By Joanne Stone, Keith Eddleman, Mary Duenwald

Many pregnant women notice that they get headaches more often than they used to. These headaches may be the result of nausea, fatigue, hunger, the normal physiologic decrease in blood pressure that starts to occur at this time, tension, or even depression.

Simple pain relievers like acetaminophen (for example, Tylenol) or ibuprofen (such as Motrin or Advil), in recommended doses, are often the best treatment for headaches, including migraines. Some women find that a little caffeine can also alleviate symptoms of a headache. In fact, some women find relief from occasional headaches by taking a combination of acetaminophen and caffeine (such as Excedrin Tension Headache).

Although this combination is fine to take once in a while, don’t use it on a regular basis because each tablet contains 65 mg of caffeine and the package recommends two tablets every 6 hours — that’s a whopping 520 milligrams of caffeine per day and way beyond the 200 mg recommended maximum for pregnant women.

This much caffeine, taken on a regular basis, could potentially cause problems with your baby’s growth, or, if consumed early in pregnancy may increase your risk for miscarriage.

Food and rest can usually cure headaches that are caused by nausea, fatigue, or hunger. So try eating and getting some extra sleep. If neither of those tactics works, something else is probably causing your headaches.

If over-the-counter medications don’t relieve your headaches, talk with your practitioner about taking a mild tranquilizer or anti-migraine medication. Base your decision on whether to use migraine medications on the severity of your problem.

If your headaches are chronic or recurrent, you may be better off taking medications, despite their potential effects on your fetus, because feeling bad all the time is likely more harmful to you baby’s development than any potential risks from the various medications available. As always, consult with your practitioner before taking these medications.

Avoid taking regular doses of aspirin unless recommended by your practitioner, because adult doses of aspirin can affect platelet function (important in blood clotting).

If your headaches are severe and unremitting, you may need a thorough medical evaluation or a referral to a neurologist. Later on in pregnancy, a headache may signal the onset of a condition called preeclampsia. In that case, your headache may be accompanied by swelling of your hands and feet and by high blood pressure. If you suffer a severe headache in the late second or third trimester, call your practitioner.