When you’re pregnant, you expect to see a growing belly. But it’s surprising to look down one day and notice swollen feet or ankles too. Rest assured, some swelling during pregnancy (also called edema) is normal and rarely cause for concern.

Here’s why swelling happens during pregnancy, how to reduce it, and when it might be a sign of something more serious.

What Causes Swelling During Pregnancy?

During pregnancy, your hormones work overtime and cause changes throughout your body so you can grow a healthy baby. One significant change is an increase in your fluid volume. Your body holds onto about 50% more fluid when you’re pregnant.

You need that extra fluid to:

  • Supply nutrients to your baby.
  • Help create the amniotic fluid that surrounds and cushions your unborn baby.
  • Prepare your body for a safe childbirth.

Swelling happens when some of that extra fluid leaks out of your blood vessels. It collects in tissue, especially in your ankles, feet, or fingers.

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When Does Swelling Start During Pregnancy?

Swelling can happen anytime during your pregnancy, but often starts around your fifth month. It can worsen in your third trimester because your growing baby and expanding uterus put pressure on your veins. That can impair blood flow back to your heart and cause fluid to leak out of tiny blood vessels called capillaries.

As you get closer to delivery, it’s not unusual to notice that your shoes feel tighter or your rings are hard to remove. For many moms-to-be, swelling in the hands and feet worsens as the day goes on. By nighttime, your feet, ankles, fingers, or face may look puffy.

Your swelling might also be worse:

  • In warmer weather.
  • When you stand for a long time.
  • When you eat very salty foods, like pizza or Chinese food.
  • If you drink too much coffee.

Home Treatments to Beat the Bloat

Most of the time, the extra fluid you retain is annoying and uncomfortable but not harmful. It should go away on its own overnight, but there’s always a chance it will return. If you have repeat episodes of swollen feet or ankles, try these tips:

  • Take a break and get off your feet. Sit or lie down periodically with your feet elevated.
  • Wear elastic compression stockings. They gently squeeze your legs to reduce the buildup of fluid.
  • Do some walking, swimming, or stretches each day to keep your blood moving.
  • Limit salty foods like packaged snack foods, fast foods, and canned soups.
  • Drink eight to 10 cups of water each day to help flush extra sodium out of your body.
  • Stand, swim, or float in a pool. If you don’t have access to a pool, try a bathtub. The water pressure can help compress tissues in your feet and legs.
  • Sleep on your left side. That relieves pressure on the large vein that returns blood to your heart.
  • Wear loose-fitting clothing that doesn’t restrict circulation around your waist or calves.

Despite your best efforts, you may still retain some fluid. As long as it’s mild and not painful, it is a normal part of pregnancy.

When to Call Your Doctor or Midwife

If you have numbness in your hands and feet, tell your obstetric provider.

Painful swelling that comes on suddenly or swelling in only one leg is not normal and could be serious. The same is true if you notice more severe face or hand swelling during pregnancy that doesn’t go away overnight.

If you have these symptoms, call your doctor or go to the nearest emergency department. These can be signs of a heart problem, high blood pressure, or a blood clot.

Other concerning symptoms include swollen legs along with:

  • Chest pain.
  • High blood pressure (over 140/90).
  • A sudden severe headache.
  • Confusion.
  • Breathing problems.
  • Vision changes.
  • Sudden abdominal pain.
  • Shaking or a seizure.

These are warning signs of pregnancy complication called preeclampsia,

which is serious and requires immediate medical attention.

Merck Manual. Swelling During Late Pregnancy. LINK

American Pregnancy Association. Swelling During Pregnancy. LINK

About UPMC Magee-Womens

Built upon our flagship, UPMC Magee-Womens Hospital in Pittsburgh, and its century-plus history of providing high-quality medical care for people at all stages of life, UPMC Magee-Womens is nationally renowned for its outstanding care for women and their families.

Our Magee-Womens network – from women’s imaging centers and specialty care to outpatient and hospital-based services – provides care throughout Pennsylvania, so the help you need is always close to home. More than 25,000 babies are born at our network hospitals each year, with 10,000 of those babies born at UPMC Magee in Pittsburgh, home to one of the largest NICUs in the country. The Department of Health and Human Services recognizes Magee in Pittsburgh as a National Center of Excellence in Women’s Health; U.S. News & World Report ranks Magee nationally in gynecology. The Magee-Womens Research Institute was the first and is the largest research institute in the U.S. devoted exclusively to women’s health and reproductive biology, with locations in Pittsburgh and Erie.