Most women get swollen ankles and feet while pregnant. It’s natural to have concerns about swelling since it can be uncomfortable, make your shoes tighter and possibly make you feel embarrassed. Knowing what to look for and how best to manage it can help you stay as comfortable as possible.
There are 3 main reasons women experience swelling while pregnant.
- Throughout pregnancy, you produce more blood than usual to help your baby grow.
- As the baby grows, your uterus presses on and slightly blocks the veins that return blood from your legs to your heart.
- Your hormones make the walls of your veins softer, which makes it harder for them to work properly.
For these reasons, your blood tends to pool in your legs. There, a small amount of blood leaks through tiny blood vessels into the tissues and produces the swelling you can see and feel.
Where and when will I get swelling?
The swelling should be only in your feet and ankles. Your fingers might get a little larger — enough to make any rings feel tight — but they shouldn't be obviously swollen.
Your feet and ankles are likely to swell later in the day. This is mainly due to gravity — any extra fluid in your body will sink to your feet and ankles, especially if you spend a lot of time on your feet.
Swelling is also more likely to happen later in your pregnancy.
Gradual swelling isn't harmful to you or your baby, but it can feel uncomfortable.
How can I reduce swelling?
Some simple things can help you feel more comfortable and can also aid in preventing swelling.
Try to:
- avoid standing for long periods without moving
- wear comfortable shoes (avoid tight straps or anything that might pinch if your feet swell)
- put your feet up as much as you can
- limit salty foods and excessive salt in your diet
- sleep on your left side, which will help blood return to the heart
- exercise regularly by walking or swimming — this helps keep your circulation going
If you need to stand for long periods, try to move around and change position regularly.
Compression stockings can help the blood flow back to the heart and limit how much swelling you get. Massage and reflexology might also help reduce swelling and associated symptoms.
Even if your swelling is bothering you, remember to still drink plenty of water. Keeping your fluids up is important to avoid dehydration and stay healthy.
Normal or abnormal swelling?
Most pregnant women have swollen feet and ankles at some point, and this is perfectly normal. However, there are times when swelling could indicate something more serious.
Contact your midwife, doctor or hospital immediately if:
- swelling is there at the start of the day or doesn't go down when you rest
- your face or hands are swollen
- the swelling is more than you have had before
These are warning signs for pre-eclampsia, which is high blood pressure caused by pregnancy. This is a very serious condition both for you and your baby, so call your doctor or midwife as soon as possible. Don't wait for your next regular appointment.
If one leg is more swollen than the other, this could suggest a more serious problem with one of your veins, such as deep vein thrombosis. Again, contact your doctor or midwife as soon as possible.
Most swelling is a normal part of pregnancy and will usually go away after you've given birth. However, if you're concerned about anything, no matter how small or seemingly insignificant, talk to your doctor or midwife.
You can also call Pregnancy, Birth and Baby on 1800 882 436 to talk to a maternal child health nurse.
Of all the body parts you expect to get bigger during pregnancy, feet might not be at the top of your list. But most pregnant women experience swelling in their lower legs and feet.
If your ankles appear puffy and your shoes don’t feel quite right, you’re not imagining things. The additional fluid and blood your body creates to support healthy fetal growth also slows down blood circulation. That can cause blood to accumulate in your lower extremities, causing swelling.
During pregnancy, you also produce more relaxin, a hormone that helps your tendons, ligaments, joints, and muscles – you guessed it – relax. While relaxin helps your pelvis open to give birth, it also loosens the tendons and ligaments in your feet.
The combination of extra weight and hormones during pregnancy can cause your feet not only to widen but also flatten and lengthen. Leg or ankle swelling likely will decrease a week or two after your baby is born, but your feet may never be the same again.
Studies have shown that pregnancy can cause a permanent decrease in your arch and increase in foot length – typically only after a woman’s first pregnancy.
While more research is needed to determine whether these structural changes can be prevented, there are a few things you can do throughout your pregnancy to reduce swelling and feel more comfortable.
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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 around week 22 to week 27 of pregnancy, and will likely stick around until you give birth (on the bright side, pretty soon you won't be able to see anything below your belly anyway).
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 as a result of increased blood flow and pressure of your growing uterus 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-necessary increase as 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 your rings). You might also be sporting more swelling in your feet if your weight gain has been on the faster side.
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.
It's also just as normal not to experience noticeable swelling (one in four lucky pregnant women don't).
However if your hands or face become puffy or if swelling persists for more than a day at a time (i.e., it doesn't improve overnight), call your practitioner.
Excessive swelling can be one sign of preeclampsia — but when it is, it's accompanied by a variety of other symptoms (such as elevated blood pressure, rapid weight gain and protein in the urine). If your blood pressure and urine are normal (they're checked at each prenatal visit), there's nothing to be concerned about.
Rarely, swelling in the legs could be a sign of 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 only affect one leg (usually the left leg) and might cause a feeling of heaviness or pain that gets worse when you stand up, or skin that’s red or warm to the touch. If you notice any of these signs, call your practitioner right away.
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. 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 elimate waste and reduce swelling.
- Move it. Do some pregnancy-appropriate exercise, such as walking (which keeps the blood flowing instead of pooling). Or if your practitioner OKs it, try swimming (the water pressure 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 don't 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 support hose. 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 of support hose 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. Limiting salt too much increases swelling — so don’t cut it out entirely. But like everything, it’s best to keep your intake in moderation and salt your food to taste.
Another reason your shoes are getting tighter: foot growth
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.
If you stick with your old shoes, your feet may feel pinched. After a few months, the swelling will recede and the extra weight will fall away (usually).
But although your joints and ligaments will tighten up, your feet may remain permanently larger — up to a full shoe size. Shoe shopping, anyone?
- What to Expect When You're Expecting, 5th edition, Heidi Murkoff .
- American College of Obstetricians and Gynecologists, How Your Fetus Grows During Pregnancy, August 2020.
- Centers for Disease Control and Prevention, Gestational Diabetes, May 2019.
- Mayo Clinic, Edema, October 2017.
- WhatToExpect.com, Preeclampsia: Symptoms, Risk Factors and Treatment, April 2019.
- WhatToExpect.com, Deep Vein Thrombosis (DVT) During and After Pregnancy, November 2018.
- WhatToExpect.com, Sleeping Positions During Pregnancy, March 2020.
- WhatToExpect.com, Back Pain During Pregnancy, January 2020.
- WhatToExpect.com, Are You Drinking Enough Water During Pregnancy?, October 2019.
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