Most women get swollen ankles and feet while pregnant. It’s natural to have concerns about swelling since it can be uncomfortable, make your shoes tighter and possibly make you feel embarrassed. Knowing what to look for and how best to manage it can help you stay as comfortable as possible.
There are 3 main reasons women experience swelling while pregnant.
- Throughout pregnancy, you produce more blood than usual to help your baby grow.
- As the baby grows, your uterus presses on and slightly blocks the veins that return blood from your legs to your heart.
- Your hormones make the walls of your veins softer, which makes it harder for them to work properly.
For these reasons, your blood tends to pool in your legs. There, a small amount of blood leaks through tiny blood vessels into the tissues and produces the swelling you can see and feel.
Where and when will I get swelling?
The swelling should be only in your feet and ankles. Your fingers might get a little larger — enough to make any rings feel tight — but they shouldn't be obviously swollen.
Your feet and ankles are likely to swell later in the day. This is mainly due to gravity — any extra fluid in your body will sink to your feet and ankles, especially if you spend a lot of time on your feet.
Swelling is also more likely to happen later in your pregnancy.
Gradual swelling isn't harmful to you or your baby, but it can feel uncomfortable.
How can I reduce swelling?
Some simple things can help you feel more comfortable and can also aid in preventing swelling.
Try to:
- avoid standing for long periods without moving
- wear comfortable shoes (avoid tight straps or anything that might pinch if your feet swell)
- put your feet up as much as you can
- limit salty foods and excessive salt in your diet
- sleep on your left side, which will help blood return to the heart
- exercise regularly by walking or swimming — this helps keep your circulation going
If you need to stand for long periods, try to move around and change position regularly.
Compression stockings can help the blood flow back to the heart and limit how much swelling you get. Massage and reflexology might also help reduce swelling and associated symptoms.
Even if your swelling is bothering you, remember to still drink plenty of water. Keeping your fluids up is important to avoid dehydration and stay healthy.
Normal or abnormal swelling?
Most pregnant women have swollen feet and ankles at some point, and this is perfectly normal. However, there are times when swelling could indicate something more serious.
Contact your midwife, doctor or hospital immediately if:
- swelling is there at the start of the day or doesn't go down when you rest
- your face or hands are swollen
- the swelling is more than you have had before
These are warning signs for pre-eclampsia, which is high blood pressure caused by pregnancy. This is a very serious condition both for you and your baby, so call your doctor or midwife as soon as possible. Don't wait for your next regular appointment.
If one leg is more swollen than the other, this could suggest a more serious problem with one of your veins, such as deep vein thrombosis. Again, contact your doctor or midwife as soon as possible.
Most swelling is a normal part of pregnancy and will usually go away after you've given birth. However, if you're concerned about anything, no matter how small or seemingly insignificant, talk to your doctor or midwife.
You can also call Pregnancy, Birth and Baby on 1800 882 436 to talk to a maternal child health nurse.
When pregnant, your body expands to accommodate your growing baby. However, you probably had not anticipated that your feet could swell along with your waistline.
Feet swelling, sometimes referred to as edema, affects approximately eight out of 10 pregnancies. It's usually caused by the increased fluids circulating around your body. Sufferers tend to notice swelling of their hands, arms, feet, or even face in their second or third trimester, though feet swelling particularly can happen at any time.
“Swelling in pregnancy is completely normal and expected,” says Sherry Ross, MD, a Santa Monica-based OB/GYN. “If you think about it, your body produces [approximately] 50% more blood volume and other body fluids that help in the growth and development of the baby.”
Although feet swelling can feel uncomfortable (not to mention inconvenient), it generally isn’t harmful to either you or your baby. Find out what causes it, how to find relief, and how to spot when feet swelling might be cause for concern.
There are several reasons why your feet (and body!) might swell during pregnancy. The first is due to a normal physiological change that occurs when carrying a baby. Your blood volume steadily increases as your pregnancy progresses.
