Swollen ankles during pregnancy are a common concern, and while often harmless, they can sometimes signal a more serious condition. Understanding why this happens, what’s normal, and when to seek help can help you feel more confident and safe during your pregnancy.
## Why Do Ankles Swell During Pregnancy?
Swelling, also called edema, happens when extra fluid builds up in your body’s tissues. During pregnancy, your body goes through many changes that make swelling more likely, especially in the legs, feet, and ankles[1][3][5]. Here’s why:
– **Increased Blood Volume:** Your body makes more blood to support your growing baby. This extra blood can put pressure on your blood vessels, especially the veins in your legs, causing fluid to leak into the surrounding tissues[5].
– **Hormonal Changes:** Pregnancy hormones cause your body to hold onto more water and salt, which can lead to swelling[5].
– **Pressure from the Uterus:** As your baby grows, your uterus gets bigger and can press on the large vein (the inferior vena cava) that returns blood from your legs to your heart. This pressure can slow blood flow and cause fluid to pool in your legs and ankles[1][5].
– **Gravity:** Standing or sitting for long periods can make swelling worse because gravity pulls fluid down into your lower legs and feet[5].
## Is Swelling Normal During Pregnancy?
Mild swelling in the ankles and feet is very common, especially in the third trimester and during hot weather[3][5]. This type of swelling usually gets worse as the day goes on and improves after resting or elevating your feet. It’s often symmetrical, meaning both ankles swell about the same amount[3].
## When Should You Worry About Swollen Ankles?
While mild swelling is usually normal, sudden or severe swelling can be a sign of a serious condition called preeclampsia[2][4][8]. Preeclampsia is a pregnancy complication that involves high blood pressure and signs of damage to other organ systems, often the kidneys[4][6][8]. Here are some warning signs that your swelling might not be normal:
– **Sudden or Severe Swelling:** If your ankles, feet, or hands swell suddenly or a lot, especially if it happens quickly, you should contact your healthcare provider[2][4].
– **Swelling in the Face or Hands:** Swelling in these areas is less common in normal pregnancy and can be a red flag for preeclampsia[4][8].
– **Other Symptoms:** Headaches, vision changes (like blurry vision or seeing spots), pain in the upper right abdomen, nausea or vomiting, shortness of breath, or decreased urine output can all be signs of preeclampsia and require immediate medical attention[4][8].
– **High Blood Pressure:** Preeclampsia often causes high blood pressure, which you might not notice without checking. Regular prenatal visits help catch this early[4][8].
– **Protein in Urine:** Preeclampsia can cause protein to leak into your urine, which is detected with a simple test at your doctor’s office[6].
If you notice any of these symptoms, don’t wait—call your healthcare provider right away. Preeclampsia can develop quickly and can be dangerous for both you and your baby if not treated[2][4][8].
## Who Is at Higher Risk for Preeclampsia?
Some women are more likely to develop preeclampsia. Risk factors include[4]:
– Having had preeclampsia or HELLP syndrome in a previous pregnancy
– Being pregnant for the first time, especially if you’re under 18 or over 40
– Having a family history of preeclampsia (mother or sister had it)
– Having high blood pressure, kidney disease, lupus, diabetes, or certain other medical conditions before pregnancy
– Being overweight
– Carrying more than one baby (twins, triplets, etc.)
– Having used assisted reproductive technology (like IVF)
– Being of African ethnicity
If you have any of these risk factors, your healthcare provider will monitor you more closely during pregnancy[4].
## What Causes Preeclampsia?
The exact cause of preeclampsia isn’t fully understood, but it’s thought to be related to problems with the blood vessels that supply the placenta[4]. These blood vessels may not develop properly, which can affect blood flow to the placenta and lead to high blood pressure and other complications[4].
## How Is Swelling Managed in Normal Pregnancy?
For normal, mild swelling, there are several things you can do to feel better[3][5][7]:
– **Elevate Your Feet:** Rest with your feet up above the level of your heart to help fluid drain back toward your body.
– **Avoid Standing or Sitting for Long Periods:** Take breaks to walk around if you’ve been sitting, and avoid standing in one place for too long.
– **Wear Comfortable Shoes:** Avoid tight shoes or socks that can restrict circulation.
– **Stay Cool:** Heat can make swelling worse, so try to stay in a cool environment.
– **Drink Plenty of Water:** Staying hydrated helps your body manage fluids better.
– **Gentle Exercise:** Walking or swimming can help improve circulation.
– **Massage:** Gentle massage may help reduce swelling and discomfort, but always check with your healthcare provider first[7].
Avoid cutting back on salt unless your doctor advises it, as your body needs a certain amount of salt during pregnancy.
## What About Protein in Urine?
Protein in the urine (proteinuria) can be a sign of kidney problems. Before 20 weeks of pregnancy, protein in the urine is usually due to a pre-existing condition, not pregnancy itself[6]. After 20 weeks, new protein in the urine can be a sign of preeclampsia, especially if you also have high blood pressure[6]. Your healthcare provider will check your urine at prenatal visits to monitor for this[6].
## When Is Swelling Not Related to Pregnancy?
Sometimes, swelling can be caused by other medical conditions, such as heart disease, kidney disease, or blood clots. If your swelling is only on one side, is painful, or is accompanied by redness or warmth, it could be a sign of a blood clot and you should seek medical attention right away.
## What Should You Do If You’re Concerned?
If you’re ever unsure whether your swelling is normal, it’s always best to check with your healthcare provider. They can examine you, check your blood pressure, test your urine, and make sure everything is okay. Never ignore sudden or severe swelling, especially if you have other symptoms like headache, vision changes, or upper abdominal pain[4][8].
## Final Thoughts
Swollen ankles are a common part of pregnancy for many women, usually due to normal changes in your body[1][3][5]. But it’s important to know the difference between normal swelling and signs of a more serious problem like preeclampsia[4][8]. Regular prenatal care, knowing the warning signs, and communicating with your healthcare provider are the best ways to keep you and your baby safe.
If you hav
