When to worry about swelling during pregnancy

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 were dramatically swollen and 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 causes swelling during pregnancy?

Edema (or swelling) 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.

Should I be worried about swelling during pregnancy?

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 can I treat my swollen ankles, feet and legs?

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 pregnancy swelling go away?

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.”