing headaches during pregnancy includes acupuncture among the non-medication approaches that are unlikely to cause harm, although it notes that evidence about effectiveness remains limited.
If you are interested in trying acupuncture during pregnancy, talk with your prenatal healthcare provider and look for a licensed acupuncturist who has experience working with pregnant patients and people with migraine.
Free Migraine Management Program
If you are looking for more tools to add to your migraine management plan, I recommend the Danielle Foundation’s virtual Migraine Management: Tools for Lasting Relief program. Start with the six-week Starter Course, which teaches practical relaxation techniques, pain management strategies, and coping skills to help you manage migraine and the stress and anxiety that can come with it. These skills may be especially helpful during pregnancy, when treatment options can feel more limited, and you can continue using them long after pregnancy.
4. Build Your Migraine Toolkit
Now is a good time to build a migraine toolkit with products and comfort measures that may help you manage symptoms before, during, and after pregnancy. A toolkit includes your personal go-to items for making migraine attacks a little more manageable. Here are some of the non-medication tools and comfort items I personally use and keep in my migraine toolkit:
Migraine glasses: Avulux lenses help me manage light sensitivity. Get $25 off with code parentingwithmigraine.
Green light: The narrow-band green light from my Allay Lamp feels soothing when I am sensitive to light. Get 10% off with code MARINA10.
Ice therapy: TheraICE is a wearable gel ice hat that provides cooling relief during a migraine attack.
Heat therapy: This neck and shoulder heating pad helps soothe the tightness and muscle tension I experience with migraine.
Earplugs: Loop earplugs help reduce background noise when I am sensitive to sound.
AirPods: AirPods with noise cancellation help soften background noise and let me listen to calming music or an audiobook during an attack.
Supplements: If your healthcare provider recommends supplements during pregnancy or breastfeeding, Parenting With Migraine readers can receive a discount through my Fullscript dispensary.
There Is Hope
Despite all the debilitating pain I’ve experienced due to migraine during pregnancy, I am incredibly grateful for my children and the light they bring into my life, even in the darkest of times. I want you to know that if children are a priority for you, but you are worried about your migraine disease, please do not let it stop you. Though I can’t promise it will be easy, there is hope, and there are treatment options you can discuss with your healthcare team.
Medical Advice Disclaimer
THIS WEBSITE DOES NOT PROVIDE MEDICAL ADVICE. All content is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional about any medical condition or treatment and before changing your healthcare routine. Never disregard or delay seeking professional advice because of something you have read on this website.
