Swollen extremities (edema) during pregnancy

Reviewed by the BabyCenter Medical Advisory Board

Why are my ankles and feet so swollen?

What you're experiencing is edema — that's when excess fluid collects in your tissue. It's normal to have a certain amount of swelling during pregnancy because you're retaining more water. Changes in your blood chemistry also cause some fluid to shift into your tissue.

In addition, your growing uterus puts pressure on your pelvic veins and your vena cava (the large vein on the right side of the body that carries blood from your lower limbs back to the heart). The pressure slows the return of blood from your legs, causing it to pool, which forces fluid from your veins into the tissues of your feet and ankles.

Edema is most often an issue during the third trimester, particularly at the end of the day. It may be worse during the summer.

You can help relieve the increased pressure on your veins by lying on your side. Since the vena cava is on the right side of your body, left-sided rest works best.

After you have your baby, the swelling will disappear fairly rapidly as your body eliminates the excess fluid. You may find yourself urinating frequently and sweating a lot in the first days after childbirth.

When should I be concerned about swelling?

A certain amount of edema is normal in the ankles and feet during pregnancy. You may also have some mild swelling in your hands.

Call your midwife or doctor if you notice swelling in your face or puffiness around your eyes, more than slight swelling of your hands, or excessive or sudden swelling of your feet or ankles. This could be a sign of preeclampsia, a serious condition.

Also call your caregiver if you notice that one leg is significantly more swollen than the other, especially if you have any pain or tenderness in your calf or thigh.

What can I do to minimize the puffiness?

Here are a few tips:

• Put your feet up whenever possible. At work, it helps to keep a stool or pile of books under your desk. At home, lie on your left side when possible.
• Don't cross your legs or ankles while sitting.
• Stretch your legs frequently while sitting: Stretch your leg out, heel first, and gently flex your foot to stretch your calf muscles. Rotate your ankles and wiggle your toes.
• Take regular breaks from sitting or standing. A short walk every so often will help keep your blood circulating.
• Wear comfortable shoes that stretch to accommodate the swelling.
• Don't wear socks or stockings that have tight bands around the ankles or calves.
• Try waist-high maternity support stockings. Put them on before you get out of bed in the morning so blood doesn't have a chance to pool around your ankles.
• Drink plenty of water. Surprisingly, this helps your body retain less water.
• Exercise regularly, especially by walking, swimming, or riding an exercise bike. Or try a water aerobics class — immersion in water may temporarily help reduce swelling, particularly if the water level is up near your shoulders.
• Eat well, and avoid junk food.

Try not to let pregnancy swelling get you down. The sight of your swollen ankles will probably add to your feeling of ungainliness, but edema is a temporary condition that will pass soon after you give birth.