GUIDE
Increased blood volume, fluid retention, and the growing uterus pressing on veins cause swelling in the feet and ankles — especially in the 2nd and 3rd trimesters.
Some swelling during pregnancy is normal and expected. Your body produces about 50 percent more blood and fluid to support the baby. Most pregnancy swelling is benign and responds to simple remedies, but sudden or severe swelling can be a warning sign.
Be prepared from day one
Pregnancy swelling — medically called edema — makes your feet, ankles, and sometimes your lower legs feel puffy, tight, and heavy. Shoes that fit comfortably in the morning may feel painfully tight by evening. Your skin may look stretched and shiny, and pressing on the swollen area may leave a temporary indent.
The swelling is caused by a combination of factors. Your body produces about 50 percent more blood and body fluid during pregnancy to nourish the baby. The hormone progesterone causes blood vessel walls to relax and become more permeable, allowing fluid to leak into surrounding tissues. As the uterus grows, it presses on the inferior vena cava — the large vein returning blood from the lower body — which slows venous return and causes fluid to pool in the feet and legs.
About 75 percent of pregnant people experience some degree of swelling. It is almost always harmless, but in some cases, sudden or severe swelling can be an early sign of preeclampsia, which requires immediate medical attention.
Mild swelling can begin in the second trimester as blood volume increases, but it most commonly becomes noticeable around weeks 22 to 27. Swelling typically peaks in the third trimester and is worst in the final weeks of pregnancy, especially during hot weather or after long periods of standing.
The end of the day is usually when swelling is most pronounced — gravity has been pulling fluid downward all day. By mid-pregnancy, many people start needing wider shoes. By the third trimester, going up a half or full shoe size is common.
Swelling tends to worsen in summer, after eating salty foods, and when you have been on your feet for extended periods. It is typically symmetrical — affecting both feet equally. Swelling that is significantly worse on one side warrants a call to your provider.
You cannot fully prevent pregnancy swelling, but you can significantly reduce it with consistent, simple measures. The key is improving venous return — helping blood and fluid flow back up from your lower body.
Raise your feet above the level of your heart for 15 to 20 minutes several times a day. Gravity helps fluid drain from the lower extremities back toward the heart. Use pillows, a footstool, or lie down with your feet propped on the arm of the couch.
Drink 8 to 12 glasses of water daily. It sounds counterintuitive, but good hydration helps your kidneys flush excess sodium and reduce fluid retention. Dehydration causes your body to hold onto even more water, making swelling worse.
Excess sodium causes your body to retain water. Avoid highly processed foods, canned soups, and salty snacks. Flavor food with herbs, lemon, and spices instead of salt. You do not need to eliminate sodium entirely — just aim for a moderate, balanced intake.
Graduated compression stockings apply gentle pressure that helps push fluid up and out of the feet and legs. Put them on first thing in the morning before swelling builds up for the best effect. Look for 15 to 20 mmHg compression, which is available over the counter.
Sitting or standing in one position for long periods allows fluid to pool in the lower legs. Walking, gentle ankle circles, and calf raises keep the calf muscles pumping blood back toward the heart. Even a 10-minute walk every hour helps significantly.
Lying on your left side takes pressure off the inferior vena cava, the large vein that returns blood from the lower body to the heart. This improves circulation and reduces fluid accumulation in the feet and ankles. Use a pillow between your knees for comfort.
These symptoms can occasionally signal something that needs medical attention. When in doubt, call.
Pregnancy swelling resolves after delivery, usually within 1 to 2 weeks. Your body will shed the excess fluid through increased urination and sweating in the postpartum period. Many people are amazed at how quickly their ankles return to normal once the baby is born.
In the meantime, consistent use of the strategies above — especially elevation, hydration, and compression stockings — can make a significant difference in your daily comfort.
Swelling often pairs with other third-trimester symptoms, so you may also want to read about pregnancy back pain, leg cramps, and pregnancy insomnia. If you notice sudden, severe swelling along with headaches or vision changes, that is a potential medical emergency — do not wait to call your provider. For overall body changes during pregnancy, our guides on pregnancy weight gain and stretch marks cover what to expect.
This guide is for informational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider with any questions about your pregnancy.
