The technical term for swelling during pregnancy is edema. This happens in about 80% of all pregnancies. While swelling in your legs and feet is common and usually not an issue, it can also be a sign of a more serious condition, like preeclampsia. Learn why swelling happens, how to prevent and treat it, and when you should call your doctor or midwife.
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Swelling During Pregnancy
Swelling during pregnancy is most common in the third trimester. Normal swelling is physiologic edema caused by the accumulation of fluids in tissue. In the legs and feet, this can also be called peripheral edema. Swelling can also show up in your hands, which you will notice when your rings don’t fit anymore. Edema can be accompanied by numbness, tingling, or your legs and feet being achy. Plus, let’s be honest; no one likes the look of swollen feet or ankles.
Pregnancy-Related Causes of Swelling
During pregnancy, several physical changes can contribute to swelling. The first is that you have 50% more blood and fluids in your body. All of this extra fluid accounts for 25% of your weight gain. The second reason is that your growing uterus puts pressure on the blood vessels in your pelvis and legs. This pressure can slow down circulation and cause blood to pool in your legs, ankles, and feet. The third reason for swelling is that some elevated hormones during pregnancy can make the walls of your veins softer, which makes them not work as effectively.
Additional Causes of Swelling
In addition to the physical changes from pregnancy, your diet and environment can also contribute to edema.
Hot weather can contribute to swelling, and it can be more common in the summer months. Watching your heat exposure and making sure you are staying cool can be helpful in both preventing and reducing edema. If you have swollen legs or feet using ice packs or a cold compress can give you some relief.
Sodium and Potassium
You could also be contributing to edema with your diet. Sodium and potassium are the two primary electrolytes in your body. These help you regulate fluids, and they have an inverse relationship. Higher sodium levels mean lower levels of potassium. To help your body out, you can watch how much sodium you are consuming and increase your intake of foods that are high in potassium. Processed foods tend to be higher in sodium. Prenatal vitamins usually contain a small amount of sodium, which the FDA requires on the nutrition facts. You will not see potassium on the label of your prenatal vitamin. Potassium is an element you should be getting from your diet. Some of the foods with the highest levels of potassium are avocados, beets, bananas, sweet potatoes, spinach, watermelon, potatoes.
During pregnancy, it is unlikely you are consuming high amounts of caffeine. Since caffeine is a diuretic; it causes you to go to the bathroom more often, which can trigger your body to retain more fluids.
How Can You Treat Swelling?
There are many easy adjustments you can make to help prevent and reduce swelling during pregnancy.
Elevating Your Feet
The easiest way to reduce swelling in your feet, ankles, and legs is to elevate your feet as often as possible. Ideally, your feet are above your heart. This elevation helps the fluid that has pooled in your lower extremities to move toward your pelvis.
If your job requires you to stand or sit for long periods, I know it can be challenging to prop your feet up or move around often. In the event you usually stand for long periods at work, ask for a seat. If you are sitting all day, try to avoid crossing your legs when you sit, since this can restrict blood flow. It may not be ideal to prop your feet up on your desk at the office. Even propping your feet up on a small stool, or even a box under your desk to elevate them a little bit can be helpful.
One study compared leg elevation versus water immersion on leg edema. Half of the participants immersed their leg to the knee in a container filled by tap water for 20 minutes. The other group sat upright in a chair with legs elevated for 20 minutes above the level of the heart. The result was the group who used leg elevation had slightly better results. 85% of the group who elevated their legs had no edema after doing this twice per day for two weeks. 75.5% of the group who submerged their legs in the water had no edema at the end of the study.
Water immersion puts pressure on your body, which can help with swelling. This pressure is called hydrostatic force, and it is proportional to the depth of immersion. One way to benefit from water immersion is to fill a bucket with water and put your feet in it. Bonus if you use cold water. To increase the pressure on your legs, you could go into a pool. If you are standing in the water, there is even more pressure on your legs since they are deeper. Floating or swimming also reduces swelling because your body is not in an upright position, and blood flow isn’t as restricted to your legs and feet.
If you have access to a pool and enjoy swimming or being in the water, then water immersion can be great. From an evidence standpoint, elevating your feet is just as good, if not better, to reduce swelling.
There are many benefits to massage during pregnancy. There is some evidence foot massage can have a beneficial effect on swelling of the legs and feet. Manual lymph drainage massage can also help reduce edema because it stimulates blood flow, fluid movement, and lymphatic system. This style of massage uses strokes in upward motions toward the heart to encourage the lymph movement. Massage can come from a prenatal massage therapist or a foot rub from your partner or a friend. You can even benefit from massage by massaging your own feet if you do not have the luxury of someone else to do it for you.
Compression stockings may not be the sexiest thing ever, but they can help prevent and treat edema. These stockings generate variations in pressure as they go up your leg. During pregnancy, you may want to go with compression stockings that go all the way up to your waist. Knee-high compression stockings could be too tight in the middle of your leg and end up making your swelling worse. On the same note, you want to avoid tight clothing that is uncomfortable or tight, especially in your arms or legs.
Your shoe collection may be collecting some dust during your pregnancy if you are used to lots of high heels and have swelling. You want to wear shoes that are comfortable and that do not constrict circulation. If you have an office job and you usually wear heels, you may want to consider some flats. Wearing comfortable shoes will go a long way with swollen feet. I am also an advocate for getting insoles that will make your shoes more comfortable and give you some arch support, which can prevent a lot of foot issues that can happen during pregnancy.
A big help for swelling is movement. Take breaks throughout the day to stretch your legs and walk around. Any type of exercise, even walking can help to promote circulation. A study found exercise in a pool helped reduce swelling. The key to incorporating exercise into your routine is finding workouts that you enjoy.
Drink plenty of water. I know this seems counterintuitive, but staying hydrated will help your body retain less fluid. If you are dehydrated, your body wants to hang on to as much liquid as possible, which can contribute to edema. During pregnancy, you have increased requirements for how much fluids you should be consuming. The general recommendation is that you should drink ten 8-ounce cups (2.4 liters) of fluids daily. If you are exercising or are in hot weather, you may need to increase your consumption of fluids to stay adequately hydrated.
When to Call Your Doctor or Midwife
Normal swelling is a common pregnancy symptom, but sometimes it can be an indication of a more serious issue like preeclampsia, a blood clot (deep vein thrombosis), and cellulitis. If you are ever concerned about any symptoms you are experiencing, please contact your doctor or midwife. It is always better to be safe and get an expert opinion if you are worried about anything. Here are some signs that swelling could be more serious:
- Signs of preeclampsia can include swelling combined with headaches, vision changes, sudden nausea, stomach, shoulder, or lower back pain, sudden weight gain, or shortness of breath.
- A sign of a blood clot is if you have more swelling in one leg combined with pain or tenderness.
- Sudden swelling in your face and around your eyes.
- Swelling combined with chest pain or any difficulty breathing.
- Extreme or sudden swelling in your hands, feet, or ankles. Typically common edema builds up throughout the day and tends to be more bothersome towards the end of the day.
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