During pregnancy, the body produces approximately 50% more blood and body fluids to meet the needs of the developing baby. Swelling is a normal symptom of pregnancy that is caused by this additional blood and fluid. Swelling is usually found in the legs, feet and hands. You may notice any rings you wear becoming tighter, sometimes making it necessary to take them off until after your baby is born. Some women notice their feet increasing by a half to one shoe size (or more).

Normal swelling, which is also called oedema, is experienced in the hands, face, legs, ankles, and feet. This extra retention of fluid is needed to soften the body, which enables it to expand as the baby develops. Extra fluid also helps prepare the pelvic joints and tissues to open for delivery. The extra fluids account for approximately 25% of the weight women gain during pregnancy.

But, if you notice that you have swelling beyond 20 weeks of pregnancy, you should have your blood pressure checked by your doctor  to make sure it is NOT related to high blood pressure in pregnancy.

When Does Swelling Occur During Pregnancy?

Swelling may be experienced at any point during pregnancy, but it tends to be noticed around the fifth month and can increase while you are in the third trimester.

The following factors may also affect swelling:

  • Summer time heat
  • Standing for long periods of time
  • Long days of activity
  • Diet low in potassium
  • High level of caffeine consumption
  • High level of sodium intake

Why do some pregnant women experience excessive swelling?

Fluid retention affects about 65 per cent of healthy pregnant women with normal blood pressure.While it can occur at any time in the pregnancy, it more commonly happens in the last trimester of pregnancy. This is because by about 32 weeks, the blood circulating in the woman’s body has increased by up to 50 percent, contributing to swelling or fluid retention.

This ‘pregnancy swelling’ is generally more noticeable at the end of the day, although it may be worse on hot days, after a plane trip or if you are on your feet for long periods of time. Swelling can be also associated with varicose veins of the legs, so support strategies for these may help.

Ways to relieve fluid retention during pregnancy

Try these ways to help with fluid retention but remember to always check with your caregiver first.

Slow down: Put your feet up as much as possible. Put them up at the end of the day for at least 20 minutes. Some women will wear full support stockings if they are on their feet all day. Wearing comfortable shoes with a very slight heel (not completely flat) may help.

Physical activity: Try some gentle, regular exercise such as swimming or yoga.

Look at your diet: Restricting salt during pregnancy is not supported by research so far and is not generally recommended. However salt intakes should not be excessive.

Drink lots of water: Drink at least eight glasses of water a day to keep the kidneys functioning well. Contrary to popular belief, you are better off drinking more water when you have fluid retention, rather than restricting your fluids.

Massage: A massage can be very beneficial. If you don’t have the time or can’t afford a professional one, ask your partner or friend to massage your legs from the feet upwards with a gel, oil or lotion. When massaging the hands, firmly press from the nails to the bases of the fingers.

How to prevent swelling?

You may not be able to stop parts of your body from swelling. But you may be able to limit how severe it is. Severe swelling can make your legs painful and can affect day to day activities.

  • Try to eat a balanced diet so that you put on a healthy amount of weight during pregnancy.
  • Your diet should include a small amount (between 50g and 75g) of protein such as lean meat, poultry, fish, eggs, or beans and pulses, with each meal.
  • Eat at least five portions of fruit and vegetables every day. Try to have a variety of colours in your selection of fruit and veg.
  • Avoid cut, pre-packaged, highly processed meats. Excess salt causes your body to hold on to more fluid.
  • Drink plenty of water to stay hydrated, as this will help your body to hoard less water.
  • Opt for foods that are naturally rich in vitamins C and E.
  • You can also do these simple foot exercises to reduce swelling in your ankles:
    • Bend and stretch your foot up and down 30 times
    • Circle each foot eight times one way and eight times the other way
  • You can do these whether you’re standing or sitting.
    • Wear support stockings.
    • Soak feet in water with Epsom salt.

When to worry-

Oedema 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).
  • 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.

– Dr Prerna Gaur

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