Swelling During Pregnancy: Causes, Normal Signs, and When to Worry

In short: Blood and fluid volume in a pregnant woman’s body increase by up to 50%, so gradual swelling of the feet and ankles appears, worse at the end of the day and better with rest and raising the feet; this is normal. Sudden severe swelling, or swelling of the face and hands, especially with severe headache, changes in vision or high blood pressure, may point to pre-eclampsia and means seeing the doctor at once.

Body swelling during pregnancy is a common symptom experienced by a large percentage of pregnant women, especially in the second and third trimesters. If you’re noticing puffier feet, ankles, or hands, know that this swelling usually occurs as a result of a range of normal physiological changes that accompany pregnancy — and understanding why it happens can help ease your worries.

What causes swelling during pregnancy?

During pregnancy, the volume of blood and fluids in a woman’s body increases by up to 50% to support the growth of the fetus and placenta and to prepare the body for childbirth. This increase in fluids can lead to their accumulation in the tissues, causing what is known as edema, which often appears in the feet and ankles, and sometimes in the hands and face.

Hormonal changes also play a significant role. Progesterone causes the walls of blood vessels to relax, making it easier for fluids to leak into surrounding tissues. Additionally, an enlarged uterus compresses the veins in the pelvis, slowing the return of blood from the lower extremities to the heart and increasing swelling.

When is swelling normal?

Swelling is often normal when it:

• Appears gradually during pregnancy.
• Increases towards the end of the day or after prolonged standing.
• Improves with rest or elevating the feet.
• Primarily affects the feet and ankles.

When should you see a doctor?

Although swelling is often normal, some cases may indicate a medical problem such as preeclampsia. Therefore, you should see a doctor if the swelling is:

• Sudden and severe.
• Accompanied by significant swelling in the face and hands.
• Accompanied by severe headaches, blurred vision or flashing lights, pain just below the ribs (upper abdomen), or vomiting — in these cases seek care the same day.
• Accompanied by high blood pressure.

• Affecting only one leg, especially if the calf is painful, red, warm or tender (this can be a sign of a blood clot and needs urgent same-day assessment).

Tips to reduce bloating during pregnancy

• Avoid standing or sitting for long periods.
• Elevate your feet when sitting.
• Drink plenty of water.
• Reduce your intake of salty foods.
• Take light walks to improve blood circulation.
• Wear comfortable shoes and avoid tight ones.

Body swelling during pregnancy is a normal change in most cases, resulting from increased fluids and hormonal changes in the body. However, any sudden or severe swelling should be monitored, and a doctor should be consulted to rule out any complications. If you have concerns about swelling or other symptoms during your pregnancy, Dr. Najeeb Layyous and his clinical team are available to help guide you through a safe and well-monitored pregnancy journey.

Dr Najeeb Layyous F.R.C.O.G

Consultant Obstetrician, Gynecologist and Infertility Specialist