"The total blood volume increases, but that blood is a bit more watery than outside of pregnancy," explains Leah Savitsky, MD, a board-eligible OB/GYN and acting clinical instructor for the Department of Obstetrics and Gynecology at UW School of Medicine. "The technical term for this is decreased plasma osmolality." Dr. Savitsky explains that when blood is watery, it is harder for the water part to stay entirely within the vessels. Some of it can leak out into surrounding tissues, causing the swelling you see.
Swelling can start at any time in pregnancy, including postpartum. It most commonly occurs in the third trimester. Between 28 to 42 weeks, your blood volume is almost double that from before pregnancy. However, foot swelling can occur in every stage of pregnancy, and might not be caused just by blood volume.
If you are newly pregnant and have discovered that your shoes no longer fit, swollen feet might not be the culprit at all. Relaxin, the reproductive hormone responsible for loosening up the pelvis in preparation of labor, can increase a pregnant person's foot size.
"[Relaxin] allows the ligaments, tendons, and joints to literally relax and stretch to allow for birth," says Dr. Savitsky. "This hormone isn’t pelvis-specific, though, so it also affects your feet and can cause your feet to flatten and lengthen."
Relaxin levels are at their highest during early pregnancy, which is why you may have trouble fitting into your shoes during your first trimester.
Relaxin levels are at their highest during early pregnancy, which is why you may have trouble fitting into your shoes during your first trimester.
However, sudden swelling in one foot or leg could be cause for concern. Blood clots that appear deep in the body are called deep vein thrombosis (DVT). If left untreated, they can potentially be fatal. Signs of DVT include painful swelling, redness, and warmth to the touch in the affected area. Studies estimate that pregnancy increases the risk of DVT by five times, so it is important to seek immediate medical attention if you suffer from any of these symptoms.
As you enter the second trimester at 13 weeks, you may notice your feet begin to swell for the first time. Perhaps your shoes feet tighter when you take them off at night than they did in the morning. This is because fluid gathers towards the lowest part of your body as the day goes on, particularly if you have been on your feet for long periods of time.
"Pain, heaviness, and tingling are common symptoms," says Dr. Ross. "Prolonged standing and being on your feet for long periods of time will also make the swelling worse."
While this is inconvenient (and annoying!), hopefully, you can take comfort in the fact that this is a sign that your body is doing exactly what it should—preparing for childbirth. "This increase in fluid pools in your tissues and joints in order to soften the body and prepare for giving birth," says Eric Winiarz, DC, a chiropractor in New York City.
At 28 weeks, you enter the third trimester. If you've never had your feet swell, this is the most common time for it to appear. If you've been experiencing it throughout your pregnancy, you may find that the swelling increases in severity. "During the third trimester, the growing uterus puts additional pressure on the lower extremities making the swelling even more pronounced in the legs, feet, and ankles," says Dr. Ross.
In addition to the increase in fluid (of which there is now 50% more than before you became pregnant), the weight of your uterus is adding additional strain on your cardiovascular system. Your baby is pushing on a large vein called the inferior vena cava. This pressure can slow circulation, making it harder to move fluid from the legs and back to the heart.
"When you are pregnant and lay on your back the increase in weight from the baby may compress this vein and may not allow proper draining of the blood from the lower limbs," says Dr. Winiarz. "This is why you don’t want to sleep on your back in the later trimester of your pregnancy."
The last few weeks of pregnancy can be the most challenging. The good news is that you lose that excess fluid in the days following the birth. The less pleasant news is that you lose it through increased urination and night sweats.
While most swelling in pregnancy is normal, it can feel achy and uncomfortable. Thankfully, there are things you can do to relieve symptoms and ease your discomfort.
Regular gentle exercise, such as walking or swimming, increases circulation which can help shift any stubborn swelling. In addition to this, Dr. Winiarz recommends a more specific exercise.
"You can lay on your back with your butt against a wall and your [legs and] feet straight up on the wall," says Dr. Winiarz. "Start pumping both of your feet up and down. You can perform this exercise for a couple of minutes. This helps to flush some fluid from the lower extremities."
