Edema during pregnancy third trimester

5 ways to manage swollen legs and feet during pregnancy | Your Pregnancy Matters

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Your Pregnancy Matters

September 14, 2021

Your Pregnancy Matters

Robyn Horsager-Boehrer, M. D. Obstetrics and Gynecology

The additional weight and hormones you experience during pregnancy can cause swelling and structural changes in your feet.

Of all the body parts you expect to get bigger during pregnancy, feet might not be at the top of your list. But most pregnant women experience swelling in their lower legs and feet.

If your ankles appear puffy and your shoes don’t feel quite right, you’re not imagining things. The additional fluid and blood your body creates to support healthy fetal growth also slows down blood circulation. That can cause blood to accumulate in your lower extremities, causing swelling.

During pregnancy, you also produce more relaxin, a hormone that helps your tendons, ligaments, joints, and muscles – you guessed it – relax. While relaxin helps your pelvis open to give birth, it also loosens the tendons and ligaments in your feet.

The combination of extra weight and hormones during pregnancy can cause your feet not only to widen but also flatten and lengthen. Leg or ankle swelling likely will decrease a week or two after your baby is born, but your feet may never be the same again.

Studies have shown that pregnancy can cause a permanent decrease in your arch and increase in foot length – typically only after a woman’s first pregnancy.

While more research is needed to determine whether these structural changes can be prevented, there are a few things you can do throughout your pregnancy to reduce swelling and feel more comfortable.

Coping with swollen legs and feet during pregnancy

1. Wear compression socks

Wearing 15-20mmHG compression socks that end at your knee can help alleviate achiness. The socks gradually increase pressure in your legs and move some of the excess fluid back into your blood vessels and the rest of your body.

Avoid socks with a tight band at the top. The tightness might worsen swelling by blocking blood return. That can increase your risk of developing a blood clot – which is already five times higher during pregnancy. You don’t need to purchase medical-grade socks, but you can find a good pair of compression socks for $10-$20.

Compression socks also can prevent the formation of new varicose veins, which occur in 15% of pregnant women for the same reason that causes swelling. The risk doubles after your first pregnancy and is four times higher in women over 35. These veins start out as little bumps under your skin; the socks squeeze them just enough to prevent backward blood flow and bulging. Existing varicose veins aren’t likely to shrink, but compression socks can reduce the pain and discomfort they cause.

2. Rest efficiently

You can easily improve blood circulation during downtime and sleep:

Elevate your legs above heart level while reading, watching TV, or doing other seated activities. The simple change in body position decreases pressure on your veins, which no longer have to work against gravity to send blood to your heart. Use cushions for comfort and elevate in 15- to 20-minute intervals a few times a day.
Sleep on your left side. While you can safely sleep on either side during pregnancy, the left side is often recommended to avoid putting pressure on the inferior vena cava, a large vein that carries blood from your lower extremities to your heart.

3. Get your feet wet

Immersing your feet and ankles in cool water for 20 minutes a few times a week can minimize swelling, whether you use a pool, bathtub, or even a large bowl. Bonus: It’s also a great way to deal with the Texas heat if you’re pregnant during the summer.

Be sure the water temperature is moderate and not ice cold. Cooler temperatures cause the smaller blood vessels close to your skin to constrict, which reduces blood flow to and swelling within the affected area. Water that is too cold can have the opposite effect. Whether you stand and sway or sit and dangle your feet, water therapy is a great way to relieve stress and pain.

Related reading: Water immersion during labor

4. Invest in supportive shoes that fit.

Unsupportive and uncomfortable shoes can cause even more leg and foot pain, plus backaches. Even if your feet return to their pre-pregnancy size, you’ll feel more comfortable in shoes that fit your feet and support your additional body weight. The American College of Obstetricians and Gynecologists recommends wearing shoes that:

Have a low heel but are not flat
Provide good arch support, such as athletic shoes

Many patients prefer shoes that have mesh, which allow their feet to breathe, and can easily slip on and off to limit bending over while pregnant. More shoe brands are merging comfort and style, so even the most fashionable patients will have no problem finding footwear they feel good about wearing.

5. Visit a podiatrist or pedicurist.

Another reason to wear shoes that fit: Stress from tight shoes can cause ingrown toenails, and so can infrequent nail trimming. In the first two trimesters you probably won’t have any difficulty trimming your toenails. But once you reach the third trimester, it might get more challenging.

