Dealing with Swollen Feet and Ankles in Pregnancy

Pregnant and feeling puffy? Suddenly can’t seem to squeeze into your shoes? Are you in desperate need of ways to reduce the swelling, so it doesn’t look like you have cankles?

Swelling of the feet and ankles can be a strange, but totally normal part of pregnancy. And, while it can be quite uncomfortable, there are things you can do to get some relief. But there are also times when swelling can be a red flag there’s a more serious problem going on.

In this post, we will talk about the causes of swelling during pregnancy, when it typically starts and ends, how you can get some relief, and when you should be concerned.

Why Does It Happen?

Normal swelling during pregnancy, also called edema, occurs for several reasons but is typically from the additional blood and fluids your body likes to hang onto to support your growing uterus, placenta, and baby. Nearly 25 percent of the weight gained during your pregnancy is from all these extra fluids.

Now that you’re expecting, you have 50 percent more blood and fluids in your body, but it needs to be stored somewhere, hence your new cankles. Your growing uterus also puts pressure on your veins, impairing the return of blood to your heart, so it tends to pool in your hands, feet, and ankles (source).

And while fluid retention can be quite the nuisance, it plays a vital role during pregnancy, as it softens your body, allowing it to expand as your baby grows. It also helps prepare your pelvic joints and tissue to open for delivery (source).

There are some factors which will put you at higher risk for swelling:

• Standing or sitting for long periods: Sitting or standing for long periods of time can diminish your circulation, and your blood and fluids will start to pool down south.
• Long days of activity: While staying active and exercising is important for a healthy pregnancy, too much can cause swelling in your feet and ankles.
• Heat exposure: Swelling tends to be worse on hot summer days. Too much heat can lead to dehydration, and when you’re dehydrated, your body tries to retain as many fluids as possible.
• High or low sodium intake: A moderate amount of salt can help keep blood in the fluid rather than the tissue, but too much or too little will leave you feeling puffy.
• Electrolyte imbalance: Along with sodium, an imbalance of potassium, magnesium, and calcium can also lead to inadequate hydration, and hence swelling.
• Consuming large amounts of caffeine: Caffeine is known to cause dehydration, which makes your kidneys hang on to more excess fluids.
• Carrying multiples: Moms with multiples tend to retain more water and therefore experience more swelling.

When Does the Swelling Typically Start?

Swelling can occur at any point throughout your pregnancy, but most women begin to notice it during month five, and it often increases during the third trimester as you get closer to delivery. Those who have excessive amniotic fluid or are carrying multiples will probably notice the swelling sooner.

With my first baby, my swelling was the worst at three days postpartum. It was the only point in my pregnancy where I couldn’t get my shoes on. Not even close.

How Can I Reduce the Swelling?

Swelling doesn’t usually pose any threat during pregnancy, but it can sure be annoying and uncomfortable.

Here are 11 ways you can reduce the swelling in your feet and ankles and get some relief:

