Swelling in pregnancy

What causes swelling in pregnancy?
About half of all pregnant women experience swelling (also called oedema) around their ankles, particularly in the last few months of pregnancy.

Oedema is caused by increased pressure in the veins of your legs, and by pressure from your growing baby compressing the big veins in your groin. Water retention adds to the problem.

Oedema usually worsens as the day progresses and if you are on your feet, as gravity makes the fluid accumulate at the lowest point. Hot weather and being tired can also make it more pronounced.

Normal oedema occurs only in your feet and ankles, in both legs. If it becomes very marked, progressing up your calf and leaving an indentation when you press on it, it may be pre-eclampsia and you should see your midwife or doctor straight away to ensure that no complications are developing.

If the swelling occurs only in one leg, particularly if your calf is red, tender and lumpy, you should call your doctor, as you may have thrombosis (a blood clot).

Swelling may also happen in your fingers, face, lower back and wrists. If it occurs in your wrists and hand, this is called carpal tunnel syndrome, as the swelling compresses the channel of nerves running up your arm.

If you have been prone to oedema in pregnancy, be prepared for it to become temporarily worse in the first three or four days after birth. This is because, as your body starts to return to normal, all the extra tissues, blood vessels and fluid needed during pregnancy now has to be dissolved and excreted as urine via your kidneys. (This is why you pass large quantities of urine at this time.) However, your kidneys are not immediately able to cope with all the extra fluid, so some of the fluid accumulates in the tissues around your body until it can be passed as urine.

How can I prevent it?
It may not be possible to prevent some swelling from developing, but you can take steps to prevent it from becoming very severe, when it can make your legs painful and the skin tender.

Try to avoid putting on too much weight, by eating a well balanced diet and cutting down on high-fat foods which contribute to extra weight gain. Drink plenty of water to ensure that your kidneys function well so that excess fluid flows through your urinary system efficiently.

Foods which can assist in maintaining good kidney function and act as a natural diuretic (making you pass out urine) include celery, watercress, parsley (in small amounts), apples and citrus fruits, while onions and garlic help the circulation.

Avoid too much salt and pre-packaged, highly processed foods which contain both salt and other additives which can contribute to fluid retention. Eating foods which are naturally rich in vitamins C and E may also be helpful. Foods rich in vitamin C include citrus fruits, green and red peppers, melon, potatoes, tomatoes, strawberries, cabbage and broccoli. Foods rich in vitamin E include vegetable oils (especially corn, soy and wheatgerm oil), sunflower seeds, wheatgerm, sweetcorn, cashews, almonds and corn oil margarine.

There is also some suggestion that smoking contributes to the development of swelling – yet another reason to quit during pregnancy.

Self-help suggestions
Rest as much as possible, putting your feet up above your hips by resting them on a stool, but avoid crossing your legs as this restricts blood flow and can cause blood clots. Sit down when you can, and if your work involves standing for long periods of time, move about from one foot to the other to increase blood flow.

Ask your partner to massage your feet and legs gently, using both hands and working upwards from feet to knees, using a base oil such as grapeseed. However, if your legs are excessively swollen and the skin is very tight this may be too painful for you.

Avoid using aromatherapy essential oils for massage, but you can add them to a bowl of water and soak your feet in the mixture. Cypress oil is particularly good for circulation (also good for varicose veins), or lavender or chamomile may ease the discomfort and relax you.

You could try wrapping a leaf of dark green cabbage around your legs to ease the swelling. Do not wash the leaves, just wipe off any dirt and cool them in the fridge before wrapping them round the most swollen parts of your legs and feet. When they become wet, remove them and replace them with more cooled leaves. They are thought to work by osmotic pressure which draws out excess fluid, and you can repeat this as often as necessary until you feel more comfortable.

The homeopathic remedy natrum muriaticum may help, as this remedy is said to be especially good for fluid problems. Take one or two tablets of the 30c strength under your tongue four times daily for five days, and consult a qualified, registered homeopath if there is no improvement after this.

Dandelion tea, a herbal remedy, is thought to help fluid retention, but do not take this if you have a gall bladder condition. (Always drink herbal teas in moderation during pregnancy.)
Which complementary therapies could help?
Acupuncture may help to rebalance your internal energies, aiding circulation and kidney function. Osteopathy or chiropractic can release misalignments in your skeleton which may be putting stress and tension on certain parts of your body, preventing adequate blood flow and kidney function.

Reflexology has been shown in one small study to ease oedema and associated discomforts, but make sure you choose a registered reflexologist who is qualified and insured to treat pregnant women.