Headaches in pregnancy 2nd trimester | Causes & Treatment
1) What headache means, according to medical science:
"Headaches in pregnancy 2nd trimester" Literally, headache implies a feeling of pain or discomfort lying partly or wholly in the head. Primary headaches are discomforts caused directly by overactivity or on account of problems with the structures in the head that are pain sensitive. This includes the blood vessels, muscles, and nerves of the head and neck. They may also result from changes in the chemical activity in the brain. Although, popularly it is called ‘headache,’ in fact it is not a pain in the head (or in mind). The brain sends us the message when other parts of the body hurt. Most headaches appear in the nerves or blood vessels or muscles that cover a person’s head or neck.
To well explain the severity of the headaches, sometimes instance is given like ‘ two big spikes are being hammered into the brain from both the sides.’ Again metaphorically, any discomfort or sufferings afflicting the baby (who has not yet learned to speak to make complaints about the distress, except crying at the top of the voice) may itself be the headaches of the parents,
2) Importance of headaches in pregnancy 2nd trimester:
From time immemorial pregnancy has been a period in a woman’s life full of expectancy, excitement, pride, and joy, which, however, to some extent involves concerns about the risks of delivery as well as the post-delivery health condition of both the mother and the baby. A healthy full-time pregnancy covers 40 weeks. It can, however, range 37—42 weeks. According to the various stages of pregnancy path, the division may be made into three trimesters., each consisting of around 13 weeks. Pregnancy is measured in trimesters from the first day of the last menstrual period (the menstrual period is the regular natural change that occurs in the female reproductive system that makes pregnancy possible.
The monthly cycle of hormonal changes occurs from the beginning of the one menstrual period to the beginning of the next — ) totaling around 40 weeks. However, among the three trimesters, the 2nd trimester is often adored as the golden period as most of the unpleasant features of the earlier period of pregnancy disappear.
During the 2nd trimester of pregnancy, one is likely to experience the least hazards in terms of reduced nausea as well as better and comfortable sleep in addition to increased energy level to perform domestic and job responsibilities. However, in some cases during the 2nd trimester, ( somewhere between 16—20 weeks during pregnancy period) adversities may afflict the pregnant women in terms of abdominal pain, back pain, leg cramps, constipation, and heartburn. Additionally, the first fluttering movement of the baby is felt heralding the imminent and the auspicious arrival of the incoming guest on earth.
3) Cause of Headaches in pregnancy 2nd trimester
‘Being pregnant’ can itself be a headache to many pregnant women. Most women complain of constant and annoying headaches during pregnancy stage, which may occur at any time starting from the beginning of the first trimester lasting till the delivery. But they usually appear in the 1st and the 3rd trimester according to APA (American Pregnancy Association) when hormone levels get skyrocketing that can lead to daily headaches.
Common causes behind pregnancy headaches include dehydration, increased stress, and poor sleep. However, during pregnancy in the 2nd trimester, a headache could be a sign of preeclampsia (it is a condition that develops during pregnancy and typically resolves with the birth of the baby. It usually develops after the 20th week of the pregnancy, i.e., during the 2nd trimester. But this severe condition can occur after the baby has been born.). Preeclampsia is a critical pregnancy-induced situation attended with high blood pressure. Other symptoms include an unusual amount of protein in the urine, vision changes, and liver and kidney abnormalities. So far as the liver problem during pregnancy is concerned, very severe itching is felt by some pregnant women.
The common cause is cholestasis--a common liver disease that happens only during pregnancy. As regards kidney problem arising during the pregnancy period, it needs to be asserted that acute pyelonephritis—a bacterial infection of the kidneys afflicts around 2% of the pregnant women. Also, as the uterus becomes enlarged during pregnancy, it can compress the ureter. These changes can lead to problems with proper drainage of urine from the kidneys causing urine to remain stagnant. Headaches during the 2nd trimester tend to be related more often to poor posture attended with the tension from carrying extra weight. Headaches during pregnancy, may appear, more or less, in all the trimesters which may be categorized into the following four types:
3.1) Preeclampsia headache:
A persistent severe headache during the 2nd trimester (or even during the 3rd trimester) may be a warning sign of preeclampsia, which, however, is a rare condition that afflicts approximately 5%--10% of pregnancies according to UDH (Utah Department of Health).
