Understanding Postpartum Headache

After nine months of pregnancy, it’s exciting to meet your new baby. It’s also a relief to finally say goodbye to some of those annoying pregnancy symptoms. Unfortunately, you may be saying hello to other symptoms. Along with all the joy, the postpartum period can bring fatigue and some new discomforts. One of the common complaints is a headache.

A headache in the first six weeks after childbirth is called a postpartum headache. Postpartum headaches are usually not dangerous. However, they could be a sign of a health problem. Here’s what you need to know about the causes and treatments of postpartum headaches.

Symptoms

Studies show that approximately 30% to 40% of new mothers report a headache during the first week after having a baby. A headache is a sensation of pain in your head that may feel like:

• Aching
• Throbbing
• Pounding
• Pressure
• Tightening

Other symptoms can accompany a head pain. You may also have:

• Pain around your eyes
• Nausea
• Vomiting
• Dizziness
• Sensitivity to sound or light

Causes

There are different types of headaches with different causes and triggers. Most of the time, postpartum head pain is just a typical headache and not harmful. The usual reasons you might get one are:

• Hormones. The level of estrogen in your body is associated with headaches. A steady level can keep hormone-related head pain at bay. But, when estrogen levels drop, as they do right after you have a baby, it can trigger a headache.
• Stress. The postpartum period can be stressful and overwhelming. Stress and worry can lead to tense muscles and a headache.
• Exhaustion. When you’re a new mom healing from childbirth, taking care of a newborn, and adjusting to your baby’s schedule, it can be exhausting. Fatigue and lack of sleep are headache triggers.
• Not enough food and water. It’s easy to ignore your hunger, skip meals, or forget to drink enough liquids when you’re caring for a newborn. But, low blood sugar and dehydration can cause a headache.
• Breastfeeding. Some new moms get a headache when they’re breastfeeding. The release of the hormone oxytocin during the let-down of breast milk may be to blame. You could get lactation headaches for a few weeks, or they could continue until you wean your child.
• Allergies and Sinus Issues. Seasonal allergies, a cold, or a sinus infection can lead to swelling and pressure in your sinuses.
• Eye Strain. Spending a lot of time reading, on your computer, or looking at your smartphone can lead to tired eyes and a pounding head. 

Migraines

A migraine is a type of headache. Sometimes it's not that easy to tell the difference between a bad tension headache and migraine. But, there are things that set them apart.

A migraine is usually a throbbing on one side of the head where a regular headache may be on both sides. A migraine may also be more painful than a typical headache. Plus, where a headache is mostly just head pain, a migraine often comes with other symptoms such as:

• Nausea with or without vomiting
• Sensitivity to light and sound
• Vision changes such as flashing lights or spots
• Numbness and tingling

Studies link migraines in women to hormone changes, specifically estrogen withdrawal. During pregnancy, estrogen is high, so migraines tend to get better. But, when the body's estrogen level drops after giving birth, migraines tend to come back. 

It is unusual to get a migraine for the first time right after childbirth. But, according to research, 34% of those who suffer from migraines before pregnancy see them return in the first week after delivery, and approximately 55% get one during the first month.

Complications

A headache can be normal and harmless, or it can be a symptom of another condition. So, if you’re having severe or frequent headaches, your doctor may want to order some tests. You may have:  

• Bloodwork
• CT scan
• MRI
• Other tests

A severe postpartum headache can be a sign of the following postpartum complications.

Spinal Headache

A spinal or postdural puncture headache (PDPH) is severe. It is seen in approximately 1% of women and can come on within three days of receiving anesthesia through an epidural. It develops when fluid from your spine leaks out of the spot where the epidural was. A PDPH gets worse if you sit or stand, but feels better if you lie down. 

Rest, IV fluids, caffeine, or medication can help to relieve the pain. An anesthesia headache may go away on its own, but if it continues, you may need a blood patch. A blood patch is a surgery that injects your blood into the puncture site to stop the spinal fluid from leaking. 

Preeclampsia

Preeclampsia can develop during pregnancy or after your baby is born. Studies show that preeclampsia and high blood pressure occur in 0.3% - 27.5% of new moms. 

The signs of preeclampsia include a headache, high blood pressure, vision changes, weight gain, and swelling in the body. In most cases, it occurs during the first week, but it can develop later - from two to six weeks after the birth of your baby.

