Migraine and Pregnancy

Pregnancy means big changes in a woman’s body: what does that mean for women with migraine?

Starting a family is one of the most amazing experiences in a woman’s life. It can be exciting, intimidating, joyous and even a little bit scary—especially if you are one of the millions of women in the United States who are living with migraine. But before you put your pregnancy dreams on the backburner, we have great news: pregnancy can oftentimes bring relief to migraine patients.

Dr. Matthew Robbins, associate professor of neurology at the Albert Einstein College of Medicine, researches headache and pregnancy. In a recent Facebook Live event hosted by the American Migraine Foundation, he revealed that pregnancy, and breastfeeding after birth, can actually reduce the frequency of headache attacks in women with migraine.

“Women with migraine should definitely not be afraid of becoming pregnant, and there’s no evidence or experience that suggests that having children is in any way harmful to women with migraine, overall,” Dr. Robbins said.

Migraine and Pregnancy

Migraine and estrogen have a “complicated relationship,” Robbins said, but the increased level of estrogen that pregnant women experience has been shown to lessen the frequency and severity of headaches. This can be true even for women who suffer chronic migraine with auras. “In pregnancy, when estrogen levels really steadily increase, most women report improvement in migraine in terms of how frequent the attacks are and how severe the attacks are,” Robbins said. In fact, doctors may even take women off their daily preventive migraine medicine when they become pregnant.

Pregnancy and Migraine Medication

Pregnant women have to be very careful about what they put into their bodies, which is also true for most migraine medications. Women in early stages of pregnancy and on migraine medication should call their doctor as soon as they learn that they’re expecting. But don’t be too worried about negatively impacting the fetus from medication you were taking before you found out, as the bloodline between mother and fetus doesn’t open until six weeks (please confirm from video..) For women who do experience migraine attacks during pregnancy, some medications are safe for pregnant women to use, including Benadryl and Tylenol, but call your doctor to confirm. An obstetrician should work “quite closely” on a treatment plan with a mom-to-be’s migraine management team, whether that includes a primary care physician, neurologist, a headache specialist or someone else. Of course, migraine and the experiences of pregnancy vary from person to person. Women who have their headaches accompanied by aura may not see the same improvement other migraine sufferers do, Robbins said.

Migraine and Breastfeeding

Newborns and their mothers can receive many benefits from breastfeeding, but one of the more surprising advantages is that breastfeeding can help women who suffer from migraine. Breastfeeding can prevent estrogen levels from dropping after a woman gives birth—which can help lower the frequency of migraine attacks in women.Just as higher, steady estrogen levels can decrease the frequency and severity of migraine during pregnancy, Robbins said, it can be equally helpful for breastfeeding women. “We always encourage our patients to breastfeed, especially if they have migraine, because it might confer an added benefit,” Robbins said. As breastfeeding tapers off, Robbins said, migraine frequency may start to increase again.

Postpartum Depression

Postpartum depression is very real for up to 20 percent of new moms. The good news is that, according to Robbins, there’s no clear link between migraine and postpartum depression, and migraine sufferers do not have to specifically worry about an increased risk of postpartum depression. Migraine treatments that weren’t available to moms during pregnancy will once again be safe  after a woman gives birth, so moms-to-be shouldn’t worry that migraine pain will compound their risk for emotional distress. “Women with migraine should not specifically worry about postpartum depression,” Robbins said. “They should just worry about themselves and having a healthy family, having a healthy baby, and making themselves as functional as possible and seeking care proactively.”

Bringing a baby into the world is an exciting, optimistic time, and future mothers shouldn’t worry about the anguish casting a dark cloud over their pregnancy and new motherhood. While the experience of living with migraine can be fraught with challenges, for many women, becoming a mother is a bright spot in that journey in more ways than one. For more information about migraine, including how to identify and treat headaches in kids, visit the American Migraine Foundation’s resource library.