Some women see no difference in their migraine during pregnancy, while others may feel their migraine attacks worsening. But the vast majority of women report that they experience less frequent and less intense migraine attacks while pregnant. According to Dr. Hamilton, women with migraine who are pregnant, or are planning to become pregnant, will likely have to change their treatment plan as the majority of pharmacological migraine treatments are contraindicated for pregnant women and women who are breastfeeding.
Advice: If you are planning to become pregnant, work with your headache specialist to identify treatment options that are safe during pregnancy. If you find out that you are pregnant, consult a physician right away about your treatment options during gestation.
According to Dr. Angeliki Vgontzas, a neurologist at Brigham and Women’s Hospital, women with migraine have a high risk of having a migraine in the postpartum period. While estrogen and progesterone levels soar during pregnancy, both those hormones decrease dramatically after delivery, which may result in the return or first appearance of migraine. About 25% of women have a migraine within two weeks of delivery, and almost half of women have one within the first month.
Advice: If you are one of the many women who experience postpartum headache, make sure to prioritize self-care. Ask for help and get some rest.
Researchers found that breastfeeding does not contribute to increased frequency of migraine, and in fact, there’s data to suggest that breastfeeding could reduce the frequency of migraine. However, when it comes to treatment, breastfeeding mothers have to determine whether the medications they take are excreted in breast milk and whether they are safe for infants. “There are options out there,” said Dr. Vgontzas, “They do have to be individualized, but having migraine should not change your decision about whether to breastfeed or not.”
Advice: Speak with your healthcare provider or consult Motherisk.org about specific migraine treatments that are safe during lactation.