Postpartum headaches: Causes, symptoms & how to prevent

What are postpartum headaches?

Postpartum headaches are headaches that you experience after having a baby. As your body undergoes physical, mental, and emotional changes after childbirth, you are at an increased risk of experiencing headaches. 

Around a third of women will experience headaches during their first week postpartum, with up to 80% of women reporting experiencing a headache sometime during the first 6 weeks [1,2]. While tension headaches and migraines account for the vast majority of headaches experienced during the postpartum period, it’s good to familiarize yourself with other types that might require medical attention.

Tension headaches

Tension headaches are some of the most common, affecting everyone regardless of whether you have just given birth. Tension headaches are often described as a dull ache or as a squeezing feeling around your head. They are usually less severe and don’t last as long as migraines. [1] Tension headaches are commonly caused by stress and sleeping problems [3]. 

Migraines

Migraines can range from mild to severe and typically last longer than tension headaches, sometimes up to 3 days. Migraine pain is often described as throbbing and can sometimes be felt locally in one area, like above the eyebrow. Increased sensitivity to noise and light, along with nausea is not uncommon. Most women who experience postpartum migraines also had migraines before getting pregnant; rarely do migraines appear for the first time in the postpartum period. [1] 

Migraines are linked to a number of different causes, such as hormone changes, anxiety, stress, lack of exercise, and not eating regularly or skipping meals [4].

Spinal headache

In rare cases (between 0.5-1% of people), you can experience a headache if you had an epidural during birth. This is called a post-dural puncture headache, or spinal headache. It can occur if the needle used to administer your epidural accidentally pierces the fluid sac that rests around your spine, causing fluid to leak. Spinal headaches usually start 1-7 days after receiving an epidural. They can be severe, and are most commonly felt in the front or back of your head. They are also usually worse when sitting or standing, and you can usually find some relief when lying down. [5]

If you suspect you have a spinal headache, you should contact your midwife or hospital team. In some cases, it’s possible to treat your spinal headache with over-the-counter pain relief, fluids, and rest. However, if the headache is unresponsive to medication, further treatments may be recommended by your healthcare professional. [5]

Blood pressure-related headaches

High blood pressure during pregnancy and preeclampsia are both commonly associated with postpartum headaches. Preeclampsia is a blood pressure-related pregnancy complication that arises most commonly during the second half of pregnancy or right after giving birth. Preeclampsia requires medical monitoring throughout pregnancy for the health of both the mom and baby, and poses a serious health risk to the mother if it develops after childbirth. [6] 

Postpartum preeclampsia typically develops in the first week postpartum, but can develop until about 6 weeks after giving birth [7]. Symptoms of postpartum preeclampsia include [8]:

• A headache that will not go away 
• High blood pressure (over 140/90mmHg)
• Changes to your vision
• Stomach pain
• Swelling in your hands and feet
• Nausea or vomiting

If you experience any of these symptoms, you should consult a healthcare professional right away. If you experience shortness of breath or trouble breathing, seeing spots, seizure, or your blood pressure exceeds 160/110mmHg, contact emergency health services immediately [8].

What causes postpartum headaches

Your body undergoes a number of changes that are physical, mental, and emotional after giving birth. Hormone fluctuations, like those you experience during your menstrual cycle and pregnancy, also occur postpartum. Headaches that are linked to hormonal changes are sometimes referred to as hormonal headaches, or hormonal migraines [9].

At the same time, caring for an infant can be demanding and stressful. Skipping meals, not being able to eat a balanced diet, not drinking enough water, and not sleeping enough can all put you at a greater risk of experiencing headaches. 

Spinal headaches are a specific and rare side effect that can only happen if you have had an epidural. Hypertension, or high blood pressure, related headaches can be experienced postpartum, whether you had elevated blood pressure or preeclampsia during your pregnancy or not. The risk factors of pregnancy preeclampsia are similar to postpartum preeclampsia. These include a history of preeclampsia, having a multiple birth, chronic high blood pressure, type 1 or 2 diabetes, kidney disease, or autoimmune disease [6]. 

What are the symptoms of postpartum headaches

The different types of headaches can have slightly different symptoms. Being able to recognize what type of headache you are suffering from can help you find relief, and indicate when to seek additional medical guidance or care. 

• Tension headaches are characterized by dull or pressing pain or discomfort that can occur anywhere on the head. The strength of discomfort, or pain, can be moderate to intense and there are typically no other accompanying symptoms. [10]
• Migraines typically last between 4 and 72 hours and are characterized by a stabbing or pulsating pain, usually on one side of the head. Migraines can also be accompanied by a sensitivity to light and/or noise along with nausea. [4]
• Spinal or post-dural puncture headaches are usually severe headaches felt in the front or back of your head that are worse when standing or sitting and improve when lying down [5].
• Headaches relating to high blood pressure or preeclampsia are severe and do not improve with over-the-counter pain medication. They are often accompanied by other symptoms like swelling of the face, hands, and feet, vision changes, stomach pain, nausea, and/or vomiting [6].

How do you get rid of postpartum headaches?

Postpartum headaches usually become less frequent as the postpartum period proceeds and eventually ends. Migraines and tension headaches can both be treated through a number of methods, while spinal/post-dural puncture and blood pressure-related headaches often require medical attention.

• Over-the-counter (OTC) medication: paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) are recommended as medical treatment for both tension and migraine headaches [1]. Speak with your pharmacist, nurse, or midwife about what is safe to take during your childbirth recovery and if you are breastfeeding. 
• Hot/cold compresses can provide temporary relief, particularly for tension headaches
• Self-care: as you take care of your newborn, try your best to eat regularly and drink enough water. If you can, you can try to nap while your baby naps to get a little bit of extra rest. 
• Stress management: deep breathing, yoga, and stretching can also help to release tension and stress.

Not all headaches are preventable, but there are steps you can take to try and keep some of them at bay. Staying hydrated as best you can and eating regularly throughout the day can help [10,11]. Light, regular exercise, stretching, and incorporating deep breathing exercises can all help you try and manage your stress during this intense time.  

When should I worry about postpartum headaches?

Most common tension headaches and migraines aren’t serious. However, it’s important to be on the look out for any signs of postpartum preeclampsia requiring care. Seek medical attention immediately if you experience sudden or severe headache pain that is accompanied by any of the following:

• Unexplained vision changes like sensitivity to light or blurred vision
• Confusion or other mental changes
• Swelling in your hands, feet, hands, or extremities
• Unexplained nausea and vomiting
• Pain near your ribs
• Shortness of breath
• Seizure 
• Pain that doesn’t go away after a day or two or that doesn’t improve with OTC painkillers

If you are ever concerned about your headache, or if they are keeping you from performing day-to-day tasks, contact your healthcare provider for guidance.

Navigating your postpartum recovery with NC° Postpartum

Postpartum looks different for everyone, and Natural Cycles is here to help. NC° Postpartum supports you through your journey with daily check-ins that help monitor your physical recovery and how you are feeling, guides and messages to help you prepare for what lies ahead, and informative articles specific to the postpartum period. Why not give Natural Cycles a try today?