The preeclampsia headaches consist of persistent, dull, or throbbing pains that often do not vanish. The MOD (March of Dimes) states that preeclampsia headaches are usually
accompanied by blurred vision, floating spots, sudden weight gain, upper right abdomen pain, and swelling in the hands and face.
3.2) Migraine headache:
Migraine is an intense headache triggered by a host of factors: stress, noise, exertion, and certain foods and medications. A migraine is a type of headache that causes an intense throbbing sensation in one area of the head. It may arrive with the feelings of nausea, vomiting, and sensitivity to light and sound. Many women complain of migraine headache during pregnancy. Reportedly, 15% among the migraine headache sufferers get their first migraine during pregnancy period. While the exact cause of migraine is unknown. It is believed that increased blood flow in the brain contributes to the onset and creation of these headaches. Migraines usually appear during the 1st trimester, but can also occur later during the 2nd trimester pregnancy period and onwards.
These types of headaches can cause moderate to severe throbbing, typically on one side of the head. The headache can last up to 72 hours and tend to be triggered by physical activity. Migraine headaches may involve nausea and sensitivity to light and noise, according to UDH. The migraine headaches usually occur less frequently after the 1st trimester. But some women report that their migraine headaches worsen or even stay the same throughout the pregnancy period. According to the report of the AHS (American Headache Society), 28 million Americans (around 8% of the total population) aged 12 years and above suffer from migraines. And among the migraine sufferers majority (approximately 75%) are female.
3.3) Tension headache:
Many women are found to suffer from tension headaches throughout the pregnancy period. But it may be highly likely to appear dreadful during the 1st trimester according to the UDH. Tension headaches resemble a squeezing pain or a steady dull ache on both the sides of the head or at the back of the neck. The tension headaches are usually caused by a lack of sleep, uncontrolled depression, and caffeine withdrawal. Rising hormone level may also trigger tension headaches in some cases. The tension headaches can crop up at the 16th week of pregnancy period (i.e., during the 2nd trimester), partly due to anatomical and physiological changes.
The weight of the belly of the pregnant woman starts to throw her off balance, and as such, she may not be able to engage her core stomach muscles. This can cause poor posture and lead to a muscle strain in the head, neck, and shoulder areas. In order to counteract this adversity a good attitude during the 2nd trimester of the pregnancy period, along with massage, regular exercise, eating small meals frequently and staying well hydrated can considerably help reduce the tension headaches.
3.4) Sinus headache:
Sinus is the hollow in the bones of the skull that communicates with the nose. Inflammation of the sinuses may decrease the ability for the mucus to drain out, thus increasing the pressure within the sinuses, which can ultimately cause sinus headaches. Many pregnant women confuse sinus headaches with migraine headaches, and it becomes difficult to distinguish between the two. Sore throat, fever, and coughing can accompany in both the cases, although nausea and sensitivity to noise and light usually accompany in migraine headaches. While sinus headaches can last for several weeks or even longer. If sinus headaches persist over 10 days, in that case, the pregnant woman is
advised to consult a doctor who can extend the necessary treatment and service to heal the sinus aches during pregnancy.
4) Concerns about Headaches in pregnancy:
Severity in headache in many cases may be an early symptom of some cancer, like bone cancer or testicular cancer. A problem that does not go away or gets better may be a symptom of a brain tumor, which may be a matter of grave concern and seeking immediate medication becomes indispensable.
5) Remedial measures of Headaches in pregnancy:
Headache is common during pregnancy, irrespective of age, height, weight, and other factors. This can, however, be either prevented or reduced to a considerable extent without any medication. A few of them are stated below:
5.1 ) Cool compress:
Etymologically, cold compress implies to press together with a pad of damp, thickly folded, soft, absorbent cloth dipped into cold water, properly wrung out and applied to the affected part of the body for relief or reduction of the pain. The benefits of new compress therapy include reducing pain and promoting faster healing, muscle recovery, and stimulating blood flow. In this connection, it needs to be mentioned that heat (instead of cold) is recommended for blood circulation and raising skin temperature.