1. Prop Your Feet Up: Be sure to take some time to rest and lounge with your feet above your hips and heart. Remember to avoid lying on your back and try not to cross your legs. If you have a desk job, it might be helpful to keep a step stool or stack some books under your desk so you can keep your feet propped up.
2. Lay on Your Side: Lying on your side, particularly your left side will relieve increased pressure on your blood vessels and facilitates the elimination of excess fluid and waste through the kidneys.
3. Avoid Lengthy Standing and Sitting: Changing positions often can really help to keep your circulation flowing and prevent blood from pooling in your feet and ankles. Try using a treadmill desk if you have a desk job, and make sure you’re taking time out of your day to sit and relax if you have a job that keeps you on your feet.
4. Avoid Caffeine: Try to keep your caffeine intake to a minimum to avoid dehydration and swelling. While a cup of coffee a day is considered safe during pregnancy, you need to make sure you’re drinking plenty of water to compensate (source).
5. Moderate Your Sodium/Salt Intake: While too much or too little sodium can cause bloating and swelling, salt is still very important for staying properly hydrated. Moderate your salt intake by staying away from processed foods and table salt, and salting to taste with high-quality sea or Himalayan salt.
6. Drink Plenty of Water: This might seem counterproductive, but drinking more water actually helps flush out the extra fluids your body is retaining. Staying hydrated rids your body of waste and excess sodium, minimizing the swelling. Aim for ten 8-ounce cups of water daily while you’re expecting (source).
7. Wear Comfy Shoes: Find some comfy shoes that stretch and are easy to slip on to accommodate your puffy feet. Put the high heels in storage and avoid clothing that’s tight around the ankles and calves.
8. Stay Cool: Those steamy summer days can aggravate your swelling, so stick to the shade or dip your feet in the pool. Minimize your time outside and just enjoy the A/C. Keeping a cold compress on swollen areas also does wonders.
9. Go For a Swim: Swimming isn’t just a great prenatal exercise. It also helps improve circulation in the legs (source).
10. Get a Prenatal Massage: Cash in on a much-needed massage to stop yourself from feeling like a giant marshmallow. Prenatal massage has been shown to improve circulation, stimulate the soft tissues, and reduce the collection of fluids in swollen joints. Always check to make sure your massage therapist is certified in prenatal massage.
11. Try Compression Stockings: Talk with your doctor about compression stockings if your swelling is significant. These can help keep circulation flowing through your legs, but you need to be sure to get ones that are thigh high and put them on before you get out of bed in the morning, so that blood and fluids don’t have a chance to pool up around your ankles.

When Do I Need to Worry?

While some swelling can be a normal part of pregnancy, excessive or sudden onset of swelling is cause for concern, as this can be a sign of preeclampsia.

Other signs of preeclampsia include:

• High blood pressure.
• Headache that doesn’t go away with Tylenol.
• Blurry vision.
• Nausea or vomiting.
• Facial swelling.
• Puffiness around your eyes.
• Pain in the upper right abdomen.
• Weight gain of more than two pounds in one week.
• Shortness of breath.
• Decreased urinary output.

Be sure to contact your health care provider if you experience any of these signs of preeclampsia throughout your pregnancy, as the condition can lead to seizures, stroke, kidney and liver failure, and even stillbirth and maternal death. Preeclampsia is nothing to mess around with!

You’ll also want to be sure to call your doctor if one of your legs is significantly more swollen than the other, as this can be a sign of a blood clot. You might also have tenderness, the area maybe hot or pain in your calf or thigh. Your provider will most likely order an ultrasound to rule out a clot.

Remember – Preeclampsia and blood clots can happen in the postpartum period as well, so don’t be afraid to call your provider after giving birth.

When Will the Swelling Go Away?

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Jennifer Schlette

Pediatric Intensive Care Nurse at Children's Hospital New York

Jennifer Schlette MSN, RN is a pediatric intensive care nurse at Children's Hospital of New York, New York Presbyterian Hospital for the past 14 years.
Jennifer earned her Bachelor's and Master's degree from the College of Mount Saint Vincent. Jennifer became an educator with the College of Mount Saint Vincent after earning her Master's degree. He specialties, while she was teaching, were Maternity and Obstetric Nursing and Pediatrics Nursing.
Jennifer also is the former Director for Undergraduate Education at the College of Mount Saint Vincent. Jennifer returned to the bedside and left the academic world of teaching in order to spend more time with her growing family.
Jennifer's Education & Training:
Bachelor of Science in Nursing, College of Mount Saint Vincent
Master of Science, College of Mount Saint Vincent
Jennifer's Work History & Experience:
Director of Undergraduate Nursing Education, College of Mount Saint Vincent
Professor of Nursing, College of Mount Saint Vincent
Pediatric Intensive Care Nurse, Children's Hospital of New York and New York Presbyterian Hospital

Latest posts by Jennifer Schlette (see all)

• Dealing with Swollen Feet and Ankles in Pregnancy - 19th September 2019