Is Postpartum Swelling Normal?

You expected to hold your baby in your arms after delivery, but you may not have expected to also hold onto lots of extra fluid all over your body.

Swelling after giving birth is par for the postpartum course — as normal as it is common. Here’s what you need to know about postpartum swelling.

What is postpartum swelling?

Is your face still puffy even though you’ve given birth? Do your legs, feet, ankles, hands and arms appear swollen even as your belly is deflating? 

You may have thought the days of swelling are over now that pregnancy is over … but all that extra fluid you accumulated during those nine months won’t disappear overnight. Postpartum swelling is a buildup of excess fluid in the tissues just under your skin.

Compounding that residual water weight are the extra fluids you received via IV during labor and delivery (especially true if you had a C-section). No wonder you’re a little puffy all over!

You may also have swelling in your perineum after a vaginal birth, or around your incision if you had cesarean delivery.

Is postpartum swelling normal?

Postpartum swelling may not be swell, especially when you’re eager to put your pregnancy puffiness behind you, but it’s very common and normal after delivery.

Signs of postpartum swelling

Postpartum swelling occurs primarily in the legs, feet, ankles and face. Some new moms puff up in the hands and arms, too. If you’re very swollen, your skin may also look stretched or shiny.

Causes of postpartum swelling

The puffy postpartum look you’re sporting is due to any (or all) of the following reasons:

• Leftover pregnancy fluids that have built up over the past nine months. Moms who experience swelling (aka edema) during pregnancy can be storing up to an additional 6 pounds of fluids!
• Extra fluid you received during labor. If you had an epidural during labor, you received IV fluids to make sure your blood pressure didn’t drop. If you had a C-section, you needed IV fluid to get you through the surgery. That extra fluid doesn’t go away right away!
• Pushing. The pushing you did during labor can cause the extra pregnancy fluid to move to your extremities and your face.
• Being sedentary. The fact that you’re not moving around much after delivery (especially true post-C-section) makes it more difficult for your body to rid itself of fluid.
• Hormones. During pregnancy, your levels of progesterone increased. One of the outcomes of that extra progesterone is extra water retention, leading to swelling during pregnancy and continued swelling after delivery.

Postpartum swelling treatments

There are a number of steps you can take to help treat postpartum swelling:

• Flush that puffiness out by drinking lots of water. It may seem counterintuitive to add water to your body when you’re trying to lose water weight, but dehydration can actually cause the body to hang on to those extra fluids. Drinking more will also keep your kidneys working at their peak to help remove waste (including extra fluids).
• Move around as much as possible without overdoing it. This is especially important after a C-section, but it's good advice even if you’ve had a vaginal delivery. Being active will prevent fluids and blood from pooling in your legs and will help the body flush those fluids out.
• Avoid standing or sitting for too long. Both can cause fluids and blood to pool in your legs. Moving more encourages your blood to circulate freely through your body. 
• Elevate your legs when you’re in bed. This will help move fluid from your lower extremities back into the rest of your body, where it can then be removed through your kidneys and sweat glands.
• Do circular motions with your ankles — moving them counterclockwise and clockwise 10 times in each direction. Massage them too, as long as it doesn’t cause pain. This helps prevent increased fluid retention in your feet.
• Consider compression stockings. They may not make you feel your sexiest, but they increase blood flow in your legs, which helps to move fluids upwards from your legs to your kidneys, where they’ll be removed.
• If your hands and fingers are also swollen, raise them above your head whenever you can to help fluids move from your extremities to the rest of your body so they get flushed out.
• Reduce the amount of sodium you consume in your diet, since too much sodium (aka salt) can worsen swelling.
• Keep your cool by dressing lightly and, depending on the weather, opening windows or using an air-conditioner or fan to make sure you don’t get too hot. Heat can worsen swelling. Using cold compresses can also help keep you cool and lessen swelling.

How long does postpartum swelling last?

The accumulated fluids will be released gradually over the first postpartum week through sweating and peeing. Too gradual for you? You can help speed it along by trying the tips for reducing swelling above.

What do swollen feet after a C-section mean?

Got swollen tootsies? Nothing to be alarmed about. All it means is that the fluid that has accumulated during pregnancy and during your C-section surgery is pooling in your legs and feet. Using the tips for treating swelling should help ease some of that fluid accumulation.

Swelling in your feet following a cesarean delivery usually eases up within the first week or two after delivery.

When to call the doctor about postpartum swelling

Most postpartum swelling is normal and will go away on its own. It may even increase a day or two after delivery before it starts to improve. 

But sometimes swelling that happens in the days after delivery may indicate an underlying condition that warrants a call to the doctor. Call your practitioner if:

• You notice swelling that comes on suddenly.
• You feel pain or irritation in your leg along with swelling.
• One leg is more swollen than the other leg, and/or there’s redness, cramping and increased warmth along with swelling in one leg.
• You notice swelling plus other signs of postpartum preeclampsia such as severe headaches, vomiting, blurred vision or sensitivity to light.
• You have chest pain or difficulty breathing.
• Your C-section scar is swollen and accompanied by increasing pain, bleeding or foul discharge or fluid.