Pregnant Women Deserve Pain Relief

I was pregnant for nearly all of 2023, between a full-term pregnancy and a miscarriage. Being prone to status migraines linked to hormone changes and episodic cluster headaches, I spent a chunk of that time in pain. People with various pain disorders become very good at managing "low level" (not low level to the average person!) pain. We save medications and other treatments for the really nasty attacks. That's not an option for cluster headaches, and migraine attacks can worsen during pregnancy.

Did oxygen therapy work for both pregnancies?

When I was pregnant with my first daughter in 2020, I wrote about surviving pregnancy with cluster headaches. High-flow oxygen helped me get through the 9-week bout of 3-4 daily attacks (mostly at night, waking me up with severe pain). I was fortunate that I only needed oxygen therapy back then. Unfortunately, I needed additional treatments this time around with my second daughter.

How do I know when to grab my oxygen?

Oxygen is my go-to whenever I feel the familiar twinge or tickle in my trigeminal nerve and the right side of my neck. These sure-fire signs that the beast is about to visit let me know it's time to pull my tanks out of the hallway closet. I nestle them next to my side of the bed within arm's reach. Most of the time, 15 liters per minute (lpm) with a nonrebreather mask followed by 5 lpm with a nasal cannula is enough to kill the pain until the next attack. But Cluster Headache isn't the only animal I have to tame.

What did my second pregnancy bring?

Pregnancy is a whirlwind of symptoms and constantly changing hormones. My status migraines flared with a vengeance through the first and second trimesters. About 18 weeks along, I developed my worst one yet, which coincided with COVID. Oxygen did nothing because this wasn't a cluster headache.

What "safe" medications are available?

Pregnant women and women trying to conceive are routinely told that Tylenol is the only "safe" medication for aches and pains during one of life's most trying times. Tylenol is a poor treatment for head pain (putting it lightly). Considering at least 29.5 million Americans have migraine disease, and 75% of them are women, it's terrible that OBGYNs push you to push through the pain of a diagnosed condition.¹

What migraine treatment options did I have?

I called up my headache specialist, who assured me the one-time use of a sumatriptan injection would be fine. I needed relief to be able to eat and hydrate. The shot worked within 30 minutes. Luckily, that was all I needed. Oxygen helped during my 8-week cluster headache cycle in the second trimester and the brief cycle after birth. The status migraines left in the second half of pregnancy. Unfortunately, that's not the case for other women with headache and migraine disorders.

Why does pregnancy become a treatment barrier?

Some women I've talked to have even been denied oxygen for cluster headaches during pregnancy. Doctors are wildly uneducated about the safety and efficacy of oxygen for this condition. Their ignorance and caution are costing pregnant people around the world a lot of pain and, in some cases, their lives. Other women have told me they wanted to kill themselves during pregnancy because they couldn't treat their attacks with oxygen. Many doctors also withhold medications or refuse to discuss the benefits and risks of medicines with pregnant women. It's like we stop being human beings with a medical condition when we're gestating.

Why can't women discuss their own care?

What's infuriating is the fact that there's ample research about migraine medications and other headache treatments during pregnancy. Women deserve to discuss the benefits and risks of potential treatments with their healthcare providers so they can make informed decisions about their pain. I'm lucky that my headache specialist is a woman devoted to helping her patients get relief with safe and effective treatments. I'm the anomaly, though. Most women I talk to say they had to suffer through most or all of their pregnancies due to their doctors' opinions. What good is medical research if we can't use it to make an informed decision?

My husband and I welcomed a happy, healthy little one earlier this year whose cuteness more than makes up for the pain.