There is a tone of reasons why we women swell during pregnancy. The composition of our blood changes, hormones, the natural increase in blood volume, and fluid retention all contribute to pregnancy swelling. As most of our bodies are not used to these often sudden changes it can cause discomfort and account for up to 25% of the weight we gain.
Pregnancy swelling can feel like you are becoming a balloon, and especially during the summer heat can be rather dramatic. It is important to learn how to prevent swelling during pregnancy and why swelling in some areas are more significant than others.
What causes Swelling During Pregnancy?
Swelling is one of those things many of us expect during pregnancy, there are even jokes and meme’s out on the net about it because it is fairly common. But what really causes the swelling in the first place?
You produce more blood
As your body develops and grows this new human it needs more nutrients and materials. This means things like getting hungry more often and some way of moving the nutrients and materials from your digestive tract to the baby and the uterus.
Pregnancy also re-wires your brain with some new developments you didn’t need before and to fuel that you also need to move nutrients in that direction. There are some other really cool things that your body does too with other organs, all of which need more fuel.
With all that going on your body bumps up your transportation system aka your circulation system with about 50% more blood volume then you had before. However the blood vessels and arteries don’t get a whole lot bigger, so the extra volume adds pressure which can cause the fluid to seep or leak into the surrounding tissues.
During pregnancy, a lot gets “blamed” on changing hormones and swelling is no exception.
During pregnancy, your body gets hyper-focused on building your new little one, and understandably so, this usually means the body retains extra fluid in case it needs it later. The extra fluid needs to be stored somewhere and it usually accumulates in the lower part of the body though may also be seen elsewhere too.
A Growing Uterus
As the baby grows so does your uterus, in turn, this creates additional internal pressure in your abdomen and can impact the flow of blood and fluids back to the heart. There is a large vein that runs parallel to your spine that brings blood back to your heart from your lower body. The location of this vein means it often is impacted by your growing baby, and the blood may take longer to return to your heart the bigger kiddo gets.
While swelling may be experienced anytime during pregnancy many women notice it starting more mid-pregnancy and increasing the closer you get to birthing your little one. As long as swelling is not a result of a pregnancy-related complication there are ways you can keep the swelling down.
What is “normal” swelling during pregnancy?
As a rule, you should always seek medical advice or evaluation for a specific answer to your situation. However, there are some general similarities that happen in most pregnancies that I will be discussing in this post.
During pregnancy, our bodies do some pretty cool things, and a number of the changes affect our circulation system. For instance, our bodies produce more blood volume (50% to be specific) than before, this added volume puts more pressure on our blood vessels which can make them leak or seep some of the additional fluid into the surrounding tissues. This is commonly called “pitting edema” and is noticeable when you press on your swollen ankles. Commonly this will resolve it’s self as the fluid redistributes within your body.
Blood flowing into your legs is a high-pressure system. Arteries move blood away from your heart and especially in your legs gravity pulls it down when you are standing or sitting.
Blood flowing out of your legs is a low-pressure system. The veins don’t have the same strong muscle pumping blood through them to push the blood back up into your body towards your heart. Instead, they use built-in valves and muscular contractions around them to work the blood up higher.
This is why putting your feet up helps the swelling to go down, it adds the help of gravity to the valves and muscles in your legs.
Pregnancy Complications that cause swelling
Some swelling in pregnancy is abnormal and if you have any concerns about these you need to see your Doctor or Midwife right away to be evaluated and if needed managed:
Toxemia (gestational hypertension, preeclampsia)
According to MedicineNet.com Toxemia is also known as preeclampsia and occurs in approximately 5% of pregnancies, usually in the last trimester (third). It’s characterized by swelling of the hands, feet, and face and is also known to be more common in a first pregnancy and women who have diabetes or are carrying twins.
Phlebitis (vein Inflammation) or blood clots
According to WebMD Phlebitis is an inflammation of a vein. It increases the risk of forming a blood clot and can be caused by prolonged inactivities like staying in bed for hours on end and pregnancy. While this condition is considered rare it does cause swelling in the ankles and legs usually accompanied by redness, tenderness or pain in the calves.
With all the extra blood running through your veins it is possible to develop blood clots. While not exclusively a pregnancy condition it is something to watch for just in case. If one leg swells more then the other, or you have sudden swelling that is painful (especially in one leg only) it could be an indication of a blood clot also known as a deep vein thrombosis.
High Blood Pressure
High blood pressure is something our care providers watch for at all our appointments for a reason. And one of the symptoms of it can be a sudden increase in swelling.
Medical problems not related to pregnancy
Maternal medical problems like kidney disease, diabetes and a number of other concerns can also cause swelling. A thorough medical history and physical exam at your first prenatal visit are needed to look for these potential underlying issues.
