Your belly isn't the only thing that's swelling these days. During pregnancy, you may have mild swelling throughout your body — especially, thanks to the laws of gravity, in your feet and ankles.
The amount of swelling you experience can vary by the hour (increasing in the evening) and by the weather (warmer temperatures forecast more swelling).
When do feet swell during pregnancy?
Edema affects about three quarters of pregnant women. It can start as early as the middle of the second trimester, and when it does appear, it will likely stick around until you give birth.
It's also normal not to experience noticeable swelling. One in four lucky pregnant women don't.
What causes swollen ankles and feet during pregnancy?
During pregnancy, edema occurs when body fluids increase to nurture both you and your baby and accumulate in your tissues. Due to normal pregnancy-related changes, the water content in your body will increase about 6.5 liters, or up to 15 pounds, by term. This water goes towards the growing fetus, placenta, amniotic fluid and maternal blood volume.
Edema is the result of this increased blood flow and the pressure your growing uterus exerts on the pelvic veins and your vena cava (the large vein on the right side of your body that returns blood from your lower limbs to your heart).
This causes you to experience this oh-so-annoying swelling — particularly swollen ankles and feet (but also your hands, as you may have noticed when you last tried to take off a ring). You might also sport more swelling in your feet if your weight gain has been on the faster side.
In addition to edema, there's another factor at play if your shoes are feeling a big snug: Like the rest of the ligaments in your body, the ones in your feet are loosening thanks to the hormone relaxin, allowing the bones to spread out.
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If you stick with your old shoes during pregnancy, your feet may feel pinched. After giving birth, the swelling will recede and weight will fall away. And although your joints and ligaments will tighten up, your feet may remain permanently larger — up to a full shoe size. Shoe shopping, anyone?
Are there risks associated with swollen ankles and feet?
Although it sure isn't swell (especially when you try to squeeze into your shoes at the end of the day, when puffiness is at its peak), mild swelling of the ankles and feet caused by edema is harmless and perfectly normal.
However if your face becomes puffy, if you notice more than five pounds of weight gain in one week, or if the severity of the swelling persists for more than a day at a time (i.e., it doesn't improve overnight), call your practitioner.[1]
Excessive swelling can be one sign of preeclampsia — but when it is, it's always accompanied by other symptoms (such as elevated blood pressure, protein in the urine and possibly rapid weight gain). If your blood pressure and urine (checked at each prenatal visit) are normal, there's nothing to be concerned about. Edema or swelling is never the only symptom of preeclampsia, so once you're evaluated by your doctor or midwife, you can feel confident nothing concerning is going on in your pregnancy.
Rarely, swelling in the legs could be a sign of a deep vein thrombosis (DVT), a potentially life-threatening condition that occurs when a blood clot forms in a deep vein. Swelling from DVT tends to affect only one leg (usually the left leg), might cause a feeling of heaviness when you stand up, pain in the calf when flexing the foot, or skin that's red or warm to the touch.
This asymmetrical swelling of one leg is significant in cases of DVT — the calf of the affected leg can have a circumference that's more than 1 centimeter greater than the unaffected leg. If you notice any of these signs, call your practitioner right away. Your doctor can easily evaluate you with non-invasive ultrasound imaging of the veins in your legs.
How to stop feet from swelling while pregnant:
- Avoid long periods of standing or sitting. If you're on your feet a lot, take breaks and have a seat.[2] If you're sitting down a lot, take a 5-minute stroll at least once an hour.
- Kick up your feet. If possible, elevate your legs when you're sitting. Who has a better excuse to put up her feet than a pregnant woman?
- Sleep on your side. If you don't already, try sleeping on your side (preferably your left) — it helps keep your kidneys humming along, which helps eliminate waste and reduce swelling.
- Move it. Do some pregnancy-appropriate exercise, such as walking (which keeps the blood flowing) or if your practitioner okays it, try swimming. The water pressure from the pool pushes fluids from your tissues back into your veins, where it goes to your kidneys so you can pee it out.
- Avoid too-tight elastic-top socks or stockings. Your goal is to let blood and fluids flow as freely as possible. Socks that leave an indentation mark around your leg are likely too tight.
- Wear comfy shoes, especially while you're out. (Those sexy slingbacks may not fit now, anyway.) Consider orthotic shoes or inserts as well, which can make your feet feel better and can reduce leg and back pain during pregnancy too. Once you get home, switch to a pair of soft slippers.
- Try compression socks or stockings. Opt for full pantyhose (with extra tummy room) or knee- or thigh-highs (a better choice if you're perpetually warm) that aren't tight on top. Whichever type you choose, put them on in the morning before the daily swelling starts so they can do their job more effectively.
- Drink lots of water. It may seem counterintuitive to try to flush out fluids with fluids, but drinking 8 to 10 glasses of water a day will help rid your system of excess sodium and other waste products, minimizing swelling.
- Don't go crazy with the salt shaker. Eating too much salty food can increase swelling.[3] Like everything, it's best to keep your intake in moderation and salt your food to taste.
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