The stress of childbirth that a mother goes through is undeniable. The occurrence of a headache after a C-section or labor induction is one of the many consequences of the stress that the mother goes through during this transformation of the amniotic stage into life. The strenuous procedure of giving birth by cesarean section includes anesthesia that causes excessive strain which leads to the development of a headache, lethargy, and a sense of severe fatigue.
How does it feel?
The pleasant feeling of having a child often comes along with a post partum headache with the following symptoms:
- Pain in the back of the head
- Retroorbital pain
- Sharp pain in the neck and shoulders
- Vision changes
- Hearing changes
- Neck stiffness
- Nausea or vomiting
- Dizziness
- Lightheadedness.
What can cause a headache after C-section?
Causes of headache after C-section may vary, depending upon the type of headache. General causes include:
- Anesthesia: Spinal anesthesia provided to the mother during childbirth may lead to severe headaches. The onset of headaches is usually within the first 48 hours of surgery due to leaking cerebrospinal fluid from the spinal cord membrane reducing cerebral pressure. Recovery is on its own within several weeks. Symptoms associated with a headache due to spinal anesthesia include nausea or vomiting, a tingling sensation, hypotension, and back pain.
- Blood pressure fluctuations: Anesthesia received via epidural block during C-section triggers nerves that control blood vessel contractions, which lowers blood pressure and allows vessels to contract. This decreased blood pressure may induce a headache associated with other symptoms, including nausea, vomiting, and lightheadedness.
- Iron deficiency anemia: A caesarian section offers a higher tendency for a parturient to suffer from post-partum hemorrhage (PPH), quantitatively more than 1000 ml after a caesarian compared with more than 500 ml after a labor induction. This heavy bleeding for a woman leads to a drop in the iron content in her blood, leading to iron-deficiency anemia that may last for 6 to 12 months. Symptoms associated with iron deficiency anemia include fatigue, weakness, pale skin, dizziness, and headache.
- Hormonal fluctuations: After delivery of the neonate, hormonal levels of estrogen and progesterone undergo a dramatic shift. This decreased hormonal level leads to a condition called baby blues, recognized as post-partum depression. Symptoms associated with post-partum depression include mood swings, anxiety, irritability, headache, and sadness.
- Non-specific: Childbirth stress is an undeniable phenomenon and may lead to a post-surgical headache. This tension headache is usually persistent for a short period and generally resolves spontaneously.
Pre-eclampsia and headache
A pregnancy complication offering high blood pressure and proteinuria may also be significant after parturition. Beginning after 20 weeks of pregnancy, this condition may be fatal for both the mother and the child, often a major cause of death. Post-surgical eclampsia and pre-eclampsia are common. Other characteristic symptoms of the disease include:
- Thrombocytopenia (decreased platelet count in the blood)
- Increased levels of hepatic transaminases in the blood
- Vision changes
- Shortness of breath owing to pulmonary edema
- Pain in right hypochondrium
- Nausea and vomiting.
This condition is often significant with a severe headache and demands proper medical treatment.
Migraine and C-section
Developing a migraine after C-section is common, often termed as postpartum migraine. The probability of a parturient developing migraine is 1 in 4, succeeding 2 weeks after pregnancy, and 1 in 2 within the first month. This highly prevalent condition after childbirth is associated with the typical symptoms of migraine including unilateral pulsating or throbbing pain in the head, nausea, vomiting, and increased light and sound sensitivity.
Types of headache after C-section
Headaches during the post-partum period may range in severity. It’s easy to classify these headaches for our ease into the following:
Primary headaches
The cause of a primary post-partum headache is unknown and presents without any significant underlying cause. The following are the types of primary headaches:
Secondary headaches
Secondary headaches usually present with a known underlying cause. Diagnosis and proper treatment of the cause provoking the headache is a necessary measure that may be one of the following:
- Injury to the head or neck
- A brain infection
- Space-occupying lesion—a brain tumor or a subdural hematoma
- Hypertension
- Eclampsia/pre-eclampsia
- Aneurysm
- Cortical vein thrombosis
- Subarachnoid hemorrhage
- Posterior reversible leukoencephalopathy syndrome
- Post-dural puncture headache (PDPH)
- Cerebral infarction (ischemia)
- Sinusitis
- Meningitis.
What may trigger a headache after C-section?
- Inadequate sleep
- Excessive water loss in sweat
- Lactation headache due to hormonal fluctuations during breastfeeding
- Sinusitis
- Inadequate diet
- Excessive bleeding
- Blood clot.
Management of post-partum headaches
Diagnosis
The condition may be diagnosed as a post-partum headache if the complaint of headache and neck or shoulder pain presents within six weeks of parturition, with several parturients complaining of a headache within the first week of delivery. Other symptoms that may accompany headache after a C-section include nausea, vomiting, drowsiness, vision changes, and neck stiffness.
Treatment
- Over the counter pain killers like Tylenol, Ibuprofen, etc. are recommended
- Headaches owing to spinal anesthesia may be cured by a blood patch that restores spinal CSF pressure
- Headaches owing to preeclampsia are a medical emergency and need instant medical care
- Primary headaches can be treated with mild painkiller drugs and some proper measures, however, secondary headaches need proper consultation by a practitioner.
Other measures include
- Increased fluid intake
- Caffeine
- Bed rest.
Prevention
Headaches after C-section though common can be prevented. Preventive measures include:
- Taking frequent naps
- Adequate fluid intake
- Taking healthy diets regularly
- Relaxing activities to reduce stress. Try reading a book or chatting a friend.
When to consult a doctor?
Postpartum primary headaches usually fade away on their own with 6 months after the baby is delivered. However, if they persist longer you may need to see your doctor. Postpartum secondary headaches are serious and need proper medical advice. You must consult your doctor.
FAQ
What does headache after C-section feel like?
A caesarian section delivery is often followed by a headache that may vary in intensity. Neck stiffness, retroorbital pain, and headaches are common findings that may be accompanied by other symptoms.
How long do headaches last after C-section?
Headaches after C-section usually fade away with time, usually within a period of 6 weeks.
What helps with headaches after the C-section?
Primary tension headaches after a C-section may be alleviated with mild-potency painkillers like Tylenol. Headaches resulting from secondary causes need treatment of the underlying cause.
Is a headache an alarming sign after the C-section?
Headache after a C-section is common and is often significant. However, an underlying cause that results in headaches may lead to something serious if left untreated and needs consideration.
