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A Mother of a Headache

For many migraine sufferers, pregnancy brings blessed relief. Studies show that migraine-prone moms-to-be get the severe headaches up to 70 percent less frequently. But pregnancy can sometimes bring on a migraine for the first time or increase the frequency of migraines, especially during the first trimester and right after delivery, probably as a result of fluctuating hormone levels.

What to do? The first step is to find a physician who takes migraines seriously, says Merle L. Diamond, M.D., associate director of the Diamond Headache Clinic in Chicago. "If your doctor tells you nothing can be done because you're pregnant or nursing, speak to another doctor who will explore options with you," she advises.

If the pain is debilitating and accompanied by nausea and vomiting, you may need to try medication. During the first trimester, when many of the baby's organs are forming, Dr. Diamond recommends Tylenol or prescribes Tylenol with Codeine. In the second and third trimesters, Imitrex and other commonly prescribed related drugs may be used for severe migraines, but many doctors prescribe them only reluctantly. If you're taking medication while nursing, Diamond advises disposing of the first pumping of breast milk after taking the drug.

As with any ailment, the best policy is prevention. Women who keep to routine mealtime and sleep schedules, get enough rest, exercise regularly, and avoid trigger foods such as caffeine, chocolate, aged cheese, and foods with MSG report a drop in migraine frequency, says Diamond.

Another possible nondrug option for preventing (and treating) migraines is acupuncture. Although the treatment has never been studied on pregnant women, it is believed to be safe during pregnancy, says Robbee Fian, a licensed acupuncturist and president of the American Association of Acupuncture and Oriental Medicine.