Pregnant and feeling puffy? Suddenly can’t seem to squeeze into your shoes? Are you in desperate need of ways to reduce the swelling, so it doesn’t look like you have cankles?
Swelling of the feet and ankles can be a strange, but totally normal part of pregnancy. And, while it can be quite uncomfortable, there are things you can do to get some relief. But there are also times when swelling can be a red flag there’s a more serious problem going on.
Let’s learn more about the causes of swelling during pregnancy, when it typically starts and ends, how you can get some relief, and when you should be concerned.
Why Does It Happen?
Normal swelling during pregnancy, also called edema, occurs for several reasons but is typically from the additional blood and fluids your body likes to hang onto to support your growing uterus, placenta, and baby. Nearly 25 percent of the weight gained during your pregnancy is from all these extra fluids.
Now that you’re expecting, you have 50 percent more blood and fluids in your body, but it needs to be stored somewhere, hence your new cankles. Your growing uterus also puts pressure on your veins, impairing the return of blood to your heart, so it tends to pool in your hands, feet, and ankles (1).
And while fluid retention can be quite the nuisance, it plays a vital role during pregnancy, as it softens your body, allowing it to expand as your baby grows. It also helps prepare your pelvic joints and tissue to open for delivery (2).
There are some factors which will put you at higher risk for swelling:
- Standing or sitting for long periods: Sitting or standing for long periods of time can diminish your circulation, and your blood and fluids will start to pool down south.
- Long days of activity: While staying active and exercising is important for a healthy pregnancy, too much can cause swelling in your feet and ankles.
- Heat exposure: Swelling tends to be worse on hot summer days. Too much heat can lead to dehydration, and when you’re dehydrated, your body tries to retain as many fluids as possible.
- High or low sodium intake: A moderate amount of salt can help keep blood in the fluid rather than the tissue, but too much or too little will leave you feeling puffy.
- Electrolyte imbalance: Along with sodium, an imbalance of potassium, magnesium, and calcium can also lead to inadequate hydration, and hence swelling.
- Consuming large amounts of caffeine: Caffeine is known to cause dehydration, which makes your kidneys hang on to more excess fluids.
- Carrying multiples: Moms with multiples tend to retain more water and therefore experience more swelling.
When Does the Swelling Typically Start?
Swelling can occur at any point throughout your pregnancy, but most women begin to notice it during month five, and it often increases during the third trimester as you get closer to delivery. Those who have excessive amniotic fluid or are carrying multiples will probably notice the swelling sooner.
With my first baby, the swelling was so bad in the third trimester I would wear my UGG slippers to work because I had nothing else that fit.
Editor's Note:Jennifer Schlette, MSN, RN
You might also have some postpartum swelling thanks to IV fluids during labor and the crazy hormone changes that are going on in your body. Both of these can cause you to retain fluids in your extremities after delivery. The swelling can often get worse before it gets better (3) but is typically a very normal part of the recovery process.
With my first baby, my swelling was the worst at three days postpartum. It was the only point in my pregnancy where I couldn’t get my shoes on. Not even close.
How Can I Reduce the Swelling?
Swelling doesn’t usually pose any threat during pregnancy, but it can sure be annoying and uncomfortable.
Here are 12 ways you can reduce the swelling in your feet and ankles and get some relief:
- Prop Your Feet Up: Be sure to take some time to rest and lounge with your feet above your hips and heart. Remember to avoid lying on your back and try not to cross your legs. If you have a desk job, it might be helpful to keep a step stool or stack some books under your desk so you can keep your feet propped up.
- Lay on Your Side: Lying on your side, particularly your left side will relieve increased pressure on your blood vessels and facilitates the elimination of excess fluid and waste through the kidneys.
- Avoid Lengthy Standing and Sitting: Changing positions often can really help to keep your circulation flowing and prevent blood from pooling in your feet and ankles. Try using a treadmill desk if you have a desk job, and make sure you’re taking time out of your day to sit and relax if you have a job that keeps you on your feet.
- Avoid Caffeine: Try to keep your caffeine intake to a minimum to avoid dehydration and swelling. While a cup of coffee a day is considered safe during pregnancy, you need to make sure you’re drinking plenty of water to compensate (4).
- Moderate Your Sodium/Salt Intake: While too much or too little sodium can cause bloating and swelling, salt is still very important for staying properly hydrated. Moderate your salt intake by staying away from processed foods and table salt, and salting to taste with high-quality sea or Himalayan salt.
