Jennifer is 14 weeks pregnant and proudly holds out her right hand to her midwife. A wedding ring has recently appeared on it. "We got married!" A short time later, the ring has already disappeared again - but not because Jennifer's marriage is already over. No, the ring had to come off again so quickly due to some nasty but annoying water retention on her hands!
Water retention (oedema) during pregnancy is extremely common in the hands, but especially in the legs and feet. Suddenly the ring constricts the finger that has become fat, from one day to the next your favourite shoes no longer fit your swollen feet and your socks leave notches on the edges of your legs. Around two thirds of all pregnant women experience this. In principle, however, this is nothing to worry about, because there is a reason for these "phenomena". They are due to the interaction of various factors that occur with the physical changes during pregnancy.
How does oedema develop during pregnancy?
In a nutshell, the development of water retention during pregnancy is mainly related to hormonal changes, increased blood volume and the growth of the uterus.
Hormonal changes: Yes, hormones are once again to blame. One example of this is the Progesteronewhich not only loosens the muscles, but also causes your blood vessels to dilate and become more permeable. This allows fluid contained in the blood to escape more easily and enter the spaces in the surrounding tissue. In the third trimester, the hormone Relaxin plays an increasingly important role in these processes. To prepare the body for birth, it causes the ligaments and joints to loosen, which also favours the accumulation of fluid in the tissues.
Increased blood volume: During pregnancy, the blood volume in a pregnant woman's body increases by around 40 %. This is nature's way of ensuring that the child growing in the womb is always well supplied with all the necessary nutrients and oxygen. Now we can extrapolate: If the fluid can escape more easily due to the lower resistance of the blood vessels and there is more blood in the body anyway, then fluid can also accumulate more in the surrounding tissues.
Weight of the uterus: As the foetus grows, the uterus can put more pressure on the blood vessels in the pelvic area. However, if the blood from there drains more slowly and causes "congestion" in the leg veins, more fluid can also get into the spaces between the tissues and cause swelling in the legs and feet - preferably around the ankle. To make matters worse, the so-called Calf pumpwhich transports the venous blood upwards, is less active during pregnancy. This also leads to slower blood flow and consequently to increased fluid accumulation in the surrounding tissue.
How does harmless oedema manifest itself during pregnancy?
Ideally, a woman who becomes pregnant without being significantly overweight or underweight will gain between 10 and 16 kilograms by the time her child is born. Of this, water retention in the tissue alone accounts for 2 to 2.5 kilograms.
However, as already mentioned, oedema during pregnancy is generally harmless, but certainly annoying. Very few women notice water retention from the early stages of pregnancy. Talk to your midwife or doctor about it so that you can be sure that there is nothing problematic behind it.
In the vast majority of those affected, oedema occurs as the weeks progress from the second half of pregnancy and increasingly in the third trimester. The fluid usually collects in the hands, legs and feet, which is also due to gravity: it keeps the water "down". Occasionally, subtle water retention can also make the face appear a little "fuller".
You can detect oedema on your feet, for example,
- that the skin at the site is taut, puffy and may bulge outwards slightly.
- that the affected area dents for a few seconds when you press on it because the fluid in the tissue moves to the side.
If you have water retention around the ankle, for example, it can cause pain in the ankle and also restrict your mobility. This applies to all oedema around joints.
You should also be aware that water retention can increase in summer temperatures because heat also dilates the blood vessels. And don't be surprised if your legs or feet are more swollen in the evening than in the morning.
The good news is: Harmless oedema caused by pregnancy disappears naturally after the birth as part of the recovery and regeneration process. For some women this can take a little while, but it always works!
What can you do about swollen legs or feet during pregnancy?
If you suffer from oedema, you will not be able to eliminate it completely. But you can still do a lot to alleviate, reduce or prevent them. Most of the following tips against water retention are based on activating or supporting blood flow:
- The most important thing: drink a lot! This applies both to existing oedema and to its prevention. At first glance, it may seem paradoxical that pregnant women are encouraged to drink as much (still) water or unsweetened tea as possible to prevent swollen legs and feet. But this is actually important to boost the metabolism and thus reduce swelling. If you drink enough fluids at all times, your body won't even think of retaining water in your tissues so that there is always enough available for important processes. In addition, regular fluid intake helps your body to rid itself of excess water (i.e. also to reduce oedema) and eliminate harmful substances.
