How To Manage Swelling During Pregnancy

By Margarete Harper

Medical Experts: Chris Just, RN, MSN, CNM and Melissa Goist, MD

It starts with your feet. All of a sudden, they don’t fit into the shoes you wore comfortably last week. Before long, your hands and face start to feel puffy, too. Off comes the wedding ring that’s growing tighter by the day. It seems like just when you get a reprieve from the morning sickness of early pregnancy, your body has thrown you another wrench: swelling.

At some point during pregnancy, most women will develop at least mild swelling, a condition also known as edema, notes Chris Just, RN, MSN, CNM, a consultant and perinatal program development specialist in Boston, Massachusetts. Often, edema becomes more noticeable as the baby’s due date approaches, as the body experiences increased pressure and weight. Although some pregnancy swelling is expected and not entirely preventable, there are a number of ways you can help reduce the inflammation (and keep comfortable) until you reach the delivery room.

Why All The Puffiness?

Wondering why you suddenly feel so swollen? Thank your burgeoning bump. Your growing uterus puts pressure on the surrounding veins and in turn impairs circulation. By the third trimester, this situation can be especially problematic. The extra fluid volume is necessary to support the last months of pregnancy, but that combined with the weight of the increasing uterus compression on lower extremity veins slows down the pumping of blood as it returns to the heart, explains Melissa Goist, MD, an OB-GYN with The Ohio State University Wexner Medical Center.

As a result of the impaired circulation, the parts of the body that are farthest away from the heart, including the face, hands, and ankles, are most likely to be affected and swell, explains Just. The feet and fingers are vulnerable as well.

While pregnancy swelling is common in the third trimester, some expectant parents will experience it earlier on than others. That’s because hormones may also play a role when it comes to who experiences edema. “Beginning with conception, a woman’s progesterone level increases, and this decreases the smooth muscles’ ability to function, which leads to swelling anytime,” Dr. Goist says. Similarly, swelling is a common side effect as a result of the hormonal influx caused by fertility medication.

How To Reduce Swelling During Pregnancy

As nice as it is to understand why you’re experiencing swelling during pregnancy, you’re probably more interested in what you can do to alleviate the symptoms. Here are a few tips.

Keep Cool And Avoid Salt

Although you can’t entirely prevent swelling from affecting you at some point over the next nine months, there are two things to avoid that could make it worse: heat and salt.

If your cheeks have ever become red and puffy on a hot summer day, you’re already familiar with how uncomfortable the heat can make you feel. Add pregnancy to the mix, and it can become downright miserable.

Unfortunately, that means ladies with summer due dates are particularly vulnerable to edema. “Heat and humidity make the veins expand (vasodilate) and draw all the blood to the extremities,” Dr. Goist explains, “so then the poor veins have a hard time pumping blood to the heart because of the proestrogen.” In the summer, be sure to keep the air conditioning cranked up and avoid going outdoors at the hottest time of the day. Cooling off in the swimming pool can be especially beneficial to reduce swelling (if you don’t have a pool, a cool shower or bath can also do the trick). If you can’t go for a dip, grab a cold compress and put it on the back of your neck to help you cool down.

Another thing that can worsen pregnancy swelling is salt intake, which is particularly tough news for anyone experiencing cravings for pretzels, potato chips, and french fries.

Although sodium is important for maintaining proper blood pressure and for many systems of the body to function properly, too much of it can cause cells to retain extra fluid and result in swelling. “Do not go sodium-free, but be cautious,” Goist warns, “A whole bag of chips will make you miserable the next day.”

Additional Coping Strategies

As an antidote to external factors like heat and salt, which may cause you to swell, be sure to also drink plenty of water throughout the day to help flush out excess fluids. Not only will this help with your swelling, but proper hydration is also essential to your growing baby’s health.

Kicking back and relaxing will also do wonders for your swelling, according to Just. She recommends elevating your feet whenever you can (especially at the end of the day) and not sitting or standing in one place for too long. “If you work at a desk, get up and move around; avoid staying in one position for more than 30 minutes when possible,” she says. In addition, Just recommends wearing comfortable shoes with plenty of support, and tights or socks that fit well. It’s also a good idea to avoid any clothing or legwear with constricting bands at the calves, which could cut off circulation.

Compression stockings and garments have become a popular choice to help with swelling as well. These products are specifically designed to cover areas vulnerable to swelling, such as your ankles, with tightly knit fabric that applies pressure and generates better blood flow. Try compression leggings or tights to energize your legs and reduce swelling. As a bonus, Just notes, compression apparel may also help reduce varicose veins.

Even though this may be the last thing you want to do when you’re feeling tired and swollen, Dr. Goist also recommends staying active throughout your pregnancy and engaging in light to moderate exercise. This physical activity will keep fluids mobilized and help the leg veins pump fluid back up to the heart.

When To Be Concerned About Pregnancy Swelling

Remember, although some normal swelling is expected as you make your way towards labor and delivery, it’s important to be on alert for excessive water retention in the hands or feet. Severe swelling could be a sign of dangerously high blood pressure, a condition known as preeclampsia. Contact your health care provider right away if you notice sudden swelling or swollenness in only one leg, often accompanied by tenderness or pain, severe headaches, blurred vision, or rapid weight gain.

“If you are very swollen, your provider may want to monitor your weight gain and blood pressure and check your urine for protein to rule out preeclampsia, which needs to be treated quickly for your health and that of your growing baby,” notes Just.

Even if your puffiness isn’t particularly threatening or severe, don’t swell in silence. If you’re uncomfortable, it’s worth bringing up to your health care provider because they will most likely be able to offer helpful tips for reducing sodium intake or compression garment recommendations.