Lucy Flynn, BABYGO® team
Fourteen weeks. The sickness is meant to be easing, you've started telling people, and instead you've had a headache since Tuesday. Or it's the third one this week, paracetamol only takes the edge off, and you're not sure how much of that you're allowed.
Most headaches in pregnancy are what they feel like: tiredness, not enough water, a skipped lunch, the coffee you gave up, a bad night. The NHS says they're common in early pregnancy and usually improve as it goes on.
There's one kind you don't sit on, though, so that comes first.
Quick answer: Most pregnancy headaches come from tiredness, dehydration, skipped meals or caffeine withdrawal, and the NHS says they usually improve as pregnancy goes on. Paracetamol is the NHS's first choice painkiller in pregnancy, for the shortest possible time; not ibuprofen or codeine unless prescribed. A severe headache with vision changes, swelling, pain under your ribs or vomiting is different: call your maternity unit, GP or NHS 111.
Call your maternity unit, GP or NHS 111 if you have:
- a severe headache
- problems with vision, such as blurring or seeing flashing lights
- pain just below your ribs
- vomiting
- a sudden increase in swelling of your face, hands, feet or ankles
That's the NHS's list, word for word. A headache like that can be a symptom of pre-eclampsia, which is most likely from 20 weeks but can happen at any point in pregnancy, and in the weeks after the birth too. Don't wait until the morning.
Key facts
- The NHS says headaches are common in early pregnancy and usually improve as your pregnancy goes on.
- Paracetamol is the NHS's first choice painkiller in pregnancy. Take it for the shortest possible time, and check the dose with a pharmacist, your midwife or GP (NHS, paracetamol and pregnancy).
- Painkillers containing codeine, and anti-inflammatories like ibuprofen, are on the NHS's avoid list in pregnancy unless your doctor prescribes them.
- Pre-eclampsia is most likely from 20 weeks of pregnancy onwards, but it can happen at any point. Its early signs are high blood pressure and protein in your wee, which is why your midwife checks both (NHS, pre-eclampsia).
- A cup of tea is about 75mg of caffeine and an instant coffee about 100mg, against the NHS limit of 200mg a day. Going from four coffees to none overnight is a headache in itself.
Severe headache in pregnancy
A severe headache is one that stops you doing normal things, that doesn't lift with paracetamol, or that comes with anything on the list above. The old version of this post said "see your doctor".
The NHS's wording is stronger, and it's the wording to use: call your maternity unit, GP or NHS 111. Ring the maternity unit first if you can. They'd rather check your blood pressure and test your wee and send you home than not see you.
This goes for the weeks after the birth as well. Pre-eclampsia can develop after you've had your baby, and a new severe headache with a new baby in the house is very easy to blame on the new baby.
If you get migraines anyway, tell your midwife at your next appointment so it's in your notes, and don't assume a bad one is "just a migraine" if it's different from your usual ones or comes with anything on the list.
Headaches at 14 weeks pregnant
Fourteen weeks is when most people find this page, and I think it's because it's the week you were promised things would improve. First trimester done, sickness meant to be easing, and instead there's a headache that won't shift.
There's no NHS page about 14 weeks specifically. Its line is that headaches are common in early pregnancy and usually improve as pregnancy goes on, and 14 weeks is still early enough that you're in the "common" bit. It isn't a cliff edge.
Some people's headaches stop at 12 weeks, some at 20, some carry on and need managing. Carrying on isn't a sign something's wrong on its own; the list at the top of this page is what decides that.
What's usually behind a 14 week headache is the ordinary list: you've been sick and haven't drunk enough, you've dropped the caffeine, you're not sleeping, you're eating little and late. Work through that list before you worry.
If the headache is severe, or comes with the vision, swelling, rib pain or vomiting above, it's a phone call rather than a list, whatever week you're in. Pre-eclampsia is most likely from 20 weeks, but the NHS is clear it can happen at any point.
What causes headaches in pregnancy?
The NHS doesn't give a long list of causes. It gives the things to try, which tells you the causes it has in mind: not enough fluids, not enough sleep, not enough rest. Here's the fuller list of what we hear, with the fixes.
| Usual cause | Why it happens in pregnancy | What helps |
|---|---|---|
| Not enough fluids | You're being sick, or you've just forgotten to drink | A bottle of water with you all day, sipped little and often (that's the NHS's morning sickness advice too) |
| Skipped meals | Nausea puts you off food and the gaps get long | Small, frequent, plain meals: bread, crackers, rice, pasta |
| Caffeine withdrawal | You went from four coffees to none the day the test was positive | Cut down rather than stop dead. The NHS limit is 200mg a day, not zero |
| Not enough sleep | Early pregnancy tiredness, then a bump that won't get comfy | Side sleeping with support (below), and no late naps |
| Stress | There's a lot going on | The NHS says rest and relax, and suggests pregnancy yoga. A walk counts |
| Posture, later on | Your back, neck and shoulders work harder as the bump grows | Get up and move every hour, and sort the pillows at night |
| Trigger foods | Some people find cheese, chocolate or yeast extract set them off | Notice the pattern, that's all |
| High blood pressure | The one that matters | The list at the top of this page |
Constant headache in pregnancy
A headache that's there every day for a week is wearing, and it's usually the boring causes stacked up rather than one big one. In the first trimester it's nearly always the sickness: you're not drinking because you're being sick, you're not eating because everything's revolting, and by 4pm your head's pounding.
