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Why are my ankles and feet swollen?Swollen ankles and feet (oedema) happen in pregnancy because your body is holding on to more fluid than usual.
As your baby grows, your uterus (womb) puts pressure on the blood vessels in your pelvis. This particularly affects the large vein (inferior vena cava) on your right-hand side which receives blood from your lower limbs. This pressure slows blood circulation in the area and causes the blood to pool.
Pressure from this trapped blood forces water down and out through tiny vessels (capillaries), and into the tissues of your feet and ankles. This water is normally absorbed by your body, but because you're pregnant, you retain more water, which adds to the swelling.
Swelling tends to get progressively worse as the day goes on, and is better in the morning, after you've been lying in bed. Later in the day, if you press the skin around your ankles, the skin may not spring back straight away.
Towards the end of your pregnancy, the swelling may affect your hands. If you're wearing rings, they may feel tight on your fingers.
How common is oedema?Unfortunately, it's very common to have oedema in pregnancy, particularly in the third trimester (NCCWCH 2008:82). Between 50 per cent and 80 per cent of healthy pregnant women have swelling of some kind (Shepherd et al 2004:259), and hot weather can make it worse.
However, if you have sudden or severe swelling in your face, hands or feet, call your doctor or midwife (NCCWCH 2008:228). It could be a sign of pre-eclampsia, which can be a serious condition for you and your baby.
What can I do to reduce the puffiness?Medicines to help your kidneys release water and sodium so you get rid of fluid (diuretics) aren't suitable in pregnancy (NHS Choices 2012). Instead, try these methods to control the swelling:
- Put your feet up whenever possible, as this will help with your circulation (Bamigboye and Smyth 2007, NHS Choices 2012). At work, keep a footstool or box under your desk. At home, try to lie down on your left side, as this takes pressure off the inferior vena cava.
- Try not to stand for long periods of time (NHS Choices 2012). At work, you should be able to take regular breaks.
- Put support tights on before you get out of bed in the morning, so blood has no chance to pool around your ankles. If this doesn't help, see your doctor, who may prescribe compression stockings (Bamigboye and Smyth 2007).
- Exercise regularly, especially walking, swimming or using an exercise bike (NHS Choices 2012).
- If you're travelling long distances, take regular breaks to stretch your legs.
- If your skin isn't too tight and painful, ask someone to massage your ankles and feet, using upward strokes towards your knees. This can help to move the fluid away from your feet (Tiran 2004:346).
You can also try these other natural remedies to ease the swelling.
Try to remember that the swelling, though uncomfortable, won't last forever. Like many other pregnancy niggles, it should go soon after you have your baby.
ReferencesBamigboye AA, Smyth RMD. 2007. Interventions for varicose veins and leg oedema in pregnancy. Cochrane Database of Systematic Reviews (1):CD001066. [pdf file, accessed November 2012]
NCCWCH. 2008. Antenatal care: routine care for the healthy pregnant woman. National Collaborating Centre for Women's and Children's Health, Clinical guideline. London: RCOG Press. www.nice.org.uk [pdf file, accessed November 2012]
NHS Choices. 2012. Oedema. NHS Choices, Health A-Z. [Accessed November 2012]
Shepherd J, Rowan C, Powell E. 2004. Confirming pregnancy and care of the pregnant woman. In: Henderson C, McDonald S. eds. Mayes' midwifery. 13th ed. London: Bailliere Tindall, 235-87
Tiran D. 2004. Complementary therapies in childbearing. In: Henderson C, McDonald S. eds. Mayes' midwifery. 13th ed. London: Bailliere Tindall, 338-54