Swollen feet and ankles: normal, or a reason to call?

Shoes that fitted in the morning pinch by teatime. Your rings leave marks. Pressing a finger into your ankle leaves a small dent that takes a moment to fill. Swelling, also called oedema, is very common in pregnancy, especially in the later months and in hot weather. Most of the time it is simply your body holding on to more fluid than usual. Sometimes, though, swelling is a sign that something needs checking. This guide helps you tell the difference.

Why your body swells

• Your body holds on to extra fluid during pregnancy.
• Your growing womb presses on blood vessels, slowing the return of blood from your legs.
• Gravity pulls fluid down, so feet and ankles are usually worst at the end of the day.
• Heat, long periods of standing and sitting still for long journeys make it worse.

Usually normal

• Swelling that builds up gradually.
• Swelling in both feet and ankles that is worse in the evening and better after a night's rest.
• Puffiness that eases when you put your feet up.
• Fingers that feel a little tight in hot weather.

Call your midwife or maternity unit straight away if

• Swelling comes on suddenly, especially in your face, hands or feet.
• Swelling comes with a severe headache, blurred vision or flashing lights, pain just below your ribs, or feeling very unwell.

These can be signs of pre-eclampsia, a condition linked to high blood pressure that needs prompt care. It can develop even if you felt well at your last appointment.

Get help urgently if

• One leg is swollen, especially the calf, and it is painful, red or warm. This could be a blood clot. If you are also short of breath or have chest pain, call emergency services.

Easing everyday swelling

Put your feet up

Whenever you can, rest with your feet raised, ideally a little higher than your hips. Even ten minutes after work helps. Prop your feet on a cushion while you watch television or read.

Keep moving

• Avoid standing still for long periods. If your job means standing, shift your weight, march on the spot and take short breaks.
• If you sit for long stretches, get up and walk every half hour or so.
• Try simple foot exercises: bend your foot up and down, and circle each ankle several times, a few times a day.
• Gentle walking and swimming are excellent. Water supports your body and many mums find it soothing.

Dress for comfort

• Wear comfortable, wide-fitting shoes, and avoid tight socks or anything that digs in around your ankles.
• Ask your midwife whether compression stockings or support tights might help you.
• If your rings are getting tight, take them off before they become stuck, and wear them on a chain if you like.

Look after yourself inside

• Keep drinking water. It may seem odd, but staying well hydrated helps your body manage fluid.
• Eat a balanced diet with plenty of fruit and vegetables.
• Rest on your side, especially from around 28 weeks.
• On hot days, stay in the shade and keep cool.

Long journeys

If you are travelling for a long time by car, coach or plane, take breaks to walk around, do foot exercises in your seat and drink water. Ask your midwife for advice about long-distance travel, as there is a higher risk of blood clots in pregnancy.

Rest is not a reward

Many women feel guilty sitting down while there is cooking, cleaning and work still to do. But swollen ankles are often your body asking for a pause. Jesus' invitation in Matthew 11:28 is for those who are weary and carrying heavy loads: come to Him and find rest. Putting your feet up can be a small act of trust, a moment to stop striving and let Him hold what you cannot finish today.

If you have someone at home, ask for a foot rub. If you are on your own, a cool bowl of water for your feet and a few quiet minutes with a psalm can be just as restoring.

A prayer with my feet up

Jesus, I come to You tired and heavy. Thank You that You welcome me just as I am. Ease the swelling in my body, keep my blood pressure steady and my baby safe, and teach me to rest without guilt. Amen.