Migraine Management During Pregnancy, Women’s Healthcare Providers vs. Headache Specialists: Stephanie Bakaysa, MD


The maternal fetal medicine specialist at Hartford HealthCare Medical Group talked about the challenges of prescribing migraine treatment during pregnancy. [WATCH TIME: 4 minutes]

WATCH TIME: 4 minutes

“This study highlights the need to continue to talk about [migraine management during pregnancy] and continue to provide education that's readily available to people. Just keep talking about it and hopefully we can improve the care for patients get in regard to their migraines during pregnancy.”

Headache specialists and women’s healthcare providers have differing opinions and experience with patients who have migraines during pregnancy. Therefore, they might have contrasting recommendations for pregnant patients seeking out treatment for their migraines. Having more awareness on different types of migraine management available to pregnant patients may direct clinicians to recommend the most effective treatment to their patients.

The Hartford Headache Center recently published findings on a survey of 92 women's healthcare providers that showed different levels of comfort for prescribing treatment for migraines during pregnancy.1 From the total respondents, 26% of providers counseled women on migraine treatment during pregnancy before pregnancy contemplation, and over 35% counseled for migraine treatment at pregnancy conception.

Women’s healthcare providers felt somewhat or very comfortable to recommend (63%) or continue (64%) acute treatments for pregnant patients with migraine. The highest levels of comfort for providers reported recommending or prescribing acetaminophen (100%) and prescribing (94% [85 of 90]) or continuing caffeine (91% [82 of 90]). Higher levels of discomfort were reported in 88% (n = 80) out of 91 providers with recommending or prescribing triptans during pregnancy for migraine. Forty percent of respondents felt less comfortable with recommending preventive migraine care to patients, compared with 63% who were somewhat or very comfortable with patients continuing preventive medications.

Stephanie Bakaysa, MD, maternal fetal medicine specialist at Hartford HealthCare Medical Group, sat down with NeurologyLive® in a recent interview to discuss the findings from the study. She spoke the surprising results and also some of the common themes observed in her clinical practice. In addition, Bakaysa mentioned the current challenges with recommending treatments for migraine during pregnancy between headache specialists and women healthcare providers.

1. Verhaak A, Bakaysa S, Johnson A, Veronesi M, Williamson A, Grosberg B. Migraine treatment in pregnancy: A survey of comfort and treatment practices of women's healthcare providers. Headache. 2023;10.1111/head.14436. doi:10.1111/head.14436
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