Postpartum Headaches: Are They Normal? Causes and More

By Dr. Kenosha Gleaton, OBGYN

Postpartum headaches are headaches that occur within the first six weeks of birth, often due to hormonal fluctuations and lifestyle changes associated with the postpartum period.[1]

Symptoms of Postpartum Headaches

Postpartum headache symptoms can vary greatly depending on the type of headache.

Some common headache symptoms you might experience in the postpartum period include [1-3]:

• Sharp, dull, or throbbing pain
• Pain on one or both sides of the head
• Tight headband sensation
• Pain at the base of the skull
• Facial pressure
• Postnasal drip
• Nausea
• Vomiting
• Sensitivity to light and sound
• Flushing
• Dizziness

Postpartum headaches can be related to low levels of certain nutrients, like magnesium.[2] Taking postpartum essential vitamins can help ensure you get the proper nutrients to promote health and reduce your risk of headaches.

Are Postpartum Headaches Normal?

Unfortunately, postpartum headaches are common for many postpartum mothers. But it is difficult to know exactly how common, as most women will self-medicate for mild to moderate pain and will only seek professional treatment for severe headaches like migraines or spinal headaches (which are caused by epidural complications).[3]

According to the American Migraine Foundation, 25% of women will experience a migraine within the first two weeks of birth, and 50% will experience one within the first month postpartum.[1]

When Should I Worry About Postpartum Headaches?

Fortunately, most postpartum headaches are benign. But some can be life-threatening and require emergency care. Seek immediate medical care if you experience any of the following life-threatening headache symptoms [3]:

• Severe, throbbing pain
• Vision changes
• Decreased urination
• Swelling in the legs or feet
• High blood pressure
• Fever
• Shivering
• Abnormal vital signs
• Abnormalities on neurological exams

Types of Postpartum Headaches

Tension Headaches

Tension headaches are common during the postpartum period. These headaches are less severe than migraines and may be caused by stress, disturbed sleep, and drops in estrogen levels. Pain is usually dull and across the whole head, like the feeling of wearing a tight headband.[2]

Migraines

Migraines are also common during the postpartum period but are more severe than tension headaches. Migraines can be disabling and can last between four and 72 hours. [2]

Migraine pain is throbbing and often occurs only on one side of the head. Some migraines may be accompanied by an aura (temporary visual disturbances). Nausea, vomiting, and sensitivity to light and sound are also common symptoms of migraine.[2]

Like tension headaches, migraines are also caused by drops in estrogen levels and other hormonal changes. Migraines may also be exacerbated by sleep deprivation or skipping meals.[1]

Cluster Headaches

Cluster headaches are less common than other types of headaches during the postpartum period. If you experience piercing or burning pain that may feel centered around one eye or spread out in the nearby area, you may be experiencing a cluster headache. Others describe them as causing a pulsating or squeezing sensation.[2,3]

Spinal Headaches

Spinal headaches, also referred to as postdural puncture headaches (PDPH), are rare but possibly severe headaches that may occur from an epidural complication. They happen when the anaesthesiologist takes the needle too far, causing spinal fluid to leak. Spinal headaches can be dull or throbbing. The pain is usually worse when sitting or standing and gets better when you lie down.[2,3]

Spinal headaches typically occur within the first few days after an epidural.[2,3] If you think you may be experiencing a spinal headache, see your healthcare provider as soon as possible.

Hypnic Headaches

Hypnic headaches are a rare headache syndrome characterized by dull headaches that occur during sleep at least 15 times per month in people over the age of 50.[4] It is not likely that postpartum mothers will experience this type of headache.

What Causes Postpartum Headaches?

Postpartum headaches may be caused by any of the following [1-3]:

• Sudden drops in estrogen levels
• Sleep deprivation
• Stress
• Missing meals
• Dehydration (especially if you’re nursing)
• Exacerbation of headache conditions that occurred prior to pregnancy
• Epidural “postdural puncture”
• Complications of anesthesia
• Pregnancy complications
• Postpartum hypertension (high blood pressure)
• Low levels of magnesium

How to Treat Postpartum Headaches

Many women are unsure how to treat postpartum headaches and feel unsure about medication safety while breastfeeding.

Below are some tips for treating postpartum headaches [1-3]:

• Take over-the-counter medications like Tylenol, Advil, or Aleve, which are considered safe for nursing
• If possible, relax in bed until the pain resolves
• Do your best to eat healthy, get enough sleep, and lower overall stress
• Drink a caffeinated beverage
• Receive IV fluids
• Seek medical care if headaches are persistent or severe

How Natalist Can Help

Dr. Kenosha Gleaton is board-certified in gynecology and obstetrics and is the Medical Advisor of Natalist. She received her MD from MUSC and completed her residency at Carolinas Medical Center in Charlotte, NC.

Dr. Gleaton is passionate about women, youth, and mentoring. She is a Scrubs Camp instructor, a program to increase student entry in healthcare, and serves as a Compassion International adoptive parent. She is also a member of the American College of Obstetrics & Gynecology, the American Association of Gynecologic Laparoscopists, and the American Association of Professional Women.  

References:

1. New Moms with Migraine: Understanding Postpartum Headache. American Migraine Foundation. January 25, 2018. Accessed February 10, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9039472/
2. Janvier, A.S. & Russell, R. Postpartum headache -- diagnosis and treatment. BJA Education. 2022 May; 22(5): 175-81. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9039472/
3. Boushra, M., & Rathburn, K.M. Postpartum Headache. StatPearls. July 17, 2023. https://www.ncbi.nlm.nih.gov/books/NBK537101/
4. Khalili, A.K. & Chopra, P. Hypnic headache. StatPearls. April 10, 2023. https://www.ncbi.nlm.nih.gov/books/NBK557598/