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Fighting Migraines While Pregnant?

Q. It looks like I'm pregnant. That's great, but I also suffer from really debilitating migraine headaches. I have discovered I'm not supposed to take my medication. The nurse told me that all I can take is Tylenol. I have a feeling that the nurses at my HMO are just thinking about liability cases. What are the actual risk factors of migraine medication (Imitrex, Fiornal, ergotamine)? By the way, I am very much in favor of reducing all the risk factors to the fetus. Should I limit or eliminate herbal remedies (like feverfew), too?

I'm not a fan of HMOs, and I do think corporate medicine leaves much to be desired. However, I believe your HMO was medically correct. There's a real justification not to take these drugs, because they may have significant effects on the uterus or the fetus. It is generally not a good idea to take any medication during the first three months of pregnancy, and the migraine drugs you mention are particular problems because they can affect the uterus and embryo.

I'm reluctant to recommend herbs during this period as well. We don't really understand the action of feverfew, but it seems to work by moderating the hormones that mediate inflammation. So I would not use that, either.

This all may sound very discouraging. The good news is that migraine headaches generally disappear during pregnancy. This occurs in around 70 percent of cases, and is even used as diagnostic sign that a headache is migraine; it would be unusual for your headaches to persist.

If they do, I'd say you're an excellent candidate for learning biofeedback. This training could help you stop the headache before it has a chance to take root. You start by learning to control the temperature in your hands. Machinery set up to sense the temperature of your fingers gives some audible signal, like a beep, to let you know when they get warmer. Your job is to raise the skin temperature and increase the signal. Without knowing exactly what you're doing, your conscious mind will begin to be able to control a function that is normally unconscious and beyond the reach of your will. What you're really learning is how it feels to relax your sympathetic nervous system and let more blood flow into your hands.

Once you master this technique, you can use it to stop a migraine when you feel one coming on. The training usually takes 10 weeks, with one hour-long session per week. Look in the referral directory on this site or call the Biofeedback Certification Institute of America in Colorado at +1 (303) 420 2902 to find a practitioner.


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