Common Discomforts in Pregnancy: Swelling May 5, 2010

Many (but not all) women experience swelling of the feet and ankles during late pregnancy.  Mild swelling that shows up after a long day on your feet is uncomfortable but not usually a sign of an underlying medical issue.  In fact it can be a sign that your body is working properly to increase your blood volume to ensure good circulation to your baby, to prepare for the blood loss that accompanies birth and to ensure good hydration of your body in the early breastfeeding days.  But, the weight of your uterus/baby/placenta/amniotic fluid can reduce return circulation from your legs and lead to foot and ankle swelling (and also varicose veins).

“Normal water retention comes about in pregnancy chiefly from an impressive rise in the level of female hormones, principally estrogens, manufactured by the placenta. These hormones are the same ones which cause many women to have water build-up and swelling in the few days preceding their menstrual periods, or when they are taking birth control pills. During pregnancy these hormones influence connective tissue throughout the body to retain extra fluid. Hence, the pregnant women commonly experiences swelling of her face and hands (generalized edema) in addition to that of her feet and lower legs (dependent edema).

The retained fluid is of benefit to mother and baby. Like a reservoir, it provides a water storage system in the mother’s body. The stored fluid serves as a safeguard, a backup for the expanded blood volume we have learned is needed to nourish the placenta. At the time of the birth, when some blood loss is unavoidable, the extra fluid protects the mother from going into shock. Remaining tissue fluid is mobilized in the early breast-feeding period to insure the mother an adequate milk flow. ” – What Every Pregnant Woman Should Know, by Gail Sforza Brewer and Tom Brewer, M.D

However, if the swelling is severe, pitting (leaves an impression on your skin if you press for a few moments), occurs in face or hands, visible in the morning or all the time, or is accompanied by vision changes it could be a sign of a serious condition of pregnancy called preeclampsia.  If in doubt about the type of swelling you are experiencing discuss it with your care provider.

For normal mild swelling in pregnancy there are a few measures you can take to reduce or eliminate the discomfort.

• Rest – Try to elevate above the level of your heart several times each day for at least 15 minutes.
• Walk – If you spend much of your day sitting at a desk take frequent breaks to stand up, take a brief walk and stretch.
• Sleep Position– Sleeping on your left side can improve circulation which may lessen swelling.
• Exercise – Gentle exercise can enhance circulation.  Try pelvic rocking/tilts, leg lifts and prenatal yoga.
• Your Diet – Adequate levels of protein and salt intake can prevent or eliminate swelling and may reduce chances of developing preeclampsia.  The Brewer Pregnancy Diet is a great place to start for information on nutrition during pregnancy.  Also, nettle and dandelion leaf tea can improve circulation and aid in your body’s natural detoxifying.  Herbalist and midwife Aviva Jill Romm suggests 1 to 2 cups daily of the tea/infusion or 1/2 teaspoon daily of each herb as a tincture.
• Foot Soak – Relax, unwind and ease foot and ankle swelling with an epsom salt foot bath.  Add 1/2 cup of Epsom salts to a basin of warm water and soak your feet. 
• Massage – Have your partner treat you to regular foot massages with a bit of oil or lotion.  Try arnica oil to relieve aching muscles and joints.  Caution – never massage varicose veins!
• Shoes – Switch to comfortable, open shoes that won’t restrict your feet.
• Support – Some women find relief in using a pregnancy support belt like this or this.

 

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Also, today, May 5th is not only Cinco de Mayo but also International Day of the Midwife.  A day to raise awareness of midwifery care and celebrate the women who have dedicated their lives and careers to keeping moms and babies healthy, happy and safe!