Swollen feet during pregnancy (edema)

Your feet and ankles look like they've been pumped up with water – and that's because, in some sense, they have been. The good news is, swelling in the feet and ankles in pregnancy is usually completely to be expected and manageable by following a few quick tips.

What is edema?

Edema is swelling caused by fluid that collects in your body's tissues. During pregnancy, you'll most likely notice swelling in your feet and ankles that tends to get worse as your due date nears.

In most cases, it's normal to have some swelling in pregnancy, especially in your lower extremities: Some research suggests that about two in three women experience noticeable edema in pregnancy. Mild to moderate edema is actually a healthy sign of blood flow to the growing uterus, fetus, and placenta.

What causes swollen feet and ankles (edema) during pregnancy?

During pregnancy, your growing uterus puts pressure on your pelvic veins and your inferior vena cava (the large vein on the right side of the body that carries blood from your lower limbs back to the heart). The pressure slows the return of blood from your legs, causing it to pool and forcing fluid from your veins into the tissues of your feet and ankles.

Hormonal changes can add to swelling in pregnancy, plus your body naturally retains more fluids to support your pregnancy. In fact, by the end of pregnancy you can expect to be carrying an extra 2 to 3 pounds of water weight! Swelling also tends to get worse when you spend a lot of time sitting or standing, since gravity pulls fluids down to your ankles and feet.

After you deliver your baby, you may notice even more swelling in your legs, feet, and hands. Fortunately, edema will go away on its own within about a week as your body gets rid of extra fluid. You may find yourself peeing often and sweating a lot in the first few days after childbirth. This is your body's way of mobilizing excess fluid.

When does swelling during pregnancy usually begin?

You're most likely to develop edema later on in pregnancy, especially during the third trimester. Edema also tends to be worse at the end of the day and in hotter weather. It may be especially severe for women with excessive amniotic fluid and those carrying multiples.

Should I be concerned about swollen feet and ankles during pregnancy?

It's normal to have a moderate amount of swelling in the ankles and feet during pregnancy. You may even notice mild swelling in your hands and fingers. Sometimes, however, sudden and severe edema can signal a more serious issue, including preeclampsia or a blood clot known as deep vein thrombosis (DVT).

Both preeclampsia and DVT can be dangerous for you and your baby, but they are manageable. The sooner you get checked out, the better.

Call your healthcare provider if you notice excessive and/or sudden swelling of your feet or ankles, especially if it's accompanied by any of these other signs of preeclampsia:

• Headache that doesn't go away
• Sudden weight gain
• Changes in eyesight, including spots or blurry vision
• Pain in the upper abdomen or shoulder
• Shortness of breath
• More than moderate swelling of your hands or face
• Nausea or vomiting after week 20 of pregnancy

Keep in mind that DVT almost always affects only one leg. Be sure to call your provider right away if you have signs of DVT, which include:

• Significantly more swelling in one leg than the other
• Pain or tenderness in one calf or thigh, which may feel like cramping or soreness
• Warmth in the affected leg
• Redness or discoloration in the affected leg

In some cases, DVT can progress to a pulmonary embolism (PE), which is when a blood clot moves to a lung. PE can be life-threatening, so call 911 or head to the hospital if you experience any of the following symptoms:

• Sudden shortness of breath
• Chest pain that gets worse when you cough
• Dizziness or light-headedness
• Rapid pulse or breathing
• Coughing up blood

What can I do to reduce swelling in pregnancy?

Try these tips to ease swelling in pregnancy:

• Wear the right socks. Compression maternity stockings – which you can find at most drug stores – put pressure on your feet and ankles. Put them on before you get out of bed in the morning so fluids don't have a chance to pool around your ankles. Also avoid wearing socks or stockings that have tight bands around the ankles or calves.
• Exercise a bit every day. Activities like walking or riding an exercise bike are excellent options that not only support your overall health but help flush out edema in pregnancy.
• Take a dip. Some research suggests that simply standing in a pool helps to relieve swollen feet and ankles during pregnancy. While you're at it, swim a few laps or take a water aerobics class for a dose of pregnancy-friendly exercise.
• Drink plenty of water. Believe it or not, drinking enough water actually helps your body retain less fluid. Try to have about 10 8-ounce cups of water or other low-sugar beverages each day. (You can tell you're getting enough if your urine looks pale yellow or clear.)
• Get a massage. Consider seeing a certified massage therapist who specializes in treating pregnant women: Some research suggests foot massage and reflexology may help relieve edema in pregnancy.
• Take regular breaks from sitting or standing. Frequent short walks will keep your blood from pooling in your lower extremities.
• Stretch your legs. Whenever you do have to sit or stand for longer periods of time, extend your leg, heel first, and gently flex your foot to stretch your calf muscles for about 30 seconds. Then rotate your ankles eight or so times in each direction and wiggle your toes.
• Sleep on your left side. This keeps your uterus from pressing on your vena cava and promotes circulation in your lower limbs. Sleeping on your right side is okay, too; just avoid sleeping flat on your back if you can.
• Prop up your feet. Get gravity on your side: At work, keep a stool or pile of books under your desk to keep fluids from accumulating in your lower limbs. When you're sleeping, place a couple of pillows under your feet.
• Wear comfortable shoes. Choose shoes that stretch to accommodate swelling in your feet.
• Eat a healthy diet. That means limiting salty junk food, which can add to water retention. Instead, choose fresh fruits, veggies, nuts, and whole grains as much as possible (think apple slices spread with peanut butter for a snack).

While swollen feet and ankles during pregnancy doesn't feel great, take heart: It will pass soon after you give birth.

Learn more:

• Staying comfortable in the third trimester
• Postpartum swelling