Swelling in pregnancy—why it happens and when to worry
Swelling, also called edema, in pregnancy is incredibly common—and usually not a cause for worry.
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They warned you about the pregnancy nausea. You knew you’d gain some weight. But no one said anything about swollen fingers—and ankles and calves and cheeks and toes… of all the pregnancy symptoms, pregnancy swelling is certainly an eye-opener. Things you didn’t know could get swollen suddenly blow up like a balloon.
If you’re experiencing noticeable swelling in your feet and hands during pregnancy, you’re definitely not alone.
Swelling in pregnancy—also called edema—is incredibly common, and usually not a cause for alarm. But knowing what’s behind it, how to get some relief, and when to call your provider makes a real difference. Here’s what you need to know.
Related: The new mama’s guide to pregnancy symptoms
Why does swelling happen in pregnancy?
Your body is doing something remarkable: producing roughly 50% more blood and fluid than usual to support your growing baby, placenta, and all the other changes happening under the hood. That extra fluid has to go somewhere—and it tends to pool in your tissue, especially as the day goes on.
The growing uterus also puts pressure on the inferior vena cava, the major vein that returns blood from your lower body to your heart. This slows circulation and contributes to the puffiness in your feet and ankles.
Hormonal changes play a role too: progesterone and other pregnancy hormones can make your body hold onto fluid, which is why even your face and hands might feel swollen, especially in the third trimester.
So if you’re watching your ankles disappear into your shoes by 4 p.m., you’re in very good company.
What can make swelling worse?
You may not be able to control whether you swell, but some factors can make it more pronounced:
- Standing or sitting for long stretches without moving
- Hot weather
- Eating a high-sodium diet
- Being on your feet a lot
- Late in the day (gravity has been working against you all day)
But as midwife Dianne Reynolds notes, “Lower extremity edema is an almost universal finding in late pregnancy.” So please don’t beat yourself up over it! Instead, focus on relieving the symptoms when you can, and know when to contact your practitioner.
Related: A nutritionist’s guide to the best foods for pregnancy, from the early days to the third trimester
How to relieve swelling during pregnancy
You won’t be able to eliminate pregnancy swelling entirely—but these strategies can take the edge off:
- Elevate your feet. Prop your feet above heart level for 15–20 minutes a few times a day, especially in the evenings. Even resting them on a pillow while you’re lying down helps move fluid back toward your heart.
- Stay hydrated. Counterintuitive but true: drinking more water actually reduces water retention. When you’re dehydrated, your body hoards fluid. Aim for 8–10 glasses a day.
- Sleep on your left side. This position takes pressure off the inferior vena cava, improving circulation and reducing swelling, particularly in your legs and feet.
- Move regularly. Short, frequent walks or even gentle ankle circles and foot flexes throughout the day keep fluid from pooling. Water exercise is especially effective—the gentle pressure of being in water can help push fluid out of the tissue.
- Watch your sodium intake. You don’t need to go low-sodium, but cutting back on heavily processed or salty foods can help your body hold less fluid.
- Wear compression socks. Compression stockings (grade 1, 10–20 mmHg) can help reduce swelling in the lower legs and support healthy circulation.
- Avoid standing for long periods. If your job or routine requires a lot of time on your feet, try to take breaks to sit and elevate your legs when possible.
- Skip the tight shoes. Switch to comfortable, supportive footwear with a little extra room. Shoes that are tight in the morning can be downright painful by afternoon.
When does pregnancy swelling go away?
For most people, swelling peaks in the third trimester and resolves within a week or two after delivery—sometimes faster. Your body will shed the excess fluid through sweat and urine as your hormone levels normalize postpartum. (Yes, the postpartum sweating is real, and now you know why.)
It’s worth knowing that swelling can actually get slightly worse in the first few days after birth before it gets better. This is normal.
When is swelling in pregnancy a warning sign?
Most pregnancy swelling is physiological—a normal, expected response to the demands of pregnancy. But in some cases, it can signal something that needs medical attention. Here’s what to watch for:
Call your provider if you have:
- Sudden swelling in your face, hands, or around your eyes. Gradual swelling in the feet and ankles is expected. Rapid or significant swelling in the face or hands is not—especially if it comes on quickly.
- Pitting edema that concerns you. Press your thumb into your shin or the top of your foot. If an indentation stays for several seconds, that’s called pitting edema. It’s not always dangerous—it can occur with normal pregnancy swelling—but if it’s on your hands, face, or around your eyes, let your provider know.
- Swelling in only one leg. Unilateral swelling (one leg much more swollen than the other), especially with pain, redness, or warmth, can be a sign of a deep vein thrombosis (DVT), or blood clot. Seek care promptly.
Call your provider immediately or go to the ER if swelling is accompanied by:
- Sudden, significant weight gain
- Persistent or worsening headache
- Vision changes, including blurry vision or seeing spots
- Pain in your upper abdomen or right shoulder
- Shortness of breath or chest tightness
These can be symptoms of preeclampsia, a serious pregnancy complication involving rapid-onset high blood pressure. If you’re unsure, call your midwife or OB—there are no silly questions when it comes to your and your baby’s safety.
Until fairly recently, swelling was one of the criteria used to diagnose preeclampsia. That’s no longer the case—urine and blood tests alongside blood pressure readings are now used for diagnosis—but significant swelling, particularly of the face and hands, is still worth reporting.
A note on other causes of swelling
In rare cases, unusual swelling during pregnancy can signal a skin infection called cellulitis (look for redness, pain, and possibly blisters alongside the swelling) or other conditions affecting the heart or lungs. When in doubt, it’s always better to reach out to your provider.
A version of this story was originally published on June 22, 2021. It has been updated.
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