Edema, swelling in extremities, is a common occurrence in pregnancy especially in the heat of summer. Women report more swelling in pregnancy during the last trimester.
Two Things That Cause Normal Swelling in Pregnancy
- As pregnancy progresses, the weight of the uterus including a baby, placenta and fluid causes pelvic pressure that prevents effective return of blood from the lower extremities.
- Also, the hormones of pregnancy cause your veins to be more relaxed and they are unable to move blood against gravity back to the heart and kidneys as well as usual. Sitting with the legs dependent for long periods of time like many women do at their jobs is a reason pregnant women have swollen ankles at the end of the day. If after resting all night in a horizontal position, your swelling is resolved, you can be very reassured that it is completely normal. Typically, women have more swelling in the ankles at night and in their hands in the morning.
Some women experience swelling in pregnancy that is unrelieved by rest and position change. Again, when it is of gradual onset and remains in the legs or arms it is usually normal.
When you google “swelling in pregnancy” the word pre-eclampsia is commonly pops up. The definition of pre-eclampsia is an elevation of blood pressure in pregnancy that is associated with protein in the urine, a headache unrelieved with Tylenol, hydration and rest, visual disturbances, epigastric pain or other lab abnormalities. Swelling in pregnancy can potentially be a side effect of this condition but it is NOT the way pre-eclampsia is diagnosed.
What Can You do to Relieve Swelling in Pregnancy?
- Hydration is key. It seems counterintuitive but more water intake reduces swelling (also called edema). The more hydrated you are, the less fluid your body will store in your tissues.
- Foods that are natural diuretics (foods that increase excretion of fluids through the kidneys) include asparagus, celery, artichokes, carrots, watermelon, cucumber, tomato, parsley, eggplant, cranberry juice, cabbage, apple cider vinegar, beets, ginger, brussel sprouts, and lemon.
- Your protein intake needs increase in the 3rd trimester to at about 100 grams per day. Low albumin (protein) levels in your blood can cause lower blood osmolality (“thickness”) and result in fluids “leaking” out of blood vessels into surrounding tissues (edema). You should eat protein every 2-3 hours in the 3rd trimeser. “Thicker” blood will draw the fluid back into your veins to be excreted by your kidneys.
- Garlic and parsley oil pills (they come together in one gel capsule) can also help reduce edema. Take 3 pills by mouth at bedtime.
- Reducing your sugar intake can limit water retention. Remember sugar is in all carbohydrate foods (rice, pasta, bread, grains, dessert) as well as fruits. And tropical fruits have a higher sugar content than other fruits.
- Compression stockings can also help. Put them on in the morning when your lower leg swelling is decreased. They will keep pressure on your legs to promote the return of blood through your veins.
- Immersion in water can decrease edema. Soak your feet in a bucket of warm water with some Epsom salts at the end of the day. Hydrostatic pressure pushes fluids back into veins to be excreted. For generalized swelling, try to immerse yourself in a deep bathtub or swimming pool several times a week.
- Massage therapy can also return fluid to the general circulation to help excretion through the kidneys. Choose a good massage oil and you can massage your legs or have your partner do so at home.
The pregnancy swelling will resolve after the birth, but do not be alarmed, it can actually worsen initially postpartum but it will usually resolve by about 2 weeks after your birth.