Assuming the above conditions (and any others there may be) have been ruled out by your care provider in all likelihood the swelling you experience is the effect of “normal” changes due to pregnancy.
Why swollen ankles and legs shrink overnight
There are really 2 main reasons that help the swelling in your legs and ankles decrease overnight.
All the extra pressure decreases when you put your legs, kidneys and heart on the same level. This gives your body a chance to move the extra fluid back into the veins so it can be drained to the kidneys for filtering.
As your veins are no longer fighting against gravity it also gives your body the chance to use those muscles around the veins to push the fluid back up to the heart.
Once the fluid can move back up towards the kidneys and heart it runs through our bodies natural filtration system. You’ll notice that the more you swell the more likely you need to pee at night. This is the body’s way of reducing excess fluid.
How to Prevent Swelling During Pregnancy
Whether you are trying to beat the Summer Heat or just want to reduce Pregnancy Swelling, in general, these are some of the most common and top tips out there.
I know it likely sounds counter-intuitive but drinking enough water keeps the fluid in your body moving through your bloodstream. It will also flush out any toxins in your body which means less work for your system in the first place.
If you are having trouble getting enough liquids into your system check out my recommendations on easy ways to drink more water.
This works best if you can get your feet above your heart level, or at least I’ve noticed that it reduces the swelling faster if your feet are above your heart. No need to go to crazy lengths though, headstands are not necessary. But it does take advantage of the effect gravity has on your circulation to pull the fluid back up into your body. Do it as often as you can, and especially at work if you sit behind a desk try and get those feet up for some of the day if not all of it.
You should likely discuss this one with your care provider first, especially if you are also dealing with varicose veins and other similar issues. It is also recommended that you get fitted for compression socks before using them as the pressure and intensity can vary between manufacturers, and your needs may be very different from the ones you can purchase online or in stores.
Depending on the fitness level you had prior to pregnancy can affect how much exercise you need and can handle during pregnancy, so chat with your care provider about how much is safe for your situation. However, for those of us stuck behind a desk all day a short walk around the block or even up the street can help engage the muscles your system uses to move blood back up into your body.
If however, you are on your feet all day, you’ll want to focus on getting those feet up to help drain the fluid.
Reduce your sodium consumption
Some salts like table salt are known to cause swelling and high blood pressure. So avoiding these or avoiding adding these to your food can help keep swelling to a minimum.
Clothing that restricts you will also restrict your blood’s flow, clothing that is too tight can also act like a tourniquet stopping blood flow altogether. This will cause pooling of blood which is more prone to leak out of the blood vessels into the surrounding tissues.
If you’ve ever taken socks off and noticed that band around the top left an indent you know what I’m talking about.
Don’t stand for too long at a time
It’s worse if you stand still for an extended period of time, if at all possible when you are on your feet try and create some kind of movement to engage the muscles. This will help keep some of the fluid moving. If you can’t avoid it, at least get your feet up as soon as possible.
Swelling during pregnancy is fairly common, and most of the time not something we need to worry about. However, it is a good idea to remember that it can also be associated with some complications and things like swelling of the hands and face should be brought to your care providers attention if you notice them.
Resting or floating in a pool can help your circulation system rebalance the fluids that have leaked out of the blood vessels.
Use Cold Compresses on Swollen Areas
Using cool clothes or even ice packs is common for injuries, but did you know that it can also help you reduce swelling due to pregnancy? This is actually one of my favorite tricks and keeps me cool while pregnant in the summer.
Sleep on your side
Besides being a good idea when pregnant for other reasons, sleeping on your side helps your kidneys keep working through the night. The added filtration will help remove waste and reduce the swelling. If you don’t already try sleeping on your side preferably with the left side down for the most benefit.
Wear good footwear
Swelling during pregnancy can affect the size of shoe you need, but also keep in mind that one of those things that happen to our body is that our feet actually grow! Just like the other ligaments in your body the ones in your feet are also loosening due to the hormone relaxin which means the bones spread out.
This spreading out may be a permanent change even after baby arrives, so use it as a good excuse to get yourself some new shoes with quality support that will last a while.
Some research suggests that a foot massage or reflexology (which includes applying pressure to certain areas of the feet, hands, and ears), may help decrease foot and ankle swelling during pregnancy. Even if it doesn’t help with the swelling though taking advantage of these types of relaxing treatments can be a great way to pamper yourself before baby arrives.
Pregnancy Swelling isn’t the end of the world
I know it’s not fun, but normal swelling during pregnancy is not the end of the world. If it gets uncomfortable, use any of the above tactics to help reduce the impact and make sure you keep your Care Provider aware of what you are seeing. While some of the symptoms are normal and totally expected, sudden or painful swelling needs to be evaluated right away so call your care provider. But otherwise, if you see any swelling use it as an excuse to do something to take care of yourself. You deserve it, Mamma, after all, building a new life is hard work!