Have you jumped a shoe size? Swelling during pregnancy — especially in your ankles and feet — is common and expected. Extra body fluid builds up, and your growing uterus presses on pelvic veins and the vena cava, slowing circulation. To top it off, the hormone relaxin loosens ligaments, allowing your feet to spread.
Read on to learn what causes pregnancy swelling (also called edema), when it might signal a problem (not usually), and how to cope.
When do feet swell during pregnancy?
Edema can start as early as the middle of the second trimester, and once it appears, it will likely stick around until you give birth. You might notice more swelling in your feet if your weight gain has been on the faster side.
Curious how your symptoms (and that growing bump) are changing week by week? You can track your pregnancy weight, symptoms, and more with the My Journal tool in our free What to Expect app — your personal little pregnancy diary, minus the guesswork.
It's also normal not to experience noticeable swelling. While edema affects about three-quarters of pregnant women, that means one in four lucky pregnant women don't.
What causes swollen ankles and feet during pregnancy?
Edema is the result of increased body fluids, including higher blood volume. In addition, your growing uterus puts pressure on your pelvic veins and your vena cava (the large vein on the right side of your body that returns blood from your lower limbs to your heart).
During pregnancy, body fluids increase to nurture both you and your baby, and these fluids can accumulate in your tissues. In fact, your body's water content increases by about 6.5 liters (up to 15 pounds) by term. This fluid supports your growing baby, placenta, amniotic fluid, and your own blood volume.
The amount of swelling you experience can vary by the hour (often increasing in the evening) and by the weather (with warmer temperatures leading to more swelling). You may also notice swelling in your hands as well as your ankles and feet.
"I had to take my wedding ring off a few weeks ago," says What to Expect Community mom youraveragegirl. "I almost couldn't get it off my finger, which has apparently started to swell."
In addition to edema, another factor may be at play if your shoes feel snug: Like the rest of your ligaments, those in your feet loosen thanks to the hormone relaxin, allowing the bones to spread.
Don't depend on your feet returning to pre-pregnancy size immediately after birth. While swelling will recede and ligaments will tighten, your feet may remain permanently larger — by up to a full shoe size.
Are there risks associated with swollen ankles and feet?
Mild swelling of the ankles and feet is usually harmless and perfectly normal, but sometimes swelling can be a red flag. Call your practitioner right away if you notice:
- Excessive swelling
- A puffy face
- Gaining more than five pounds in one week
- Swelling that doesn't improve overnight
- One leg that's swollen or feels heavy
- Pain in one calf when flexing your foot
- Skin on one leg that's red or warm to the touch
Excessive swelling can be one sign of preeclampsia — but when it is, it's accompanied by other symptoms (such as elevated blood pressure, protein in the urine, and possibly rapid weight gain). If your blood pressure and urine checks are normal (these are routinely checked at prenatal visits), preeclampsia is unlikely to be a concern.
Rarely, leg swelling can signal a deep vein thrombosis (DVT), a potentially life-threatening condition caused by a blood clot in a deep vein. Swelling from DVT typically affects only one leg (usually the left).
This asymmetrical swelling is significant — the affected calf may be more than 1 centimeter larger than the unaffected leg. If you notice any of these signs, call your practitioner right away. Your doctor can evaluate you with a noninvasive ultrasound of the veins in your legs.
How to reduce swelling while pregnant
Some edema might be unavoidable, but there are things you can do to minimize the swelling and feel more comfortable:
- Avoid long periods of standing or sitting. If you're on your feet a lot, take breaks to sit.[1] If you're sitting for long stretches, take a 5-minute stroll at least once an hour.
- Kick up your feet. If possible, elevate your legs when you're sitting. Who has a better excuse to put up her feet than a pregnant woman? "When it's too bad, I lay on my bed with my feet on the headboard," says Community mom Dahlquah.
- Sleep on your side. If you don't already, try sleeping on your side (preferably your left). This can help keep your kidneys humming along, which helps eliminate waste and reduce swelling.
- Stay active. Gentle exercises like walking or swimming can improve circulation and reduce fluid buildup. "I've discovered swimming helps with my swelling," says Community mom amycrystal3.
- Avoid tight socks. Avoid anything that restricts circulation around your calves or ankles. Socks that leave an indentation mark around your leg are likely too tight.
- Wear comfy shoes. Consider orthotic shoes or inserts, which can make your feet feel better and can reduce leg and back pain during pregnancy, too. (Those sexy slingbacks may not fit now, anyway.) Once you get home, switch to a pair of soft slippers. "I had to buy some shoes in a wide size because I had a lot of swelling," says Community mom slsxoxo.
- Try compression socks or stockings. Opt for full pantyhose (with extra tummy room) or knee- or thigh-highs (a better choice if you're perpetually warm) that aren't tight on top. Whichever type you choose, put them on in the morning before the swelling starts so they're more effective. "My swelling can get really bad in my legs, especially when it's warm and/or I'm on my feet a lot, and compression socks help tremendously," says Community member Amingerink.
- Drink lots of water. It may seem counterintuitive to try to flush out fluids with fluids, but drinking 8 to 10 glasses of water a day will help flush excess sodium and waste.
- Watch your salt intake. Eating too much salty food can increase swelling.[2] You don't have to give up salting your food, just go easy.
While swelling during pregnancy can be uncomfortable, it's usually a normal part of your body's incredible work supporting your baby. Pay attention to your symptoms, take simple steps to stay comfortable, and don't hesitate to check in with your provider if something feels off.
Yes 
No 
