It starts with your feet. All of a sudden, they don’t fit into the shoes you wore comfortably last week. But then your hands and face start to feel puffy, too. Off comes the wedding ring that’s growing tighter by the day. Just when you get a reprieve from morning sickness, your body has thrown you another wrench: swelling.
Most women develop at least mild swelling, a condition also known as edema, at some point during pregnancy, notes Chris Just, RN, MSN, CNM, consultant and perinatal program development specialist in Boston. Often, edema becomes more noticeable as the due date approaches, when the body experiences increased pressure and weight. Although some swelling is expected and not entirely preventable, there are a number of ways to reduce the inflammation and keep comfortable until you reach the delivery room.
Wondering why you suddenly feel so swollen? Thank your burgeoning bump. As the uterus expands, it puts pressure on the veins and in turn impairs circulation. By the third trimester, this is especially problematic. Extra fluid volume required to support the last months of pregnancy combines with the weight of the increasing uterus compression on lower extremity veins, which slows down the pumping of blood as it returns to the heart, explains Melissa Goist, MD, an OB/GYN with The Ohio State University Wexner Medical Center.
As a result of the impaired circulation, the parts of the body that are farthest away from the heart, including the face, hands and ankles, are most likely to be affected and swell, explains Just. That also makes the feet and fingers vulnerable.
Of course, some expectant ladies experience swelling earlier on than others. That’s because hormones may also play a role when it comes to who experiences edema. “Beginning with conception, a woman’s progesterone level increases, and this decreases the smooth muscles’ ability to function, which leads to swelling anytime,” Goist says. Similarly, swelling is a common side effect as a result of the hormonal influx caused by fertility medication.
Hot and salty
Although you can’t entirely prevent swelling from affecting you at some point over the next nine months, there are two things to avoid that could make it worse: heat and salt.
If your cheeks have ever felt red and puffy on a hot summer day, you’re already familiar with how uncomfortable heat can make you feel. Unfortunately, that means ladies with a summer due date are particularly vulnerable to edema. “Heat and humidity make the veins expand (vasodilate) and draw all the blood to the extremities, so then the poor veins have a hard time pumping blood to the heart because of the proestrogen,” Goist explains. In the summer, be sure to keep the air conditioning cranked up and avoid going outdoors at the hottest time of the day. Cooling off in the swimming pool can be especially beneficial to reduce swelling.
You might be craving pretzels and potato chips, but salt can also do harm. Although sodium is important for maintaining proper blood pressure and for many systems of the body to function properly, too much of it can cause cells to retain extra fluid and result in swelling. “Do not go sodium free, but be cautious,” Goist warns. “A whole bag of chips will make you miserable the next day. Try to help your body, and don’t eat chips outside in the heat.”
As an antidote to external factors like heat and salt, which may cause you to swell, be sure to drink plenty of water throughout the day to help flush out excess fluids.
Just also recommends elevating your feet whenever you can and not sitting or standing in one place for too long. “If you work at a desk, get up and move around; avoid staying in one position for more than 30 minutes when possible,” she says. In addition, Just recommends wearing comfortable, supportive shoes, such as sneakers with good arch support, and tights or socks that fit well. It’s also a good idea to avoid any clothing or legwear with constricting bands at the calves, which could cut off circulation.
Compression (or graduated) hosiery and garments have become a popular choice to help with swelling as well. The products are designed to cover areas vulnerable to swelling, such as your ankles, with tightly knit fabric that applies pressure and generates better blood flow. Try compression leggings or tights to energize your legs and reduce swelling. As a bonus, Just notes, compression apparel may help reduce varicose veins.
Goist also recommends staying active throughout your pregnancy and engaging in light to moderate exercise to keep fluids mobilized and help the leg veins pump fluid back up to the heart.
That’s not swell
Remember, although some swelling is expected on the way to labor and delivery, look out for excessive water retention in the hands or feet. Severe swelling could be a sign of a dangerous condition known as preeclampsia, or elevated blood pressure during pregnancy. Contact your health care provider right away if you notice sudden swelling or swollenness in only one leg, often accompanied with tenderness or pain, severe headaches, blurred vision or rapid weight gain.
“If you are very swollen, your provider may want to monitor your weight gain and blood pressure and check your urine for protein to rule out preeclampsia, which needs to be treated quickly for your health and that of your growing baby,” notes Just.
Even if your swelling isn’t particularly threatening or severe, it’s worth asking your health care provider about tips for reducing sodium intake or compression garment recommendations. Don’t swell in silence: Speak up!