When to worry about swelling during pregnancy

Puffy ankles and feet are normal during pregnancy, but can sometimes signal more serious problems. Learn what to look for, and how to keep edema in check.

swelling during pregnancy

Photo: iStockphoto

First-time mom-to-be Sarah Mahimwala was shocked to look down one afternoon during a heat wave this past July and see that her feet had ballooned in size.

“I couldn’t see my tendons or ankle bones, even when I flexed my toes,” she says. “I was shocked.” Although some swelling during pregnancy, called edema, isn’t usually cause for alarm, it’s important to keep an eye on your symptoms.

What is it?
Edema in the hands, feet and ankles is very common (especially during the heat of summer). Puffiness in the face and neck can also occur—especially after the 20th week, says Andree Gruslin, interim chair of obstetrics and gynecology at the University of Ottawa and Ottawa Hospital. “Virtually every woman will experience it to some degree.”

Changes in blood chemistry cause some fluid to shift into your tissues, and by the third trimester, the weight of your uterus puts so much pressure on your pelvic veins and the vena cava (the large vein on the right side of your body that carries blood from your legs and feet back up to your heart), that blood can pool, forcing fluid retention below the knees.

When to worry
Edema accompanied by certain other symptoms can signal more serious underlying problems. Be on the lookout for more swelling in one leg than the other, accompanied by pain, which can signal a possible blood clot. A headache that won’t go away, along with vision changes (like blurriness or sensitivity to light), can be signs of preeclampsia (pregnancy-specific high blood pressure), and swelling accompanied by chest pains or difficulty breathing could mean heart trouble. Contact your health-care practitioner immediately if you experience any of these additional red flags.

How to manage
As common as run-of-the-mill swelling may be, getting used to unsightly cankles and brick-like feet that no longer fit into your shoes is another story. “I’m down to one pair of ballet flats and even they’re starting to feel tight,” confesses Stephanie Plow, who’s in her eighth month of pregnancy. “I don’t know what I’m going to wear for the next few weeks.”

Despite the relentless puffiness, Plow has been doing the right things to keep swelling under control, as much as possible. “I prop my feet up on a box under my desk at work, get up and walk around as much as I can, and try to drink lots of water,” she says. “I think it’s been helping a bit.”

Massage therapy, swimming and not crossing your legs are additional ways you can ease signs of edema. But don’t bother slashing your salt. “It’s a myth that sodium has anything to do with it,” says Gruslin. You may hear that increasing your potassium intake can help, but Gruslin says this is also an ineffective pregnancy legend. “I don’t recommend compression socks, either; they’re too difficult to get on and off, and can be uncomfortable.”

When will subside?
So when will the swelling finally subside? “Within about 24 hours after delivery, most women will notice a big difference,” says Gruslin. “In the meantime, just remember that what you’re experiencing is normal and try not to worry about it too much. Take advantage of this opportunity to put your feet up—while you still can.”

A version of this article appeared in our December 2012 issue with the headline “Swelling: When to worry” p. 65.

Read more:
Varicose veins during pregnancy: Symptoms and treatment
Natural cures for common pregnancy symptoms
5 most embarrassing pregnancy symptoms

7 comments on “When to worry about swelling during pregnancy

  1. Th swelling will be better after delivery, by I didn’t swell very much until after. I was very swollen for a week or two after.


  2. my swelling wasn’t taken seriously by my GP. I had a massive blood clot that led to a pulmonary embolism, which I was lucky to survive. Please review the advise to go get massage therapy– you can throw a clot during a massage while swollen. Worth checking in with the national blood clot alliance for information.


  3. I think that you should continue to eat healthfully. There are some patients who can get compression stockings if their swelling becomes really bothersome and it can minimize how much fluid pulls in the lower extremities.


  4. My daughter in law suffered severe edema during pregnancy and it has not gotten better since delivery. She delivered 4 months ago and is still suffering with severe swelling and her doctors just give her fluid pills and I feel like there is something more serious going on but no tests have been done. I am very worried and don’t know what to do and now she is suffering severe depression………


    • She should get a second opinion. Has she started any new medications at all that coincide with when swelling started? If so that and not pregnancy could be the cause.


  5. I have edema during pregnancy I think part of the reason is that I stand on my feet majority of the day. What I really did was to avoid juices and drank water only oo cut one lemon each day in my water after I drank a lot of water throughout the day and part of the nights. I soap my feet in warm Epsom salt water for about twenty minutes after which I used the natural coconut oil that I boil down to oil and then I put can!phor block in it and rub both feet them I elevate them. Try it because it help me


  6. The first visible sign I had preeclampsia was my face swelling, not my feet or legs, although they did get swollen after I gave birth. Some of that was probably the intravenous they had put me on. I hadn’t realized I was getting early symptoms of preeclampsia when I was having trouble going up stairs and was out of breath, this was a symptom of my blood pressure rising. Within days of appearing visibly swollen my son was induced. My blood pressure was dangerously high and I had a headache that could not be brought down even with morphine, plus I started throwing up uncontrollably. My son was born 1.5 months early.


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