Try propping up your feet on a stool or ask your partner to help trim your toenails. Nail salon gift cards are a great item to add to your baby shower (or sprinkle!) registry, too.

Seeing a podiatrist is another option to prevent or treat painful foot conditions, such as ingrown toenail, bunions, or plantar warts.

When swelling becomes serious

While gradual swelling in your lower and upper extremities is normal, sudden or severe swelling in your face, hands, or feet might be a symptom of preeclampsia. This pregnancy complication involves very high blood pressure.

If you have preeclampsia, you may need to stay in the hospital until you give birth. Delivery is the only way to “treat” preeclampsia. Left untreated, the condition can cause seizures, kidney or liver damage, and in rare cases, death.

Related reading: Postpartum hypertension: When a new mom's blood pressure is too high

Talk with your doctor about foot and leg swelling, as well as any other pregnancy symptoms. The more we know about your current condition, the more we can help reduce your risk of future complications.

While we can’t fully prevent foot and leg swelling, we can recommend ways to reduce your risk, such as:

Regular exercise
Good-quality sleep
A healthy diet rich in fruits and vegetables

Discomfort during pregnancy is to be expected, but our goal is to partner with you to minimize it – as well as the risk of more serious conditions.

To discuss your pregnancy concerns or symptoms with an expert, call 214-645-8300 or request an appointment online.

Swollen ankles, feet and fingers in pregnancy

It's normal to get some swelling in pregnancy, particularly in your legs, ankles, feet and fingers.

It's often worse at the end of the day and further into your pregnancy.

Swelling that comes on gradually is not usually harmful to you or your baby, but it can be uncomfortable.

A sudden increase in swelling can be a sign of pre-eclampsia, a condition that needs to be monitored as soon as possible.

Non-urgent advice: Call your midwife, GP or labour ward immediately if you have:

a sudden increase in swelling in your face, hands or feet
a very bad headache
problems with your vision, such as blurring or flashing lights in your eyes
severe pain just below your ribs
vomiting with any of these symptoms

These could be symptoms of pre-eclampsia, which can lead to serious complications if it's not monitored and treated.

Normal pregnancy swelling

Swelling is caused by your body holding more water than usual when you're pregnant.

Throughout the day the extra water tends to gather in the lowest parts of the body, especially if the weather is hot or you have been standing a lot.

The pressure of your growing womb can also affect the blood flow in your legs. This can cause fluid to build up in your legs, ankles and feet.

What can help to reduce swelling

Try to:

avoid standing for long periods
wear comfortable shoes and socks – avoid tight straps or anything that might pinch if your feet swell
try to rest with your feet up as much as you can
drink plenty of water – this helps your body get rid of excess water
exercise – try to take regular walks during the day or doing foot exercises

Foot exercises

You can do foot exercises sitting or standing. They improve blood circulation, reduce swelling in the ankles, and prevent cramp in the calf muscles:

bend and stretch your foot up and down 30 times
rotate each foot in a circle 8 times one way and 8 times the other way

Get more tips on exercising in pregnancy.

Page last reviewed: 10 March 2021
Next review due: 10 March 2024

what to do and how to get rid of edema in the 2nd and 3rd trimesters

A fairly large percentage of women experience edema during pregnancy: moderate edema is observed in 50-80% of pregnant women with a normal pregnancy (1). Often they indicate an excessive accumulation of fluid in the tissues of the body or a violation of the outflow of blood from the pelvic organs - this should not be feared. But there are cases when swelling is the result of health problems. In this case, both the condition of the mother and the condition of the baby are at risk. It is important to consult a specialist in a timely manner and not self-medicate.

Types of edema

Edema during pregnancy is divided into physiological and pathological. The former are considered natural and do not pose a health hazard. But pathological edema speaks of problems with various organs: for example, the kidneys or the thyroid gland. We will talk about the physiological edema of various parts of the body.

Photo: pixabay.com

Swelling of the legs

The legs most often begin to swell after the fifth or sixth month of pregnancy. Severe swelling is noticeable on the calves, ankles and feet: the upper part of the legs almost never swells. Pregnant women may also experience an increase in leg size due to swelling. This happens under the action of the hormone relaxin, which is responsible for the relaxation of the ligaments. Due to its release, the distance between the ligaments becomes larger and the feet swell a little. (2)

Edema of the face

They occur due to an increase in the level of estrogen in the blood. This hormone is responsible for sexual development, reproductive function and the skeletal system. Facial swelling becomes more noticeable when the level of estrogen becomes higher than normal: the nose, lips, and upper part of the face may swell. But if a pregnant woman has severe swelling under her eyes, this is a reason to seek the advice of a specialist. The so-called bags under the eyes can indicate problems in the functioning of the kidneys.