Other serious conditions include:

• Stroke
• Dural Sinus Thrombosis
• Idiopathic Intracranial Hypertension
• Brain tumor
• Meningitis

Treatment Without Medication

Some people reach for over-the-counter drugs at the first sign of pain. But, you may want to try to get through the occasional postpartum headache without medicine. Here are some tips to get you through it:

• Rest. Turn off the lights and the TV and lie down in a dark, quiet room. Put your feet up, close your eyes, and try to take a nap.
• Have a drink of water and eat something. Drink plenty of healthy fluids can keep you hydrated. And, eat something to bring up your blood sugar, especially if you haven't eaten in a while.
• Have a little caffeine. Caffeine is a drug that can treat headaches. It is even an ingredient in some over-the-counter headache medicines. So, grab a cup of coffee or some tea.
• Relax. Meditation, yoga, stretching exercises, or a warm bath or shower can help you relax and ease tension in your muscles.
• Use warm and cold towels. Try placing a warm or cold compress on your head. Use what works best for you or alternate between warm and cold.
• Ask for help. Don't be shy about calling a family member or friend for help. The people that care about you are often more than happy to help out. You'll feel much better if you can get a little rest and have a few moments to take care of yourself.

Medication

You can try to get through an occasional headache without taking any medicine. But, some headaches and migraines are just too much to bear. If you need relief, you don't have to suffer. 

An over-the-counter pain reliever is usually enough for most typical headaches, but you may need a prescription if you suffer from migraines. Some of the options are: 

• Tylenol (acetaminophen)
• Motrin or Advil (ibuprofen)
• Aleve (naproxen)
• Aspirin
• Combination medication such as Excedrin or Tylenol Ultra with caffeine 
• Prescription medications for pain, nausea, or other symptoms

When to Call the Doctor

Occasional head pain that goes away with rest or a snack is usually nothing to worry over. However, if you’re getting headaches more often or they’re worse than usual, it’s time to notify the doctor. Your doctor may want to test you for a secondary headache or recommend a consultation with a neurologist.

Call the doctor or go to the hospital if you have:

• A headache that is not going away or getting worse
• Head pain lasting longer than 24 hours
• Fever
• A stiff neck
• Nausea and vomiting
• Dizziness
• Blurry vision
• Seizures

Headache Prevention

When you just had a baby, taking the time to care for yourself is easier said than done. But, here are a few things you can try to prevent postpartum headaches.

• Stay away from triggers. It is not always obvious, but if you can figure out which foods, plants, or smells cause your headache, you can try to avoid them. 
• Pay attention to diet. Hunger, low blood sugar, and dehydration can cause a headache, so don't skip meals and drink plenty of fluid. Try to eat at least three well-balanced meals a day along with a variety of healthy snacks. Keep your refrigerator and pantry stocked with easy to grab snacks. Put healthy snacks packed with full of protein and whole-grains in your purse or diaper bag, so you have something to munch on when you're out of the house. And, keep a bottle of water with you at all times so you can sip it throughout the day and stay hydrated. 
• Try to rest. Is it difficult with a newborn? Yes. But, but do your best to get some extra rest by going to bed earlier, grabbing a nap during the day when the baby is sleeping, or asking your partner, family member, or friend to stay with the baby while you rest.
• Lower your stress. Use some relaxation techniques to help you reduce stress and relax. You can listen to music, talk to friends, enjoy some relaxing postpartum stretches or yoga, practice meditation, or engage in safe activities and hobbies that you enjoy. 
• Engage in regular physical activity. Of course, you have to start out slowly after you have a baby, but exercise is healthy for your body and mind. Studies show that regular exercise can lead to having migraines less often or migraines that are not as severe. It may even help prevent them.
• Watch your posture. Poor posture can strain the muscles in your back and neck. But, you can help to avoid that tension by sitting and standing up straight with your shoulder back.
• Take care of your eyes. If you spend a lot of time reading or in front of a screen, take frequent breaks to prevent eye strain. You can also make an appointment with your eye doctor to see if you need glasses or an adjustment in your current vision prescription.
• Try alternative health. Alternative care such as massage, chiropractic care, or acupuncture may help to relieve and prevent headaches. Just be sure to choose a licensed professional for all your natural health care needs.
• Make healthy lifestyle choices. Limit alcohol consumption, avoid smoking and drugs.
• Talk to a counselor or therapist. If you’re feeling overwhelmed, anxious, or depressed, talk to your doctor or another health professional for help.

A Word From Verywell

Headaches are a part of life. They can come on at any time, even after you have a baby. If you think about it, there’s so much going in your life and your body in those weeks following the birth of your child, that it’s not surprising headaches are common. While they’re painful and inconvenient, they’re typically not harmful and often relieved with a little food, rest, and perhaps some Tylenol.

Try to look at it as a reminder to take some time to care for yourself. But, pay attention to any warning signs that may accompany a headache, and be sure to call the doctor if it doesn’t go away, gets worse, or you have any other symptoms.