5.2) Avoiding headache triggers:
The unhealthy habits triggering frequent or regular headaches must be avoided at all costs, and a hard brake must be applied to such avoidable patterns that include too much hard work, sun exposure, consumption of caffeine, smoking, and alcohol.
5.3) Managing stress:
Anxiety or stress may interrupt the natural healthy lifestyle. Chronic stress can affect health with the symptom of headaches, high blood pressure, chest pain, heart palpitation, skin rashes, weight loss, and loss of sleep. To manage stress, a few stress-relieving rules need to be followed:
- 5.3.1) Meditation: A few minutes of practice regularly can help ease anxiety.
- 5.3.2) Breathing deeply: Breathing deeply ( with break) for 5 minutes daily can produce an excellent result in reducing headache.
- 5.3.3) Slowing down the work speed: Speed begets exhaustion, which in turn creates a headache. For pregnant women, it is wise to perform domestic and job responsibilities at a much slower speed
- 5.3.4) Respond to the body: It is advised to act according to the need of the body in terms of timely eating, drinking, rest and sleeping
5.4) Practicing relaxation technique:
- 5.4.1) Clothing to be loosened, shoes to be taken off and sitting comfortably
- 5.4.2) Spending a few minutes to inhale and exhale fresh air deeply and slowly.
- 5.4.3) Attention must be put on the right foot to slowly tense the muscles of the right foot and then squeeze the muscles as tightly as possible, followed by relaxation. Repeating the same process with the left foot must be made alternately.
5.5) Following a regular sleep schedule to get rid of headaches:
5.5.1) A regular sleep schedule of the same bedtime and waking up right after the sleep breaks even on holidays must be meticulously followed
5.5.2) If any trouble arises to sleeping, then it is wise to avoid nap, especially in the afternoon. Additionally, the bedroom must be clean, well ventilated and free from dust, noise, light and other elements causing disturbance to a sweet, uninterrupted sleep
5.5.3) The habit of a pleasant walk and a physical exercise regularly, preferably in the morning, must be developed to ensure a sweet sleep.
It is a practice to keep the body in balance and to help activate the body’s natural abilities to heal itself. It helps to restore the body into the harmonic state. Reflexology stimulates nerve function, increases energy, boosts blood circulation, induces a deep state of relaxation, and eliminates toxins from the body. Besides, it helps to stimulate the central nervous system, prevents migraines and treats urinary tract condition
5.7) Practicing biofeedback:
Biofeedback is one of the most effective and useful adjuncts in treating anxiety disorders. It has also been proved helpful for the patients in reducing fearful anticipations. During biofeedback, electrodes are attached to the skin. The electrode sensors send signals to a monitor which displays a sound flash of light or image that represents the patient’s heart and breathing rate, blood pressure, skin temperature, sweating, and muscle activity.
5.8) Increasing blood flow:
Heat causes the blood vessels to dilate, which increases the blood flow to the desired area. Increased blood flow brings oxygen and nutrients (It is a substance that provides nourishment for the maintenance of life to survive, grow, and reproduce. For the body to function appropriately nutrients are needed that include: carbohydrate, protein, fat, vitamin, minerals, and water) to the injured area as well as flush out any metabolic waste that was created as a result of the injury.
It is a technique for creating images, diagrams, or animations to communicate messages. Through visual imagery, visualization has been an effective way to describe both the concrete and abstract ideas
It improves body function and promotes the natural self-healing process by stimulating specific anatomic sites. The most common method applied for stimulation is the insertion of line, needles into the skin. The prime goal is to promote and restore the balance of the energy which flows throughout the body. The benefits extend to a wide variety of conditions stretching from emotional disorders, anxiety, depression to digestive complains (nausea, vomiting and IBS, i.e., irritable bowel syndrome)
5.11) Remedial measures with medications:
If there is severe headache attended with fever, then it becomes necessary to consult a healthcare provider, and proper medication may be needed. In this connection, it needs to be mentioned that severe headache can be a symptom of pregnancy complications characterized by high blood pressure and sign of damage of essential organs (such as kidney, liver). Among medicines, taking ‘Acetaminophen’ is safe. However, most of the pain killers, such as ‘Aspirin,’ ’Ibuprofen’ are not recommended for the pregnant women suffering from severe headache unless approved by the healthcare provider