Migraines & Headaches Before Childbirth

Which Medications Are Safe During Pregnancy, and What Can I Do If I Have a Migraine Attack During Labor?

Reading time: 10 minutes

Last updated: February 6, 2024

My Experience: Migraines During Pregnancy

In January 2018, I found out I was pregnant, and everything changed instantly. My entire body dedicated itself to creating and nurturing new life. More than 70% of women who suffer from migraines experience either an improvement or a complete absence of symptoms during pregnancy. Unfortunately, I was not among the lucky ones in the first two trimesters. I quickly realized that migraine attacks drained my energy significantly more than before. In my article about migraines during pregnancy, I describe my experience in more detail.

For around 50% of pregnant women, migraines improve within the first three months.

During the first six months of my pregnancy, my migraines worsened, and the pain became almost unbearable during an attack. However, except for the time just before childbirth, I was fortunate in the final months of pregnancy—my migraines almost completely disappeared. Despite the intense summer heat, the unbearable temperatures, and the humidity (which usually triggers my migraines without fail), I remained pain-free. What a relief!

After my first migraine-free pregnancy months, I had almost forgotten what the pain felt like. But my body had other plans—my migraines returned with full force in the weeks leading up to childbirth. I suspect this was due to the surge in estrogen levels toward the end of pregnancy.

Migraines in the Third Trimester

For about 50% of pregnant women, migraine attacks improve within the first three months. By the second trimester, eight out of ten women experience fewer attacks, and by the third trimester, nine out of ten women see significant improvement. According to experts from the German Migraine and Headache Society (DMKG), “the dramatic improvement in migraines during pregnancy is likely associated with consistently high estrogen levels.”

Medications During Pregnancy – What Is Safe?

I avoided taking any medication throughout my entire pregnancy. The potential risks to my unborn child’s health were too significant for me. Beta-blockers, triptans, pain relievers like Novalgin, all sleep aids, aspirin, and a long list of antibiotics were strictly off-limits. However, a few medications are considered safe from a medical perspective.

For example, Ibuprofen or Diclofenac can be taken during the first and second trimesters (before the 28th week of pregnancy), but they are strictly prohibited in the third trimester. This is because nonsteroidal anti-inflammatory drugs (NSAIDs)—which include Ibuprofen and Diclofenac—can prematurely close the ductus arteriosus, a vital fetal blood vessel that connects the main artery and the pulmonary artery. This premature closure can disrupt the baby’s blood circulation. NSAIDs are also linked to persistent pulmonary hypertension in newborns and potential kidney function disorders.

For nausea treatment during pregnancy, Vomex can be used, but only in extreme cases during the third trimester and strictly under a doctor’s supervision.

Alternative Treatment Methods During Pregnancy

Fortunately, there are many non-medication options for treating migraines. In acute cases, relaxation techniques, guided imagery, magnesium supplements, ginger for nausea, or acupuncture can be effective. You can find more natural treatment methods in our article, “What Helps with Acute Migraine Attacks?”

If you want to prevent migraines naturally, check out our article “Migraine Prevention.” One particularly effective and easy-to-implement strategy is adopting a low-glycemic diet, which helps maintain stable blood sugar levels and has been scientifically shown to reduce migraine attacks.

Avoiding Large Blood Sugar Fluctuations

Recent studies have found links between insulin resistance, high blood sugar and insulin levels, and migraines. Particularly large fluctuations in blood sugar after eating can trigger migraine attacks in multiple ways.

Scientific research has demonstrated that a low-glycemic diet that keeps blood sugar levels stable can be an effective form of migraine prevention.

Using Ebby for Migraine Prevention

Ebby is designed to help with non-medication migraine prevention. During the two-week trial phase, the app, combined with a blood glucose sensor, helps you track your blood sugar response to different meals. Based on this data, you can adjust your diet to maintain stable blood sugar levels.

Since metabolism changes before, during, and after pregnancy, your blood sugar response can vary in each phase. We recommend repeating the two-week test phase in every stage of pregnancy to observe your body’s changes and effectively manage migraines.

