Edema (water retention) is a condition you are likely to experience when you are pregnant. You’ll discover that physical expansion is not limited to the middle of the body. In fact, the mum-to-be can balloon all over because of edema.
Edema commonly targets the ankles, legs, and hands and is more common in the evenings, and from the fifth month of pregnancy all the way into the third trimester. This is normal, as your body is holding around 50 per cent extra blood and body fluids to meet your baby’s needs.
As your baby grows, the uterus presses on the inferior vena cava (vessels that receive blood from your lower limbs). This slows circulation, causing the blood to pool in your legs.
Changes in your blood chemistry push excess fluid into your tissues, even softening ligaments around your body. This is mostly to ease the delivery process, but can lead to foot and knee problems when the ankle ligaments are affected.
If you press on the swelling at night you may be surprised to see that the skin does not spring back. Instead, there is a small indent left behind. This is pitting edema.
Edema is not harmful but it can be uncomfortable. Medicines (diuretics) that help your kidneys to release water and sodium leading to less fluid retention are not suitable during pregnancy. So what can you do to help ease edema during pregnancy?
How to Reduce Edema during Pregnancy
• Avoid standing for long hours (excessive pressure can loosen ligaments, create more swelling and cause leg cramps).
• While seated, do gentle leg exercises and move. Stretch regularly, rotate your ankles and wiggle those toes!
• Keep a foot stool under your desk at work to help raise your legs; it is advised not to cross your legs or ankles when sitting.
• Rest with your legs raised. Lying on your left will reduce pressure on your inferior vena cava (which brings blood back up your legs), helping to reduce swelling.
• Remain in a cooler environment as much as possible to help reduce water retention.
• Wear comfortable supportive shoes that accommodate swelling. Sports sandals are good alternatives; podiatrists can help direct you to good footwear stores if you need help to find suitable footwear.
• Wear support or compression stockings during the day. It is best to put these on first thing in the morning before swelling starts. You can get these from podiatrists and vascular doctors as medical compression stockings are not readily available outside. These can also help prevent varicose veins.
• Use a cold compress to reduce swelling and ask someone special for a gentle leg massage. Upward strokes help move fluid away from your ankles.
• Non-strenuous exercise will encourage circulation, reduce ankle swelling, and prevent muscle cramps. Swimming is a perfect exercise as immersion in water reduces pressure and swelling in the body.
• Get plenity of rest and fluids (although you are swelling, you should not skimp on your fluid intake).
• Avoid wearing toe rings in case the foot swells and the ring becomes too tight.
The Right Footwear can help ease Edema during Pregnancy too!
Extra swelling and added baby weight can lead to the ligaments and tendons of the foot being strained, weakening your foot arches. This can lead to what many call “flat foot”.
Flat foot leads to big toe bunion development and multiple joint or nerve problems along the legs, knees and spine.
So forget those stilettos – they’re not safe during pregnancy! But while flip flops may sound comfortable and ideal in our hot and humid environment, these do not provide the kind of support that your feet require.
Don’t worry, you’ll be able to wear your heels again after giving birth!
Try sports sandals instead, lower thicker wedged heels as opposed to high stilettos, and ballerina flats which come with a base cushion and arch support rather than a pair of soft almost-not-there ballerina slippers.
While these may not be the most glamorous types of footwear around, bear with it. A comfortable pair of shoes will ensure that there’s less foot pain and swelling, and help prevent long-term foot problems.
Make sure the shoe is adjustable, as it will have to accommodate daily swelling and an increase in ankle size.
Typically women’s feet can increase up to one shoe size during pregnancy. So when buying shoes, shop at the end of the day (when swelling is at the maximum) and check that there is one thumb’s width of space between the end of your longest toe and the front of the shoe.
Check that the shoes have the following features:
• A thick cushioned base bending only at the big toe
• Backing or a full ankle strap to support the ankle
• A wide forefoot
• A mid-foot strap or laces to keep the shoe on the foot
• Arch support (built-in or an orthotic)
When Swelling during Pregnancy is not right
Do note that there are times when swelling becomes abnormal. When this happens, seek immediate medical attention.
Specifically monitor for excessive swelling in your face, hands or feet. This may be a sign of pre-eclampsia, a pregnancy condition which is characterised by high blood pressure. You should also get checked if the swelling is confined to just one leg, or if you are experiencing more discomfort in the calf or thigh, as this may signal a blood clot.
Monitoring yourself regularly and understanding your norm will reduce risks to both you and your baby. If you are worried specifically about your lower legs pre- and post-delivery then contact a podiatrist for help.
Although you may be experiencing discomfort now, the swelling should go away fairly quickly after Baby is born. You may find yourself sweating and urinating much more in the first few days after birth (all that fluid has to find a way out!), but try not to let this get you down. It will pass.
In the meantime, enjoy your pregnancy and look forward to the day when you’ll be holding your bundle of joy in your arms!
This article was contributed by Georgina J. Callaghan, a Podiatrist from East Coast Podiatry.