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I did not prepare for migraine during pregnancy, although I really wish I did. I had episodic migraine all my life, and after unsuccessfully trying multiple treatments, I learned to live with it. So when my husband and I began discussing having children, I assumed there were no safe migraine treatment options during pregnancy. A headache specialist confirmed my suspicions once I became pregnant. When I was in agonizing pain and reached out for advice, she told me my only options were to “take Tylenol and drink more water.” These “treatments” never offered relief before, let alone when my hormones raged during pregnancy. I did not make a plan to manage my migraine during pregnancy, and that was a big mistake I hope you can avoid.
What To Expect: Migraine During Pregnancy
My two pregnancies were challenging and ultimately led me to a chronic migraine diagnosis complicated by rebound headaches. However, I am here to deliver some good news: For many, migraine during pregnancy actually improves. And safe migraine treatment options are available for migraine during pregnancy.
Pregnancy will usually reduce the frequency and severity of migraine attacks. Migraine attacks often increase in frequency in the first trimester but can be expected to decrease later in pregnancy. Noteworthy is that for some, pregnancy can alter the migraine pattern and trigger migraine aura. 
I wish I had known then what I know now about migraine during pregnancy. I would have experienced less pain and felt less stress about my pregnancy journey. Get ready to make a plan of action as I arm you with the knowledge to advocate for yourself.
Although this may feel like a vulnerable time, you are not helpless or alone. If you are looking for a safe space to connect with other parents or parents-to-be with migraine to exchange information and feel supported, join our Parenting With Migraine Facebook support group.
Here is a “to-do” list if you have migraine and are planning to get pregnant:
1. Assemble A Team Of Doctors To Help You Manage Migraine During Pregnancy
It is so important to know that you have options for managing migraine during pregnancy. Surrounding yourself with the right team of doctors who will advise you on safe migraine treatments during pregnancy is the first step. Once you assemble a team of doctors, you should meet them before your pregnancy and develop a pregnancy-safe migraine treatment plan and management strategies.
Three doctors should be on your team for when you get pregnant if you live with migraine disease.
- Obstetrician (OB) – this doctor specializes in caring for women during pregnancy, childbirth, and postpartum. An OB will be monitoring your pregnancy and delivering your baby.
- Headache specialist or neurologist – a headache specialist is a neurologist who focuses mainly on headache and migraine and often is board certified in headache medicine. There are currently more than 55 million Americans living with migraine and fewer than 700 UCNS-certified headache specialists. A headache specialist or neurologist will help you manage your migraine during pregnancy.
- Maternal-Fetal Medicine (MFM) physician – a high-risk pregnancy expert who helps pregnant women with chronic health problems, such as migraine, have safe and healthy pregnancies. They can ensure that any medications prescribed to you are safe for your developing baby. They will provide additional monitoring and support throughout your pregnancy.
This team of doctors will work together to develop a comprehensive plan to manage your migraine during pregnancy and ensure you have a healthy pregnancy. The goal is to help you find safe migraine treatments during pregnancy. While the OB oversees general maternal and fetal care, the headache specialist recommends medications (preventive or acute) for migraine management. Meanwhile, the MFM physician works alongside your OB and the headache specialist to ensure the recommended medications are safe for you and the baby. The doctors need to be on the same page in their goal to provide you with varied, safe options for migraine management during pregnancy.
Appointment With A Maternal-Fetal Medicine Physician
I recommend you have an appointment with an MFM and a headache specialist BEFORE getting pregnant. If you need a referral for an MFM physician, your headache specialist or OB/GYN can provide a referral or a recommendation. During your appointment with the MFM physician, you will discuss your medical history, the medications, and supplements you are currently on, and whether they are safe to continue taking while trying to conceive and during pregnancy. During this appointment, you will also discuss acute and preventive migraine treatment options to try when you are pregnant.
It is possible that your medications and supplements may need to be adjusted. For example, current research suggests that people with migraine should stop the new CGRP monoclonal antibodies (Aimovig, Ajovy, and Emgality) five months before conception.  Additionally, anticonvulsants such as Valproate and Topiramate are not safe for migraine during pregnancy. . If you are planning to get pregnant and you are taking any of these medications, you need to make an appointment with your headache specialist or neurologist to discuss how to safely stop taking these medications, as well as which preventives they recommend instead. Run the new medication recommendations by the maternal-fetal medicine physician for approval.
What If I Am Already Pregnant?
Of course, the best time to have these conversations is before getting pregnant. However, even if you are already pregnant, it’s never too late to make an appointment with an MFM physician and find treatments that are safe for migraine during pregnancy to get yourself some relief.
If you are currently pregnant, and your headache specialist or neurologist tells you there are no safe treatments for migraine during pregnancy, it is definitely the time to see an MFM physician. You need someone knowledgeable about medical treatments during pregnancy, who can give you the best possible advice.
No Access To A Headache Specialist Or Health Insurance?
If you do not have health insurance, there are no local headache specialists, your copays are too high, or your headache specialist/neurologist is not supportive of migraine treatments during pregnancy, I highly recommend Neura Health. Neura Health is a virtual neurology clinic, and its membership includes the following:
- Same or next-day video visits with board-certified neurologists specializing in headache and migraine disorders.
- Bi-weekly video sessions with a board-certified health and wellness coach to keep you on track with your personalized treatment plan and offer emotional support along the journey.
