What to do for pregnancy swelling

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

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

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.

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More Articles

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. nine0003

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.

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. nine0003

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. nine0003 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. nine0003

- 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. nine0003

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. nine0003 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. nine0003

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.

Popular questions and answers

Popular questions were answered by Nina Antipova, obstetrician-gynecologist, gynecologist-endocrinologist, hemostasiologist at REMEDI Reproduction Clinic.

Why are edema dangerous?

— Edema can be a concomitant symptom of other diseases, such swelling is also called pathological. To distinguish it from physiological edema will help the doctor during the examination. That is why it is important to visit a specialist systematically, and not only if necessary. nine0003

After examining the veins of the lower extremities and lymph nodes, the doctor may additionally prescribe medications that improve vascular permeability, as well as wearing compression underwear. If venous-lymphatic insufficiency can lead to deep vein thrombosis of the lower leg, then injections are prescribed. Risk factors include age, obesity, smoking, predisposition to thrombosis, individual characteristics with the onset of pregnancy.

Edema may occur due to preeclampsia. The complication occurs after the 20th week, in the second half of pregnancy: swelling of the extremities and face appears, blood pressure rises, and an increased amount of protein is present in the urine. Preeclampsia occurs due to disruption of the placenta, as a result of which biologically active substances begin to enter the body, which lead to disruption of the cardiovascular system and blood supply to the organs. Complications in preeclampsia can be very serious: liver dysfunction, stroke, coma, placental abruption, bleeding, acute hypoxia, intrauterine death. You can prevent the development of preeclampsia at the first screening at the 12-13th week of pregnancy. It is important to see a doctor regularly. nine0003

Swelling may be the result of a chronic disease. Women with such a diagnosis are registered with specialized specialists who are already familiar with the medical history.

What is the prevention of edema?

To reduce and prevent swelling, it is necessary to review the diet: limit or completely eliminate salty and spicy - seasonings retain fluid in the body. If there are no contraindications, then regularly go to the pool and massage.

What foods relieve swelling? nine0009

You should include more fresh vegetables and fruits in your diet, drink clean filtered water. Foods low in sodium have a diuretic effect: rice, pasta. You can eat lean fish or meat, it is better to boil the chicken. Pay attention to foods high in potassium. These are dairy products, green tea, raisins, dates.

Sources

1. Edema in pregnant women: a disease or a norm? V.E. Radzinsky, T.V. Khapova et al./2014. URL: https://cyberleninka.ru/article/n/oteki-u-beremennyh-zabolevanie-ili-norma/viewer
2. What causes ankle swelling during pregnancy — and what can I do about it? Yvonne Butler Tobah/ 2020. URL: https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/swelling-during-pregnancy/faq-20058467
3. Swelling During Late Pregnancy. By Emily E. Bunce/2021. URL: https://www.msdmanuals.com/home/women-s-health-issues/symptoms-during-pregnancy/swelling-during-late-pregnancy

Pregnancy swelling

Article content:

1. Pregnancy and edema
2. Why do edema appear during pregnancy?
3. When does edema occur during pregnancy?
4. What factors can affect the appearance of edema during pregnancy
5. What can I do to get rid of swelling during pregnancy? nine0084
6. Questions from patients about edema and pregnancy

Pregnancy and Edema

Swelling during pregnancy is normal because the body produces approximately 50% more blood and body fluids to meet the needs of a developing baby.

Edema during pregnancy

Edema during pregnancy occurs on the hands, face, legs, ankles and feet. nine0003

Why does swelling occur during pregnancy?

This extra fluid retention is needed to soften the body, allowing it to expand as the baby develops. The extra fluid also helps prepare the pelvic joints and tissues for reopening for childbirth. Additional fluids make up approximately 25% of a woman's weight gain during pregnancy.