Swelling of the hands

Quite often hand edema appears in the third trimester of pregnancy. A woman cannot wear rings, there is a strong tension when clenching her fists, and after sitting work, her hands become very numb. The duration of the manifestation of edema is individual, but if there is, for example, swelling of the hands and face that cause discomfort, you should consult a doctor.

Mucosal and skin edema

A pregnant woman may experience difficulty in breathing without other accompanying symptoms. Mucosal edema is not so common, but it still happens: with a physiological manifestation, you should not be afraid of it. The mucous membranes also swell due to the accumulation of fluid in the intercellular space. A similar thing happens with the skin: traces of clothing remain on it, and the skin itself looks loose and devoid of moisture. If the swelling of the skin covers a large area, and when pressed, a distinct hole remains, it is necessary to visit a specialist.

Photo: pixabay.com

In these cases, swelling is a natural condition that accompanies pregnancy. But swelling can be the cause of the development of serious diseases. Therefore, it is important to start treatment on time in order to prevent the threat to the life of the mother and child.

When edema occurs

In the first three months of pregnancy, a woman in most cases does not experience edema: they begin to appear in the second and third trimester.

Second trimester

Puffiness appears on the arms, legs and face, most often the hands suffer from edema from 13 to 28 weeks. Fluid retention is often reflected in the face. Swelling appears on the cheeks, nose and upper eyelids. It is necessary to monitor how much fluid is consumed and how much is excreted: if there is very little urine, you should consult a doctor. Such a condition may indicate not only puffiness, but also toxicosis of the second trimester.

- Edema can appear both in early and later pregnancy due to venous-lymphatic insufficiency. During pregnancy, a restructuring of the hormonal background occurs, progesterone disrupts vascular permeability, and as a result, water is retained in the tissues. Most often, the arms and legs swell, from where it is harder for fluids to return, - adds Nina Antipova, obstetrician-gynecologist, gynecologist-endocrinologist .

Third trimester

From the beginning of the seventh month of pregnancy until the ninth month, a woman may experience swelling of the extremities: but most often it is, of course, the legs. The shins, ankles, calves swell much more strongly in the afternoon, with strong pressure, a slightly noticeable fingerprint is formed. Such edema is aggravated by hot weather, eating salty foods, and prolonged standing.

What to do if edema occurs

Physiological edema affects no more than two areas of the body. For example, hands and feet, or swelling of the eyelids and feet. Usually such edema is not very pronounced and subsides by the next day. In this case, you do not need to worry and consult a doctor: the puffiness will subside on its own. (3)

If a woman feels that breathing is difficult, or edema appears in the early morning and does not disappear the next day, the amount of urine begins to decrease sharply, and, on the contrary, weight increases, it is worth going to a specialist for a consultation.

Photo: @shvets-production, pexels.com

How to get rid of edema

With natural manifestations of edema, it is important to monitor nutrition, do not include a lot of fried and fatty foods in the diet, and limit salt intake. In case of swelling of the legs, it is worth spending less time in a standing position, giving them a rest.

If it is possible to perform light exercises, do exercises, then it is worth paying attention to physical activity. Despite the fact that during edema water accumulates in the body, it is important for a pregnant woman to drink enough liquid - 1.5-2 liters of purified water. Compression underwear will also help get rid of edema, which alleviates symptoms and helps not only with swelling, but also with varicose veins.

Medicines may only be used during pregnancy with the permission of a doctor. Therefore, in the event of an increase in symptoms or their prolonged manifestation, you should not drink pills on your own: they should be prescribed by a specialist.

reasons, what to do, how to reduce

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Content:

Is swelling during pregnancy normal?
Where can edema appear?
How to detect edema?
Are swelling during pregnancy dangerous?
How to reduce swelling during pregnancy?
If swelling disappears during pregnancy, is it good?