For the same reasons, you should avoid all medicines, foods, teas and "rice days" that flush out water. This will only make the problem worse.
- Also: healthy eating! You can find out what this should look like during pregnancy here on my blog.
- And in addition: Regular exercise! I know - in the second trimester of pregnancy this may still be easy for you, but in the third trimester the growing belly restricts your mobility more and more. Nevertheless, you should realise that prolonged standing, sitting and lying down promotes oedema formation because the blood circulation is then not in full swing and can only remove excess fluid from the spaces between the tissues very slowly. So just see which forms of exercise you enjoy and swim, walk, dance or take a brisk stroll - ideally every day. In between, it is important that you take rest breaks where you can relax. The best way to do this is to lie on your left side.
These are three very important measures to start with. You can also do the following:
- Alternating showers: Warm - cold/cool - warm - cold/cool, this stimulates the blood flow and alleviates the discomfort. Very important: always end the alternating showers with cold water.
- Take a foot bath: Add a little sea salt to lukewarm water.
- Put your legs up for a good quarter of an hour several times a day: Especially if you have been sitting, standing or walking for a long time. This promotes the return transport of water "upwards" towards the heart.
- In the second trimester you can sleep at night with your legs slightly elevated: For the reason just mentioned, for example, insert a Nursing pillow under the legs. From the third trimester onwards, it is best to sleep on your left side. Your nursing pillow can then be a good positioning aid for your upper leg.
- Brush the legs with gentle pressure: And always in the direction of the heart from bottom to top, which promotes the return flow of blood from the legs.
- Consume more salt: Salt provides the body with important electrolytes and helps to retain water in the blood vessels, thus minimising oedema. Simply treat yourself to an extra spoonful of salt a day in addition to your normal daily salt intake. And under no circumstances should you eat a low-salt diet!
- Eat a protein-rich diet: A protein-rich diet helps the kidneys to excrete water from your body.
- Wear compression stockings: They help your calf pump to work. So if you have to stand a lot or suffer from oedema in your legs or feet, your doctor can prescribe compression stockings that are then adapted to you (pharmacy, medical supply store).
- Have lymphatic drainage prescribed: It can be carried out by specially certified physiotherapists if the oedema leads to severe strain.
- Do gymnastics for the toes and fingers: Let your feet or hands circle to the left and right, alternately pulling your toes up towards your shins and your fingers towards your wrists and then relaxing them again. Spread and relax your toes and fingers, etc.
- Apply a curd compress: Wrap some quark in a cotton cloth and place it on your swollen area. Quark takes away the heat, cools and reduces swelling.
- Wear loose clothing and suitable shoes: Anything that restricts you can hinder the blood flow. Even finger rings or anklets, tight clothes, socks and shoes! Therefore: treat yourself to comfort and a casual look!
- Avoid heat: Stay in the shade or in cool rooms in summer temperatures.
Many pregnant women also swear by Schüssler salts or homeopathic remedies for harmless oedema. Seek professional advice from your midwife.
When to seek medical advice for oedema?
In some cases, however, water retention is not harmless, but can indicate a serious illness, such as pregnancy-related water retention. Pre-eclampsia or a thrombosis. You should therefore consult your doctor or a clinic with oedema if you notice the following suspicious symptoms individually or in combination:
- Rapid and significant weight gain (more than 1 kg per week in the third trimester)
- Rapid increase in oedema in many parts of the body
- Severe swelling, also in the face
- Increased blood pressure
- Headaches, especially in the forehead area or pain in the upper abdomen
- Eye flickering/visual disturbances
- Nausea/vomiting
- Sudden swelling on one side of a lower leg or the whole leg, possibly accompanied by pain or redness
In all these cases, your doctor will know what to do and how you and your child can be helped. If a serious illness is suspected or diagnosed, this can also lead to hospitalisation.
And very importantly: Pregnant women should never take medication for oedema on their own initiative without first talking to their doctor or midwife!
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