Once you reach the third trimester, it is not recommended that you spend extended periods of time laying on your back. The weight of your uterus can compress a large vein called the inferior vena cava, which can impact the health of your baby.
Avoid foods that are high in salt, such as fast food. "When the body senses too much salt in our body, we tend to hold in water," says Dr. Winiarz. "This can cause some swelling and puffiness." Instead, aim to fill your diet with fresh fruits and vegetables and lean meats and proteins.
Another common management technique is to wear compression socks. "Wearing compression stockings that go up to the hip places light compression on the legs," says Dr. Winiarz. "This encourages fluid movement and circulation."
Opt for stockings or socks with a level of pressure of 15 to 20mmHg, says Dr. Savitsky to help relieve the swelling or aching. "Be sure that your socks don’t have too tight of a band at the top," she adds. "This can block blood return, which defeats the purpose of the socks."
Drinking more fluid when you are fighting a losing battle with fluid retention might feel counterintuitive, but our bodies retain water if it is not getting as much as it needs. According to the American College of Obstetricians and Gynaecologists (ACOG), you should drink between eight to 12 cups of water daily during pregnancy.
Avoid standing for long periods of time and put your feet up—literally. "Elevate your legs above the level of your heart periodically throughout the day," recommends Dr. Ross. This will encourage the blood and fluids to flow back to your heart.
Anecdotal evidence suggests that Epsom salts, also known as magnesium sulfate, draw out toxins from the body and reduce inflammation, but there isn't much scientific evidence to support those claims. However, taking an Epsom salt bath may still provide some relief. "Soaking in this type of bath may also help relieve muscle tension in your legs," says Dr. Winiarz. He recommends bathing for about 15 minutes.
Dr. Winiarz recommends prenatal massages to his patients. Studies show that prenatal massages, specifically a lymphatic drainage massage, can reduce swelling in the lower extremities. While prenatal massages are generally deemed safe for your baby, get the all-clear from your healthcare provider before making an appointment.
Swollen feet are usually due to normal changes in pregnancy, but they can also be a sign of preeclampsia, or more rarely significant heart problems, says Dr. Savitsky. Preeclampsia, or high blood pressure in pregnancy, is usually accompanied by protein in the urine, indicating kidney or liver damage. It occurs after 20 weeks of pregnancy and is potentially very harmful to both you and your baby. According to the Centers for Disease Control and Prevention (CDC), approximately one in 25 pregnant people will develop the condition.
"If someone has a sudden onset of swelling in their feet or elsewhere in their body that isn’t their normal amount of swelling at the end of the day, they should call their OB provider to discuss the symptoms and decide whether they need to be seen for a blood pressure check or other labs," says Dr. Savitsky.
Though rare, Dr. Savitsky points out that preeclampsia can occur after you have given birth, so don't dismiss any swelling you may experience after delivery. Be sure to bring it up with your healthcare provider.
If only one leg is swollen, that could also be a sign of a DVT in that leg. "Usually, in this case, that one leg tends to have some calf tenderness and sometimes some redness in the calf," explains Dr. Savitsky. Be sure to call your healthcare provider if you are concerned to discuss symptoms further.
The gradual onset of feet swelling during pregnancy is common, especially during the third trimester when your blood volume has almost doubled. Standing for long periods, lack of exercise, and not drinking enough water can aggravate any swelling you are experiencing. If you have attempted these remedies and your feet swelling persists, seeking the help of a chiropractor may help relieve symptoms.
However, if you notice your feet swelling rapidly, swelling in only one leg or foot, or if the swollen area is red or hot to touch, contact your medical provider as soon as possible. This could be a sign of a blood clot (called a DVT).
If you experience any sudden or worsening swelling of your body alongside symptoms of shortness of breath, dizziness or nausea, or severe and persistent headaches, this could be an indication of preeclampsia and you should contact your doctor immediately.
While swelling is inconvenient, try to think of it as your body preparing for baby—and remember it will dissipate after you give birth!