Postpartum Headache: Causes and When to Worry

Headaches are common in the weeks after birth, and most come from broken sleep, dehydration and shifting hormones. But a few are emergencies. Here’s how to tell the difference, the usual causes, and what helps.

A postpartum headache is any headache in the weeks after giving birth. They’re common: up to four in ten women have at least one in the first weeks. Most are tension headaches or migraines, brought on by lack of sleep, not drinking or eating enough, the sudden drop in hormones, caffeine changes and the strain of feeding and carrying a baby. These usually ease with rest, fluids, food and pain relief your clinician approves. A smaller number have a serious cause, such as postpartum preeclampsia or a headache after an epidural or spinal, which need prompt treatment.

Common causes of postpartum headache

• Lack of sleep from night feeds and a new routine.
• Dehydration and skipped meals, especially while breastfeeding.
• Falling hormones: estrogen drops sharply after birth, which can trigger headaches and bring back migraines that eased in pregnancy.
• Caffeine changes: drinking much more or much less coffee than usual.
• Tension in the neck and shoulders from feeding, carrying and stress.
• An epidural or spinal headache (post-dural puncture headache), described below.
• High blood pressure or preeclampsia, which can start or worsen after birth.

Headache after an epidural or spinal

Occasionally, the needle for an epidural or spinal leaves a tiny leak of the fluid around the spinal cord. This causes a headache, usually within a few days of birth, that is much worse when you sit or stand and eases when you lie flat, sometimes with neck stiffness, ringing in the ears or nausea. Tell your hospital or the anesthesia team. It often gets better on its own, and if it doesn’t, there’s an effective treatment called a blood patch.

Headache two weeks or more after birth

Headaches at two weeks postpartum and beyond are most often from sleep loss, dehydration, tension or migraines returning. But postpartum preeclampsia can also appear in the weeks after birth, even if your blood pressure was normal in pregnancy. If a headache is new, severe, or comes with any of the signs in the box above, get it checked the same day, and check your blood pressure if you have a home monitor.

What helps everyday postpartum headaches

• Drink plenty of water, especially with each feed.
• Eat regular meals and snacks.
• Rest when you can, and share night feeds if possible.
• Keep caffeine steady, rather than swinging between a lot and none.
• Ease neck tension with a warm compress on the neck and shoulders, gentle stretches and good support while feeding.
• Ask about pain relief. Common options such as acetaminophen and ibuprofen are generally considered compatible with breastfeeding, but check with your clinician or pharmacist what suits you, especially if you have high blood pressure.

If you had migraines before pregnancy, talk to your clinician about which migraine medicines are safe while breastfeeding.

When to call your clinician

Beyond the emergency signs above, call your clinician if headaches are frequent, if they keep you from caring for yourself or your baby, if you had high blood pressure or preeclampsia in pregnancy and get any new headache, or if headaches come with low mood or anxiety. For other warning signs after birth, see Postpartum Swelling and Postpartum Recovery: What to Expect in the First 6 Weeks.

The traditional Chinese medicine view

In Traditional Chinese Medicine, headaches after birth are traditionally linked to depleted blood failing to nourish the head, or to cold and wind getting in while the body is open after birth. That’s why “sitting the month” advises covering the head, avoiding drafts and cold water, and resting. These are traditional descriptions, not a diagnosis, and a new or severe headache always needs a medical check first.

Where Postpartum Recovery fits

The Postpartum Recovery herbal pouch is a sealed external pouch with nothing to swallow, for mothers exploring complementary care in the weeks after birth. It isn’t a treatment for headaches, high blood pressure or any medical condition. Confirm the current placement instructions with us, and have your obstetric clinician approve the timing and site, never over a healing incision or tear. Breastfeeding safety studies haven’t been done, so review the ingredients with your clinician and keep pouches away from your baby.

Quick answers

Are headaches normal after giving birth?
Yes, they’re common, usually from sleep loss, dehydration and hormone changes. Severe or unusual headaches need urgent care.

What causes postpartum headaches?
Most often tiredness, not drinking or eating enough, hormones, caffeine changes and tension. Less often, an epidural headache or postpartum preeclampsia.

Why do I have a headache two weeks postpartum?
Usually sleep loss or tension, but preeclampsia can appear weeks after birth. Get a new or severe headache checked the same day.

How do I know if my headache is from the epidural?
An epidural headache is much worse sitting or standing and eases lying flat. Tell your hospital or anesthesia team.

Reviewed October 2026. Author: Qingcai Wang, MD, PhD, developer of the Five Essences external herbal-pouch formulations, with a commercial interest in their sale. General education only; continue your medical care.

Sources: ACOG, Postpartum care; CDC, Urgent maternal warning signs; March of Dimes, Preeclampsia can also happen after you’ve given birth.