Swelling During Pregnancy: What's Normal, What's Not, and When to Worry
You're expecting your belly to expand during pregnancy, but did you know other body parts will probably swell up too? "If you think about it, your body produces 50 percent more blood volume and other body fluids that help in the growth and development of the baby," explains Sherry Ross, M.D., an OB-GYN and women's health expert at Providence Saint John's Health Center in Santa Monica, California.
This swelling—which is also known as edema—is common during pregnancy (especially in the third trimester) and isn't necessarily a reason for concern. Keep reading to learn about the causes and symptoms, how to relieve edema, and when to see a doctor.
What Causes Swelling During Pregnancy?
Raised hormone levels cause you to retain water during pregnancy, making you feel swollen and bloated. However, this discomfort isn't for nothing—your body needs this extra fluid so it can carry nutrients and oxygen to your baby.
Swelling occurs even in healthy women with uncomplicated pregnancies. It usually worsens throughout the day and is most severe at night. Common triggers include exercising, being particularly tired, standing or walking for an extended time (gravity can make fluid pool in your feet), eating salty foods (excess sodium causes you to retain fluids), and drinking caffeinated beverages (caffeine is dehydrating)
Where Will My Body Swell While Pregnant?
Wondering where you might experience edema in pregnancy? Here are some body parts that could expand throughout your nine month journey.
Legs, Ankles, and Feet: Swelling is most common in the legs, ankles, and feet. That's because "edema typically occurs when the uterus enlarges and presses on the vena cava [a large vein on the right side of your body] and impairs circulation," says Rini Ratan, M.D., assistant director of labor and delivery at Columbia-Presbyterian Eastside, in New York City. Consequently, blood pools in your legs, the veins swell, and some of the fluid from these veins leaks into the supporting skin tissues. Also, blood vessels are the smallest in your foot and ankle, so your body has difficulty accommodating the extra fluid pouring in there.
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Face: Pregnancy swelling can also happen in other areas of the body, such as the face. "The nose may feel like it's swollen or congested because the tiny vessels in sinuses dilate with increased volume of blood and fluids," says Kameelah Phillips, M.D., an OB-GYN in New York City. "This may lead to a sense of congestion or a bloody nose." Your gums, lips, and eyes can be affected by pregnancy-related water retention and increased blood volume, too.
Hands and Fingers: Other women experience swelling during pregnancy in the hands and fingers. "Pain, heaviness, tingling, and the feeling of hands falling asleep are also common symptoms," says Dr. Ross. "Nerves in the wrist get squeezed cause pain and numbness in the finger tips also known as carpal tunnel syndrome."
Breasts: As they begin to prepare for lactation, which can start as early as the second trimester, you can expect quite a few changes in your breasts, particularly in the size department. Dr. Ross explains that this is the result of those pesky pregnancy hormones that may cause your knockers to double or even triple in size. "The areola, nipples, and Montgomery glands also increase in size and become more noticeable," she adds.
Lady Bits: Yes—your vulva and vagina region are common sites of engorgement, especially towards your second and third trimesters. In a nutshell: Anywhere your body holds veins, blood will travel and in larger amounts during pregnancy. This can cause certain areas, including your vagina, to become congested due to the uterine pressure on the pelvic veins.
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How to Relieve Swelling in Pregnancy
Jane Anderson, a podiatrist at the Food and Ankle Center in Durham, North Carolina, offers some ideas to prevent and relieve swelling during pregnancy:
- Elevate your feet as often as you can. Try raising your legs 6 to 12 inches above your heart for 15 to 20 minutes to help the blood flow back to your heart and lungs.
- Sleep on your side, not your back. This relieves pressure on the vena cava, the largest vein leading to the heart. Otherwise, the pressure slows the blood returning from your lower body.
- Consume lots of fluids. Dehydration worsens swelling. Water prevents the kidneys from thinking you're going to be chronically dehydrated and helps flush salt out.
- Drink less caffeine. Although caffeine makes you pee, which eliminates excess fluids, it also causes dehydration.
- Watch your salt intake. You don’t want to consume too much or too little sodium.
- Monitor your weight. Women of normal weight should gain 25 to 35 pounds during pregnancy. Excessive weight gain exacerbates swelling and can lead to other pregnancy problems.
- Improve the circulation in your ankles with rotation exercises. Try sitting with one leg raised. Rotate your ankle 10 times to the right, then to the left. Switch legs and repeat 10 times.
- Ice your ankles. With your feet up, apply ice to the inside of your ankles for 15 to 20 minutes every half hour to an hour.
- If swollen ankles make it difficult or painful to walk, try out compression stockings. (Your OB-GYN can advise you on the level of compression you'll need.)
- During the final weeks of pregnancy, avoid wearing tight clothing or crossing your legs while you sit.
When to Worry about Pregnancy Swelling
Edema in pregnancy usually isn't cause for concern. And it's unlikely that you'll have long-term changes to your body from water retention or swelling, says Dr. Phillips.
That said, you should call your doctor for the following symptoms: swelling that increases very rapidly, extreme puffiness of the face and hands, blurred vision, shortness of breath, severe or constant headaches, or weight gain of more than a pound a day. These signs could indicate preeclampsia, a serious pregnancy condition associated with high blood pressure and excess protein in the urine.