- Unlimited in-app chat with your neurologist and headache care team
- Access to a range of resources, including educational materials and tools for tracking symptoms.
Overall, Neura Health offers a comprehensive approach to managing migraine while focusing on personalized care and support. I have been using this service since December 2022. I very much enjoy my coaching sessions with the care coach, Cary, who helps me work on lifestyle changes. For migraine consultations, I see Dr. Berk, who is very knowledgeable and compassionate. With my discount code: parenting15, you can get $15 off your initial membership.
2. Focus on S.E.E.D.S. Strategies For Migraine During Pregnancy
Focus on lifestyle changes that can help raise your threshold for migraine attacks before pregnancy. S.E.E.D.S. is an acronym that can help you remember some of the fundamental lifestyle changes that can effectively manage migraine.
- S is for Sleep – Keep consistent sleep. Try keeping your bedroom dark, cool, and quiet to improve sleep hygiene.
- E is for Exercise – Exercise regularly. Start slowly, even if it’s 5 minutes once a week!
- E is for Eating – Develop consistent eating patterns and avoid dehydration.
- D is for Diary – Track your migraine attacks which allows you and your physicians to identify patterns, determine triggers, and improve your treatments.
- S is for Stress Management – Find ways to manage stress effectively. It could be meditation, deep breathing exercises, or yoga. Danielle Foundation offers free virtual yoga for migraine classes for their community.
While nothing about having a baby is in line with consistency or glamorous self-care like eating, sleeping, or drinking, the pregnancy period is an excellent time to get into consistent good habits. It’ll be great for you, your baby, and your migraine disease. S.E.E.D.S. is one of the most natural ways to try and keep the number of attacks down during pregnancy.
3. Explore Natural Treatments For Migraine During Pregnancy
Try different pregnancy-safe treatments and tools to see which may be helpful to you when you get pregnant. Here are some of my recommendations:
Neuromodulation devices such as CEFALY, Nerivio, or gammaCore are pregnancy safe and can help abort and/or prevent migraine attacks without medication. Even when not pregnant, non-medication options as your first line of defense are essential in the long run. Do your research to decide which device may be right for you.
I use my Cefaly device regularly to help abort migraine attacks without medication, and it is usually my go-to migraine relief treatment when I feel an attack coming on. CEFALY for migraine is a wearable device clinically proven to treat acute migraine attacks and prevent future episodes. CEFALY offers a 90-day satisfaction guarantee, so if it is not effective for you, you can return the device to get your money back. Use code parentingwithmigraine to get 15% off the device.
I used acupuncture during both of my pregnancies. It can be a beneficial and natural treatment for migraine during pregnancy. There have been several controlled studies conducted in Germany on the effectiveness of acupuncture on migraine and they found “consistent evidence that acupuncture is beneficial in the treatment of acute migraine attacks and that the available studies suggest that acupuncture is at least as effective as prophylactic drug treatment and has fewer adverse effects. Therefore, acupuncture should be considered an option for patients willing to undergo this treatment.”  Make sure you research a reputable acupuncturist with experience in acupuncture for migraine during pregnancy.
Pain Reprocessing Therapy
I have been fascinated by pain reprocessing therapy ever since I started Lin Health 3 months ago. It is a Pain Recovery Program that would make an excellent pregnancy-safe treatment option. The program includes:
- 4 sessions with a certified pain recovery coach.
- 1 session with a physician.
- Unlimited messaging with a pain coach.
- Access to the Lin program within the app.
Check out Lin Health and get your first month for $100 with code: parentingwithmigraine.
4. Build Up Your Migraine Toolkit With Natural Migraine Treatments
Now is the time to build up your migraine toolkit with natural migraine treatments to help your migraine before, during, and after pregnancy. A toolkit is essential for anyone living with migraine. It includes your go-to tools to help you abort or ease your migraine symptoms. Here are some pregnancy-safe tools I recommend to have in your migraine toolkit:
If the light is a migraine trigger for you, you may want to try migraine glasses. These are the two brands I use.
Avulux – Get $25 off with code: parentingwithmigraine
Migraine Shields – Get a 20% discount with code: parentingwithmigraine
I use the Allay Lamp every night before bed. Allay’s unique narrow band of green wavelengths calms the brain by quieting hyperactive neurons.
Allay Lamp – Get 10% discount with code: MARINA10
Ice Therapy for Migraine
Cold therapy for migraine relief is a great natural option.
Koldtec Halo – Get $10 OFF each product with code: parentingwm10
TheraIce – this gel wearable ice hat is another option that I really like.
Heat Therapy For Migraine Relief
Neck and shoulder heating pad – Perfectly contoured to drape comfortably around your neck and shoulders to relieve muscle tension, aches, and stiffness temporarily.
Noise Sensitivity Relief
Loop earplugs – These earplugs for noise reduction help with sound sensitivity.
Talk to your doctor about Magnesium and Ginger supplements and whether they are safe for you to take before pregnancy, during pregnancy, or while breastfeeding. You can purchase them at a discount through Full Script dispensary.
There Is Hope
Despite all the debilitating pain I’ve experienced due to migraine during pregnancy, I am incredibly grateful for my children and the light they bring into my life, even in the darkest of times. I want you to know that if children are a priority for you, but you are worried about your migraine disease, please do not let it stop you. Though I can’t promise it will be easy, there is hope and safe treatments available.
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