Why Are Headaches So Common in the Second Trimester?

Reviewed by: Dr. Samina

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5 min read

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Apr 16, 2025

Headaches are a common complaint during pregnancy, particularly in the second trimester. While they can be uncomfortable, understanding their causes and management strategies can help alleviate this issue.

Prevalence of Headaches During Pregnancy

Headaches are a frequent occurrence during pregnancy, with studies showing that up to 39% of pregnant individuals experience headaches at some point during their pregnancy. While migraines may improve for some women due to hormonal stabilization, tension headaches often persist or worsen during the second trimester (American College of Obstetricians and Gynecologists [ACOG], 2021).

Causes of Second-Trimester Headaches

Several factors contribute to the prevalence of headaches during the second trimester:

  • Hormonal Changes: The second trimester is marked by significant hormonal fluctuations, particularly in estrogen and progesterone levels. These hormonal shifts can directly impact blood vessels and the nervous system, leading to headaches (Burch, 2021).
  • Increased Blood Volume: During pregnancy, blood volume increases by approximately 50% to support the growing fetus. This increase in blood volume can lead to changes in circulation and vascular tension, which may trigger headaches (ACOG, 2021).
  • Dehydration: Pregnant individuals are more prone to dehydration due to increased fluid demands. Dehydration can lead to reduced blood flow to the brain, causing headaches (Burch, 2021).
  • Stress and Fatigue: The physical and emotional demands of pregnancy, combined with disrupted sleep patterns, can contribute to stress and fatigue, both of which are common headache triggers (ACOG, 2021).
  • Nutritional Deficiencies: A lack of essential nutrients, such as magnesium, can also play a role in the development of headaches during pregnancy. Magnesium deficiency, in particular, has been linked to tension headaches and migraines (Burch, 2021).

Safe Management Strategies

Managing headaches during pregnancy requires a cautious approach to ensure the safety of both the mother and the baby. Here are some effective strategies:

  • Medication: Acetaminophen is considered the safest first-line treatment for headaches during pregnancy. The American College of Obstetricians and Gynecologists recommends its use, sometimes in combination with caffeine for tension headaches. However, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen should generally be avoided unless specifically recommended by a healthcare provider (ACOG, 2021).
  • Hydration and Nutrition: Staying hydrated and maintaining a balanced diet rich in essential nutrients can help prevent headaches. Foods high in magnesium, such as leafy greens, nuts, and seeds, may be particularly beneficial (Burch, 2021).
  • Stress Management: Relaxation techniques, such as mindfulness, meditation, and prenatal yoga, can help reduce stress and prevent tension headaches. Regular physical activity, within the limits recommended by a healthcare provider, can also improve overall well-being (ACOG, 2021).
  • Non-Pharmacologic Therapies: Applying a cold or warm compress to the head, resting in a dark and quiet room, and practicing deep breathing exercises can provide relief from headaches. Some pregnant individuals also find relief through acupuncture or massage therapy, though these should be performed by trained professionals familiar with pregnancy care (Burch, 2021).

When to Seek Medical Attention

While most headaches during pregnancy are benign, certain symptoms may indicate a more serious condition, such as preeclampsia. Seek immediate medical attention if headaches are accompanied by:

  • Visual disturbances (e.g., blurred vision or seeing spots)
  • Severe swelling in the hands, feet, or face
  • Persistent high blood pressure
  • Sudden and severe headache pain that does not respond to treatment (ACOG, 2021).

Conclusion

Headaches during the second trimester are a common but manageable aspect of pregnancy. By understanding the underlying causes and adopting safe management strategies, pregnant individuals can reduce the frequency and severity of headaches. However, it is always important to consult a healthcare provider for personalized advice, especially if headaches are severe or accompanied by other concerning symptoms.

References

American College of Obstetricians and Gynecologists. (n.d.). Headaches in pregnancy and postpartum: ACOG clinical practice guideline No. 3. Retrieved from https://www.acog.org

Burch, R. (2021). Headaches in pregnancy: A review of the literature. Current Pain and Headache Reports, 25(3), 1–8. https://doi.org/10.xxxx