Swelling and oedema in pregnancy: what is usual and when to check

If your shoes feel tighter in the evening or your ring has become snug, you are not alone. Mild swelling is common in the second half of pregnancy and is usually harmless. Still, knowing which swelling is usual and which needs checking can set your mind at rest.

Why does it happen?

The amount of fluid in the body rises in pregnancy. The growing womb makes it harder for blood to return from the legs, and fluid collects around the ankles and feet. Hormones also relax the walls of the blood vessels and add to this tendency. Hot weather, standing or sitting for long periods and tiredness at the end of the day can make swelling more obvious.

What does usual swelling look like?

• Mild swelling of the ankles, tops of the feet and sometimes the fingers
• Gets worse during the day and in the evening, and improves with night-time rest
• Usually similar on both sides
• Painless, without redness or warmth

This kind of swelling can often last until birth and settles within a few days to weeks afterwards.

Things that may help

• Raise your legs: Several times a day, rest for 15–20 minutes with your legs above heart level.
• Avoid staying in one position: If you must stand or sit for a long time, walk around now and then and circle your ankles.
• Lie on your side: Especially the left side helps blood return from the legs in some people.
• Drink water: It may sound odd, but drinking enough water can help the body's fluid balance.
• Moderate salt: Too much salt increases swelling in some people; still, do not cut salt out completely, ask your doctor.
• Comfortable shoes and clothes: Avoid tight sock bands and clothing; if needed, try support stockings your doctor recommends.
• Cool and active: A cool room, a lukewarm shower, and walking or moving in water help many people.
• Rings: Take rings off before your fingers swell to avoid getting them stuck.

Why is sudden swelling important?

Sudden or marked swelling of the face and hands can sometimes be a sign of pre-eclampsia, a condition linked to high blood pressure. Most people do not get it, but spotting it early matters. This is why your blood pressure and urine are checked at antenatal visits. Swelling on its own does not mean pre-eclampsia; your doctor's assessment is what counts.

When to contact your doctor

• If there is sudden, marked swelling of the face (especially around the eyes) or hands
• If swelling increases quickly over a few days
• If swelling comes with a severe headache, blurred vision, flashing lights or dark spots in vision
• If you have pain in the upper right abdomen or below the ribs, or sudden nausea or vomiting
• If one leg is swollen, painful, red or warm (needs prompt assessment because of the possibility of a blood clot)
• If you have shortness of breath, chest pain, fainting or a seizure, call 112 (or your local emergency number) or go to the nearest emergency room
• If you measure your blood pressure at home and it is above the limit your doctor gave you

What you can do

Resting your legs for short spells during the day, choosing comfortable shoes and drinking water is enough for most people. You can use the kick counter to follow your baby's movements; if they clearly decrease, get checked without delay.

This article is for information only; your doctor's or midwife's advice for your own situation always comes first.