Migraine Relief through Personalized Nutrition

Medication Free
Side Effect Free
Based on Science

The Worst-Case Scenario: A Migraine During Labor

The anxiety leading up to labor likely made things worse. However, my biggest fear was experiencing a migraine attack during labor. I thought, “That must be the worst pain imaginable!”

Most women describe labor as the most intense pain they have ever experienced. Since I already knew how excruciating migraines could be, the thought of both at once seemed unbearable.

However, I had spoken to a few mothers who also suffered from migraines. Some of them told me that migraine pain was worse than labor pain.

That gave me some reassurance—I had been enduring migraines regularly since I was eight years old, sometimes weekly.

Despite extensive online searches, discussions in migraine support groups, and consultations with my OB-GYN and midwife, I couldn’t find a single woman who had experienced a migraine during labor. No one could offer advice, comfort, or hope.

My OB-GYN suggested epidurals, painkillers, and a C-section, while my midwife reassured me that labor would likely not begin if I had a migraine. I clung to that hope.

My estimated due date was in mid-September, but my little belly dweller seemed to be quite comfortable in its warm, dark sanctuary and was in no hurry to arrive. The days passed, and I grew increasingly impatient and nervous. Nothing was happening—no contractions in sight.

Migraines during pregnancy not only take a toll on the expectant mother but can also affect the baby. Since pain medication is largely off-limits for pregnant women, only gentler treatment methods remain as alternatives.

The Last Migraine Attack Before Childbirth

On Sunday, September 30, I had a migraine. Since I was already 11 days overdue, the doctors planned to induce labor the next morning.

This meant I could no longer rely on my midwife’s theory that labor wouldn’t start if I had a migraine—it was going to be medically induced.

No Turning Back: The Birth

Early Monday morning, I arrived at the hospital—still with my migraine from the previous day.

To my surprise, I remained calm and collected. My excitement about finally meeting my baby outweighed any nerves.

By mid-morning, my migraine had disappeared, and after three doses of the induction medication, my contractions started immediately at two-minute intervals.

And Then He Was Here…

The moment we had been waiting for had finally arrived.

Our son, Leo, was born!

Weighing 8.3 lbs (3750 g) and measuring 21 inches (53 cm), he was healthy and perfect.

The most beautiful and painful moment of my life.

From my belly straight into my heart—love at first sight!

Labor Pain vs. Migraine Pain

Early contractions were easier to endure than migraine pain because migraine attacks offer no relief—there are no breaks. With every heartbeat, the pain throbs in your temples.

In contrast, contractions come in waves, allowing you to catch your breath and regain strength in between.

Plus, contractions have a purpose—they bring you closer to your baby. Migraines, on the other hand, are meaningless suffering, offering nothing but hours or even days of agony.

What Provides Immediate Relief for Migraines During Childbirth?

Guided Imagery as an Acute Aid for Migraines

I envisioned the contractions as waves—like a boat on an ocean, steadily moving closer to its destination. With each breath, the waves carried the boat closer to shore.

The sheer power of nature that unfolds during childbirth is indescribable. I have never experienced anything more fascinating or awe-inspiring.

Guided imagery exercises can also be helpful for managing migraine pain. By using the power of imagination, pain can be displaced or modified. One might mentally transport themselves to a beautiful place, visualize the pain flowing away, or approach it like a scientist—observing, analyzing, and ultimately diminishing it.

And as I lay there with my child resting on my chest, wrapped in a towel, healthy and safe, I realized that it had all been worth it. Enduring the pain throughout pregnancy without medication had truly paid off!

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Siva, Z.O. et al. (2018): Determinants of Glucose Metabolism and the Role of NPY in the Progression of Insulin Resistance in Chronic Migraine. In: Cephalalgia38 (11), S. 1773–81. https://doi.org/10.1177/0333102417748928.
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„CHARISMHA – Chancen und Risiken von Gesundheits-Apps“, In: http://www.charismha.de/. Letzter Zugang: 05.10.2020

About the Author

Mona Kattwinkel

Mona is a student, a young mother and, last but not least, a migraine expert. She has had migraines since she was 8 years old and is a member of a self-help group within the MigräneLiga e.V. Germany.