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Swelling in pregnancy—when it’s normal and when it’s not

They warned you about the nausea. You knew you’d gain some weight. But no one said anything about swollen fingers (and ankles and calves and cheeks and toes).


Swelling, also called edema, in pregnancy is incredibly common. In addition to your baby, your placenta and an increased fat store, your body is hard at work making more blood and fluid to help support the growth of your baby (and all the other changes your body is going through). All this extra fluid can make you look—and feel—fairly swollen.

Your growing baby and uterus also put a lot of pressure on your circulatory and lymphatic system, which can contribute to the swelling as well.

Some women start to notice the swelling early on, but it usually develops during the second and third trimester. Although we often have little control over the swelling, some things that can increase it include:

  • Standing for a long time
  • Prolonged activity
  • Hot weather
  • Eating a lot of sodium (salt)
  • Low levels of potassium
  • High levels of caffeine

Again though, midwife Dianne Reynolds states that “Lower extremity edema is an almost universal finding in late pregnancy,” so please don’t beat yourself up over it!

However, there are times where swelling can be concerning.

Preeclampsia

Until fairly recently, swelling was one of the symptoms used to diagnose preeclampsia, a condition of high blood pressure during pregnancy. It is no longer part of the diagnostic criteria—yet many women with elevated blood pressure do have swelling.

The Preeclampsia Foundation writes:

“If you think your face is getting excessively puffy, find a picture of yourself from just before pregnancy to share with your healthcare provider. If the swelling in your hands and feet becomes severe, you may notice pitting edema (when you press your thumb into your skin, an indentation remains for a few seconds) or discoloration of your legs. If you suspect this kind of edema, notify your healthcare provider.”

Blood clot

Deep vein thrombosis (DVTs) are blood clots that can form in veins. The risk of a DVT increases a bit during pregnancy because your body is producing more of the component of blood responsible for clotting. Other symptoms of a blood clot include pain, hardness and redness. You might also notice one leg is more swollen than the other. The most common site for a blood clot is in your lower legs, though they can occur in other places. If you suspect you might have one, seek treatment right away.

Skin infection

If you develop a skin infection called cellulitis, you may also have swelling. You might have a fever, pain and blisters as well. Again, this would be a reason to get medical attention right away.

When it’s okay—but annoying

Once you’ve been cleared by your provider, it’s just a matter of finding ways to minimize the annoyance of the swelling:

  • Believe it or not, staying really well hydrated (10 glasses of fluid a day) can help.
  • Make sure you change positions frequently and rest when you can if you are on your feet a lot.
  • Elevate your feet several times a day.
  • Try wearing compression socks like these.
  • Eat a balanced diet of low sodium and unprocessed food, when you can.

And remember to report any of the following symptoms:

  • Pain, redness, hardness + swelling in an area of your body
  • One leg that is more swollen than the other
  • Swelling in your face or hands
  • Headache
  • Lightheadedness
  • Belly pain
  • Difficulty breathing
  • Fever

Hang in there, mama. This part is hard, no doubt. But you’ve got this.

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