Pregnancy is a happy time in anticipation of a miracle, but even it has a few "fly in the ointment" that few people manage to avoid. Perhaps the most famous of them are toxicosis, digestive problems, back pain and, of course, swelling. Why do pregnant women swell? By what signs can you understand that it is time to start treatment? What can be done to prevent or reduce swelling? Let's discuss the causes and consequences.

Is swelling during pregnancy normal?

More likely yes than no. The key causes of edema during pregnancy are an increase in fluid in the woman's body and a high level of progesterone ¹ . This hormone begins to be actively produced even during ovulation, preparing the uterus for egg implantation. Its concentration remains consistently high in a woman's blood throughout pregnancy, providing many important functions associated with fetal development. Unfortunately, it has such a side effect.

Interesting fact

Many women experience swelling before menstruation ² . It's also progesterone. The hormone level rises in the second half of the menstrual cycle, which leads to this result.

The fact that one of the causes of edema during pregnancy is the production of a very important hormone does not mean at all that you need to accept this situation with humility. It all depends on the severity of the condition: slight swelling in pregnant women is almost inevitable, but if they become significant, it is worth thinking about treatment.

What other changes appear in the body during pregnancy, read here.

Where can edema appear?

Edema during pregnancy is most often localized on the feet, ankles and lower legs. The reasons are clear: excess liquid first collects at the very bottom - where gravity pulls it. Usually everything starts with pastosity - mild swelling with blanching and a decrease in skin elasticity.

The next favorite place for pastosity and swelling is the hands. Also, excess fluid often leaves a mark on the face, along with edema, nasal debt may appear - the so-called "pregnant rhinitis" ³ .

Important to know!

Most people consider cold drops and sprays to be among the most harmless medicines. Just not during pregnancy - many of them are dangerous for the fetus ⁴ ! Be sure to consult your doctor before treating a runny nose.

And even in the early stages of pregnancy, a woman's body temperature rises to a more comfortable fetus - just above 37 ° C. This does not mean at all that you have caught a cold or caught a virus. To learn more about basal temperature, read our article.

How to detect swelling?

Severe swelling during pregnancy is hard not to notice. When puffiness is not so pronounced, especially if the accumulation of excess fluid occurs slowly, the following signs will help to detect them:

There is a suspicious weight trend. If you follow the diet recommended by your doctor, but the weekly weight gain exceeds the norm for this period of pregnancy, most likely water is retained somewhere in the body.
Rings get stuck on the fingers, tight shoes. Signs of pastosity during pregnancy are easiest to detect by things picked up by hand or leg - they begin to press. By the way, it is better to remove the rings while there is such an opportunity.
The face is rounded. Every day you see your face in the mirror and you will surely notice if its forms begin to blur, smooth out.
There are traces of rubber bands. Many women today wear "footprints" - short socks that are almost invisible from the shoes. Perhaps the high "classic" is not so elegant, but it is an excellent tool for the early diagnosis of edema during pregnancy. If their elastic bands leave embossed marks on the legs, it means that excess fluid is collecting in the tissues.
There are unusual sensations in the fingers. If you feel tingling, burning, or numbness in your fingers, if there is pain or tension when you bend your fingers or step on your toes, it is most likely a sign of swelling.

Is swelling during pregnancy dangerous?

Edema is an excess accumulation of fluid in tissues ⁵ . As you can see, in this definition there is no clarification “in the tissues located directly under the skin”, internal organs can also swell. Often, swelling of the arms, legs, face in pregnant women is just the tip of the iceberg. Hidden from the eyes, internal stagnation of water can cause dysfunction of organs, general dehydration, and impaired oxygen transport. Ultimately, this can threaten the fetus with an insufficient supply of nutrients and oxygen starvation. Severe swelling during pregnancy affects not only the beauty of the expectant mother, but also the health of her baby.

Medicine divides edema during pregnancy into physiological and pathological. The former refers to almost inevitable changes associated with a hormonal shift and a general increase in fluid circulating in the body. The latter are a sign of various internal problems, such as kidney disease, heart failure, varicose veins, preeclampsia (late toxicosis) and others. Physiological edema usually does not require treatment - to reduce them, it is enough to follow a healthy lifestyle. In pathological cases, it is necessary to find the cause and eliminate it.

Your doctor will be able to distinguish physiological from pathological edema based on the results of the examination and tests. In particular, the presence of protein in the urine is an alarming sign. Between visits to the doctor, you yourself can suspect a pathology if the edema grows too quickly, starts to rise above the shins, and when you press on the swollen places, dents remain on the skin, which slowly resolve.

