Swelling in Pregnancy: Causes and How To Manage It

Many women talk about having the pregnancy glow and feeling like the best version of themselves during pregnancy. However, while your growing bump, luscious hair, and glowing skin are perks of pregnancy, there are less glamorous parts, too. Swelling in pregnancy is one such symptom that can be uncomfortable and may make you self-conscious. But is it worrisome? Here, we’ll dive into its causes, its onset, when to be concerned, and remedies for minimizing this symptom.

Swelling in pregnancy, also called edema, can be a normal symptom of pregnancy.¹ The body is designed to hold onto more water while you’re pregnant.² This enables it to soften and stretch to accommodate your growing baby and open the pelvis for delivery.³ By the time you reach full term, you’re likely carrying 2-3 pounds of extra fluid.⁴ In addition to the extra fluid, the weight and size of your growing baby and uterus can put pressure on major blood vessels, impacting circulation and causing fluid buildup in the legs and feet.^1,2 Other factors that contribute to it include hot weather, prolonged standing or sitting, dehydration, and diet.^1,2

You may start to experience this symptom once your uterus reaches a size where it’s pressing on the inferior vena cava. This may happen toward the end of your second trimester, or around month five of pregnancy, and it can persist or worsen into the third trimester.^1,3 However, since the larger uterus isn’t the only cause, you may experience swelling at any point in pregnancy. It can come on sooner or later based on the additional fluid weight.^3,4

Normal swelling happens mostly in the lower extremities, but it can also occur in the hands and face. Swollen ankles and leg swelling in pregnancy happen as a result of the pooling of excess blood and fluid.³ Swelling that comes on gradually and worsens as pregnancy progresses is most likely normal pregnancy swelling. It’s also normal for swelling to worsen throughout the day and improve overnight.²

Pitting edema in pregnancy, or swelling of the legs that stays depressed after you press on it, can also be normal. This is caused by circulation issues and increased fluid volume during pregnancy.⁶

Although gradual, worsening, evening swelling can be normal during pregnancy, there are times when swelling is concerning. The biggest concern is when it appears suddenly.³ Abrupt face swelling in pregnancy could be a sign of preeclampsia.⁵ In particular, extreme and sudden swollen hands during pregnancy can be concerning. Contact your provider immediately if you experience sudden swelling, especially when accompanied by:²

• A severe headache
• Vision problems
• Chest or rib pain
• Heartburn
• Nausea or vomiting
• A general unwell feeling

You might be wondering if this symptom is diet-related. While foods can sometimes cause swelling in pregnancy, most of the time, it’s caused by extra fluid and pressure from the growing uterus.³ Still, foods that may affect pregnancy swelling include:

Excessive salt in the diet may contribute to pregnancy swelling. But remember that many times, this symptom is normal.¹ Awareness of sodium intake is important, but it isn’t usually necessary to change your dietary intake unless your doctor suggests it.⁷

2. Caffeinated Food and Drinks

The American Pregnancy Association (APA) recommends limiting your caffeine intake during pregnancy.³ In addition to caffeine’s effects on your baby, it may also contribute to fluid retention that causes swelling.⁸

Similar to caffeine, simple carbohydrates can cause your body to hold onto excess water and fluid. Sweetened beverages, processed snacks, and other high-sugar foods can contribute to pregnancy swelling.⁸

While salt, caffeine, and sugar can increase swelling in pregnancy, there are also foods that can help you manage this uncomfortable symptom. To decrease pregnancy swelling, aim to consume sufficient amounts of the following:

While it may seem counterintuitive, consuming enough water each day helps the body not hold onto too much extra fluid. Water helps flush out excess swelling.¹ Aim for 8-12 cups of water per day to keep you and your baby hydrated and decrease pregnancy swelling.¹¹

2. Fruits and Vegetables

Eating plenty of fruit and vegetables daily can help reduce pregnancy edema.⁵ One study showed that pregnant women with a daily intake of fruit and vegetables had a reduced risk of developing preeclampsia, a condition in which swelling is a symptom.¹²

Adequate protein helps balance how much fluid is in the blood versus the surrounding tissue, which directly impacts swelling. Focus on getting enough protein each day from sources such as turkey, chicken, and other lean meats to mitigate excessive pregnancy swelling.⁸

4. Vitamins and Minerals

Talk to your provider about what prenatal vitamins and supplements you should take during pregnancy. In general, a prenatal vitamin can help manage your body’s delicate fluid balance.⁸

The APA reports that potassium can decrease pregnancy swelling.³ Foods that are high in potassium include bananas, avocados, kidney beans, and sweet potatoes.⁸ Another study showed that preconception and first-trimester calcium consumption might reduce the risk of preeclampsia and swelling in pregnancy.⁹ The best source of dietary calcium is dairy.¹⁰

Aside from diet, there are other interventions you can try to decrease your experience of this symptom:^1,2

• Avoid prolonged standing and sitting.
• Change positions frequently to prevent the pooling of fluid in one area.
• Elevate your feet when possible to promote blood flow back to the heart.
• Doing gentle exercise, like walking, can also promote blood flow and decrease stagnant fluid.

Swollen feet during pregnancy can be particularly uncomfortable and unsightly. Here are some additional remedies you can try to help reduce swelling in the lower extremities:

While movement and exercise, frequent position changes, and foot elevation are the best ways to prevent leg swelling in pregnancy, compression stockings can gently squeeze your lower extremities and promote fluid return to the heart. You can find compression stockings online, at a pharmacy, or at a nursing uniform store.¹

Muscle movement helps squeeze veins and send blood back to the heart. To reduce swollen ankles during pregnancy, try these exercises to promote circulation. In a seated position, flex and extend your feet 30 times, then rotate both feet clockwise and counterclockwise eight times each.²

Moderate pressure rubbing and massage of the swollen areas can help redistribute fluid and aid in circulation.¹ Enlist your partner for a nightly foot massage, or you can even use this as an excuse to treat yourself to a pedicure!⁵

Soaking your feet in cool water can reduce swelling and ease pain and discomfort. Be sure the water isn’t ice cold, as this can have the opposite effect. Soak for 20 minutes, two to three times per week, for maximum benefit.⁵

While you might be suffering from the discomfort of swelling in your pregnancy or feel embarrassed about its appearance, most of the time, this symptom is considered a completely normal part of the journey. Unless it’s sudden and severe, it’s likely nothing to worry about, but always talk to your provider about your pregnancy concerns. Although pregnancy edema is usually normal, there are interventions (from diet to massage and more) to help manage it. Usually, this symptom clears up within a week or two after delivery, but if it doesn’t, you should contact your provider.⁸ Your feet will return to normal just as you’re getting used to your new life with your new baby!