- Drink Plenty of Water: This might seem counterproductive, but drinking more water actually helps flush out the extra fluids your body is retaining. Staying hydrated rids your body of waste and excess sodium, minimizing the swelling. Aim for ten 8-ounce cups of water daily while you’re expecting (5).
- Wear Comfy Shoes: Find the best shoes for pregnancy that stretch and are easy to slip on to accommodate your puffy feet. Put the high heels in storage and avoid clothing that’s tight around the ankles and calves.
- Stay Cool: Those steamy summer days can aggravate your swelling, so stick to the shade or dip your feet in the pool. Minimize your time outside and just enjoy the A/C. Keeping a cold compress on swollen areas also does wonders.
- Go For a Swim: Swimming isn’t just a great prenatal exercise. It also helps improve circulation in the legs (6).
- Get a Prenatal Massage: Cash in on a much-needed massage to stop yourself from feeling like a giant marshmallow. Prenatal massage has been shown to improve circulation, stimulate the soft tissues, and reduce the collection of fluids in swollen joints. Always check to make sure your massage therapist is certified in prenatal massage.
- Try Compression Stockings: Talk with your doctor about compression stockings if your swelling is significant. These can help keep circulation flowing through your legs, but you need to be sure to get ones that are thigh high and put them on before you get out of bed in the morning, so that blood and fluids don’t have a chance to pool up around your ankles.
- Try Using Supportive Insoles: Many women who have been through pregnancy will tell you about the impact it had on their feet. As your baby grows during your pregnancy, and your body changes to accommodate it, your feet will too. The pregnancy hormones your body produces can loosen your foot ligaments, causing them to expand, resulting in swollen feet and ankles, flattened arches, and increased shoe size.That’s why it’s so important for pregnant women to take care of their feet.
Wearing comfortable shoes is a great start, but you might find you need to add a pair of orthotic insoles to relieve your tired, achy feet. Insoles will give your feet the support and stabilization they need, especially as your center of balance changes. And with the changes to your arch height that come along with pregnancy, you want to make sure your arches are fully supported for maximum comfort.
While they make “pregnancy support hose”, these can be very uncomfortable and bind around the abdomen. For this reason, I usually recommend thigh-high compression stockings (that can be found in non-white colors) worn throughout the day to keep fluid from collecting in the feet and ankles.
Editor's Note:Christine Traxler, MD, BS
When Do I Need to Worry?
While some swelling can be a normal part of pregnancy, excessive or sudden onset of swelling is cause for concern, as this can be a sign of preeclampsia.
Other signs of preeclampsia include:
- High blood pressure.
- Headache that doesn’t go away with Tylenol.
- Blurry vision.
- Nausea or vomiting.
- Facial swelling.
- Puffiness around your eyes.
- Pain in the upper right abdomen.
- Weight gain of more than two pounds in one week.
- Shortness of breath.
- Decreased urinary output.
Be sure to contact your health care provider if you experience any of these signs of preeclampsia throughout your pregnancy, as the condition can lead to seizures, stroke, kidney and liver failure, and even stillbirth and maternal death. Preeclampsia is nothing to mess around with!
You’ll also want to be sure to call your doctor if one of your legs is significantly more swollen than the other, as this can be a sign of a blood clot. You might also have tenderness, the area maybe hot or pain in your calf or thigh. Your provider will most likely order an ultrasound to rule out a clot.
When Will the Swelling Go Away?
Swelling typically likes to stick around until delivery. After you deliver, it will disappear pretty quickly as your kidneys kick into gear and your body gets rid of the extra fluid.
You will probably find yourself sweating and peeing a lot during those first few days after giving birth (7). And remember, it might get worse for a few days postpartum before it gets better.
Don’t Let the Swelling Get You Down
You might be feeling uncomfortable and unattractive with all the swelling going on in your ankles and feet, but it shall soon pass.
For most expectant moms, the swelling tends to peak in the third trimester and quickly goes away within that first week after giving birth.
Always be sure to keep your doctor in the loop, just in case, as the swelling could be a sign of a bigger problem, such as preeclampsia and a blood clot.
While swelling can leave you feeling puffy, don’t let it get you down. Just try to embrace this stage of your pregnancy. You’re growing another human being, and that is beautiful!