What else can go wrong while carrying a baby? Watch a video lesson on the pathologies of pregnancy from the fertility specialist Anna Ilyina.

How to reduce swelling during pregnancy?

Pharmaceutical treatment is the last resort and is used only in extreme cases. Usually it is enough to adjust the lifestyle and acquire a few good habits. We'll give you 12 simple tips to help reduce water retention ¹ .

Observe the regime of the day. Try not to overwork during the day and have a good rest. The duration of sleep during pregnancy should be at least 8 hours, and if your body has such a need, even 9-10 hours.
Walk more. Your assistants in the treatment of edema during pregnancy are fresh air and reasonable physical activity. If in ordinary life you are used to walking only from the elevator to the parked car and back, something needs to be done about it.
Wear comfortable shoes. Even if you really love high-heeled shoes, even if you have complexes without them because of your own height, you will have to give them up for a while. Uncomfortable shoes exacerbate swelling during pregnancy, and soft shoes with low heels help fight it. If your feet still hurt at the end of the day, visit an orthopedic salon and ask a specialist to make custom insoles for you.
Change your posture more often. When your body becomes numb, it swells. Try not to sit or stand without moving for a long time. Both at work and at home, periodically leave your favorite chair to stretch a little. And while you are sitting in it, do not freeze in one position - move your arms and legs, change the position of your body.
Let's rest our feet. To prevent swelling in the legs, it is necessary to periodically raise them higher. So you facilitate the work of the circulatory system and allow it to pump out a little excess fluid from the legs. It is ideal to lie on your back with your legs up, but even if you just put them on a nearby chair during lunch in a corporate kitchen, this is not bad.
Exercise. In the fight against puffiness during pregnancy, simple physical exercises are useful - tilts, turns, etc. Statics will also help: kneel, then lower yourself on your elbows, stand in this position for 5 minutes. Yoga classes for pregnant women also allow you to disperse the fluid.
Lie on your side. In late pregnancy, your body itself will tell you the correct position for rest - lying on your side. In the early stages, it is also the most useful: in this position, the kidneys work most efficiently, utilizing excess water.
Drink, and do not limit yourself in this. You might think: the less I drink, the less swelling there will be. No, you can't drive them away like that, but getting dehydrated is easy. Drink as much as you want, but only clean water, fruit drinks or decoctions without sugar. Soda, juices from the store and other sugary drinks should be excluded from the diet.
Observe nutritional balance. During pregnancy, eat more protein foods, avoid pastries, bread, sweets and other carbohydrate-rich foods, limit the amount of fat in the diet. Completely give up "empty calories" - snacks and fast food.
Arrange fasting days. Treat yourself with a diet once a week. It's not about sitting on the water all day. There are many recipes for a tasty and quite nutritious "unloading" - from a kefir or banana diet to a chicken breast day or fruit smoothies.
Control your sodium intake. Sodium salts hold fluid in tissues, and the most famous of them is ordinary table salt. To prevent severe swelling during pregnancy, limit your daily salt intake to one level teaspoon, even less is better. When calculating, do not forget that salt enters the body not only from the salt shaker. It is found in many food ingredients (meat, fish, dairy products, tomatoes, etc.), and in almost all semi-finished and finished products - from sausage to bread. Over time, you may even come to love the natural taste of food without or with minimal salt added - it is quite good.
Take natural diuretics. Rosehip, hawthorn, chamomile, lingonberry, bearberry - in the pharmacy you can find a lot of natural remedies to combat edema. Discuss the purchase with your doctor: during pregnancy, you should consult with him before taking any medications, even herbal ones.

Compression stockings ⁶ can be worn to prevent swelling and varicose veins. Consult a doctor - he will tell you what is better to buy and how to use.

If swelling disappears during pregnancy, is it good?

If you've recently changed your diet, are spending more time outdoors, or are taking other activities, that's very good. So your treatments are working and you are on the right track.

Another thing is when edema during pregnancy disappears by itself, without any changes in your life. A few days before the planned date of delivery, this is normal: progesterone has done its job, and its level drops ⁷ , releasing excess water. If the birth is still far away, a spontaneous decrease in edema is at least a suspicious sign. Contact your doctor to establish the cause of the body's unexpected gift and decide what to do about it.

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