The NHS's advice for morning sickness doubles as headache advice here: sip fluids little and often, eat small, frequent plain meals, and eat cold food if the smell of hot food sets you off (NHS, vomiting and morning sickness).
Give that a few days. If a constant headache doesn't lift, or paracetamol's doing nothing, ring your midwife.
They'll check your blood pressure and test your wee, because high blood pressure and protein in your urine are the two early signs of pre-eclampsia, and ruling that out is the point of the visit.
Headache and dizziness in pregnancy
Feeling dizzy on its own is common in pregnancy, especially when you stand up too fast, and more so later on when the bump has moved your balance. Get up slowly, sit on the edge of the bed for a breath before you stand, and eat something.
Headache and dizziness together is different. On their own, each has a boring explanation.
Together, or with anything on the pre-eclampsia list, it's a call to your midwife or maternity unit. They will not think you're wasting their time. They'd far rather see you early than late.
What helps a headache in pregnancy
The NHS's list is short and it works: drink plenty of fluids, get enough sleep, rest and relax. To that I'd add eat something, get off the screen, twenty minutes in a dark room with a cold flannel, and a walk if you can face one.
Paracetamol in pregnancy
Paracetamol is the NHS's first choice painkiller if you're pregnant. It's commonly taken in pregnancy and the NHS says it doesn't harm your baby. The rule that goes with it: take it for the shortest possible time, and check the dose with a pharmacist, your midwife or GP rather than guessing from the box.
The old version of this post said "small doses, not regularly". The NHS's version is "shortest possible time", and if you're reaching for it most days, that's a conversation to have with your midwife, not a reason to suffer through it.
What not to take: painkillers with codeine in them, and anti-inflammatories like ibuprofen, unless your doctor prescribes them. If you get migraines and your usual medicine is one of those, ask your GP what to use instead before you need it, not at 2am.
Sleep, and getting comfortable enough to get it
Bad nights feed everything else on the list. The NHS says the safest position to go to sleep in is on your side, either side, and advises against going to sleep on your back after 28 weeks (NHS, tiredness and sleep in pregnancy). Side sleeping is also the position most people can't hold all night without help.
A pillow between your knees and one under the bump stops you rolling onto your back, and stops the top leg dragging your pelvis round. A pregnancy pillow is those two pillows in one shape that stays where you put it.
BABYGO® Moon Pregnancy Pillow
Supports the bump, lower back and knees at once so you stay on your side, and folds under if you're shorter. One size, with a washable 70% bamboo and 30% cotton cover.
One reviewer wrote: "It supports my bump and hips without taking over the whole bed." That last bit matters if there's a partner in it.
Want to know what's normal, week by week? Tell us your due date and we'll send what to expect each week, including the symptoms that are worth a call. 10% off when you're ready.
Second and third trimester headaches
Later headaches have a different list. What's left is mostly mechanical and practical: posture, as the bump pulls your back and shoulders forward; tiredness from carrying the extra weight and not sleeping; skipped meals because there's no room for a full one; and blood pressure, which is why every appointment starts with the cuff.
The old post said headaches in pregnancy usually stop by the sixth month. The NHS puts it more carefully: they usually improve as pregnancy goes on. For some people they don't, and that's a conversation with your midwife rather than something to put up with.
After 20 weeks a new severe headache is more likely to be checked for pre-eclampsia, so the list at the top of this page matters more, not less, the further along you get.
If the caffeine cut is the thing that's set your head off, the tea in pregnancy post has the NHS numbers for tea, coffee and everything else so you can cut down rather than stop dead. If it's the not moving, the ball exercises are a gentle way back in.
Questions we get asked
When do headaches in pregnancy stop?
There's no date. The NHS says headaches are common in early pregnancy and usually improve as your pregnancy goes on; for a lot of people that's somewhere in the second trimester, for some it's after the birth. If they're not improving, or paracetamol isn't touching them, tell your midwife.
Can I take paracetamol for a headache at 14 weeks?
Yes. Paracetamol is the NHS's first choice painkiller at any stage of pregnancy. Take it for the shortest possible time and check the dose with a pharmacist or your midwife. Not ibuprofen, and not anything with codeine in it, unless it's prescribed.
Can dehydration cause headaches in pregnancy?
Yes, and it's the cause we hear about most, especially in the first trimester when you're being sick. Drinking plenty of fluids is the first thing on the NHS's list for pregnancy headaches. Sip little and often if you can't keep much down.
Is a headache a sign of pre-eclampsia?
It can be. The NHS lists a severe headache that doesn't go away with simple painkillers as a symptom, alongside vision problems, pain below the ribs, sudden swelling of the face, hands or feet, and vomiting. It's most likely from 20 weeks onwards but can happen at any point, including after the birth. Call your maternity unit, GP or NHS 111.
Is ibuprofen safe for a headache in pregnancy?
No, unless your doctor prescribes it. The NHS says to avoid anti-inflammatories like ibuprofen in pregnancy, and painkillers containing codeine. Paracetamol is the first choice.
If bad nights are what's behind your headaches, the pregnancy pillows collection is where the Moon pillow lives, and the due date calculator tells you how far off 28 weeks you are.
This is general guidance from the BABYGO® team, not medical advice. Your midwife or GP knows your pregnancy; ask them if anything here doesn't fit your situation.
