Does your ring no longer fit? Do the shoes that fit fine in the morning feel tight by evening, and have your ankles somehow disappeared?
If so, you are not alone. Around 80% of women experience swollen legs at some point during pregnancy, and in the third trimester it can become a rather annoying daily companion. A feeling of heaviness in the legs by evening often comes as part of the package.
The good news: in most cases it is completely normal and goes away on its own after the birth. Until then, there is quite a lot you can do to help your legs feel lighter.
Why does swelling happen? And why is it to be expected?
Swelling during pregnancy is usually not a sign that something is wrong. Your body is going through major changes right now – and many of them at once.
There is simply more fluid
During pregnancy, blood volume increases by around 40–50%. The baby, the placenta and the uterus all need more blood supply, and the body also holds on to more fluid. Some of it moves from the blood vessels into the surrounding tissues – and that is how swelling forms.
The uterus presses on the veins
The bigger the baby grows, the more pressure the uterus puts on the large veins in the pelvic area, through which blood flows from the legs back to the heart. The flow slows down, pressure in the legs rises and more fluid collects in the tissues.
Hormones do their part
Pregnancy hormones make the walls of the blood vessels more relaxed. This is a normal part of pregnancy, but it also means that fluid passes from the vessels into the tissues more easily.
Gravity does the rest
That is why swelling is worst in the evening, after long periods of standing or sitting – and mostly in the ankles and feet. Over the course of the day more and more fluid gathers in the legs, and by evening the body shows it quite visibly.
The lymphatic system has to cope with all this extra fluid
The lymphatic system has no central pump the way the circulatory system has the heart. Fluid is moved along by our movement and the work of our muscles. During pregnancy there is more fluid, and the growing uterus can make it harder for it to drain from the legs. That is why more fluid can build up in the legs over the day.
When is swelling normal and when is it not?
Typical pregnancy swelling develops gradually, is roughly equal in both legs, gets worse by evening and goes down overnight. Annoying, but usually harmless.
Contact your midwife or doctor right away if:
- the swelling comes on suddenly, especially in the face and hands
- it comes with a severe headache, vision problems or pain in the upper abdomen
- the swelling is in one leg only, especially if the leg is red, warm or painful
- the swelling does not go down even after resting overnight
Sudden swelling together with headache, vision problems or upper abdominal pain can be a sign of pre-eclampsia. One-sided swelling with pain, warmth or redness can be a sign of deep vein thrombosis. Both need prompt medical assessment.
How to support lymph flow with simple habits
The good news is that you can do many of these things entirely on your own – and they need no special equipment or much time.
1. Move in water
Swimming and water aerobics are the gold standard for pregnancy swelling. The pressure of the water works like gentle compression and helps fluid move back up. Your legs are deeper in the water, where the pressure is greater – so the water acts as a kind of natural compression stocking.
Movement itself also helps the circulatory and lymphatic systems work better. Many women find that after a session in the pool their legs feel lighter and less tense.
2. Put your feet up
“Resting your legs” does not simply mean lounging on the sofa. If your legs stay at the same level or lower, resting does not do much for the swelling.
Raise your legs above the level of your heart – on a pillow, an armrest or up against a wall – for about 15–20 minutes a couple of times a day. That way gravity helps the fluid move back out of the legs.
3. Sleep on your left side
The large veins that the growing uterus can press on lie on the right side of the spine. Sleeping on your left side may reduce the pressure on them and keep circulation flowing more smoothly.
A pillow between the knees makes the position more comfortable. A special pregnancy pillow that supports the body when sleeping on your side can also help.
4. Pump your ankles
While sitting or lying down, pull your toes towards you and then point them away. Also make circles with your ankles – about 20–30 repetitions every hour when you have been still for a while.
The calf muscles help the circulatory and lymphatic systems do their work, and these simple movements get the muscles going even when a longer walk does not feel appealing right now.
5. Avoid both sitting still for long and being on your feet for long
Both can make swelling worse. The key is balance and changing position.
A good rule of thumb: change position at least once an hour. In the office, get up now and then and walk around. If you work standing up, look for chances during the day to sit down and rest your legs.
6. Drink water and don’t be afraid of salt in sensible amounts
It sounds contradictory, but restricting fluids does not reduce swelling – if anything, the body may start holding on to more fluid. Drink according to thirst and keep your fluid intake normal.
Cutting out salt completely is not the answer to pregnancy swelling either. Eat a varied, normal diet without trying to “dry out” the swelling through food.
7. Consider compression stockings
If the swelling is a daily thing, ask your midwife or pharmacy about compression stockings suitable for pregnancy.
Put them on in the morning before getting out of bed, because overnight the swelling has had a chance to go down and the stocking helps keep it under control during the day.
Important: compression stockings are mainly for preventing swelling from forming and getting worse, not for “pushing back” swelling that is already there.
How can lymphatic massage help with pregnancy swelling?
If the simple habits are not enough and your legs still feel heavy or tense at the end of the day, one option to consider is Lymphatic Massage.
Lymphatic massage, also known as lymphatic drainage, is a very light, rhythmic massage technique that helps fluid that has gathered under the skin start moving. It is not an ordinary muscle massage – the pressure is gentle, because the lymph vessels lie just beneath the skin.
During pregnancy the massage is done lying on your side, supported with pillows, so that you are comfortable and safe throughout. For pregnancy swelling the focus is mainly on the legs, and the aim is to reduce the feeling of heaviness and tension.
If your legs feel heavy and tense at the end of the day, Lymphatic Massage or Prenatal Massage can be one way to support how you feel and give your body a little rest.
One important thing: if the swelling is one-sided, comes on suddenly or is accompanied by swelling of the face and hands, have it checked by your doctor or midwife before any massage. For typical pregnancy swelling, massage can be a pleasant extra support.
If you remember only one thing
During pregnancy your body is doing an enormous amount of work every single day. If your legs let you know about it by evening, it is worth simply giving them a little more attention and rest.
Small things can make a real difference to how you feel.
