Swelling

SWELLING DURING PREGNANCY 

Edema (swelling) is the extra fluid build-up in your tissues. This is often result of increased blood flow as well as the pressure of your growing uterus on the pelvic veins and your vena cava (the large vein on the right side of your body that returns blood from your lower limbs to your heart).  

While this is normal to some degree in pregnancy, the most important exception is preeclampsia.  

Preeclampsia overview: Preeclampsia is a complication that can occur during pregnancy that is typically characterized by damage to an organ system like the liver or kidneys.  If left untreated it can lead to very serious and sometimes even fatal consequences for you and your baby

Symptoms:

• high blood pressure

• Swelling (particularly hands and face)— if swelling is in one leg more than an other you should be evaluated potentially for a blog clot

• Severe headache

• Change or loss of vision

• Upper abdominal pain (usually right on the right side under your ribs)

• nausea/vomiting

• decrease in urination

• shortness of breath, cough 

• excess protein in urine

• decrease platelet levels in blood

It's important to talk to your doctor about possible causes of fluid retention before you try to treat it yourself. Also, some herbs and supplements can worsen medical problems you have or interact with medications you take. So if you swelling AND especially if you have swelling and something else on this list— please check-in with your provider ASAP.  

Swelling often starts a the mid-point of pregnancy and can often increase while you are in your third trimester.  Swelling can often pool in the lower legs due to fluid moving downward with gravity.  Mild swelling of the ankles and feet is usually no cause for concern.  The body produces 50% more blood and body fluids to meet the needs of the developing baby. The presence of this additional blood and fluid, increased pressure from growing uterus, and the body being more inclined to retain fluid are all pregnancy-related explanations for swelling. If it is uncomfortable or excessive, there are are steps you can do to try and reduce it. 

Pregnancy predisposes many women to increased swelling, which can also be made worse by:

• Summertime heat

• Standing for long periods of time/long days of activity

• High level of sodium and/or caffeine intake

Ways to get swelling moving

Exercising

• A combination of both cardio and strength training helps improve circulation.  The muscles working more effectively to pump excess fluid back into our veins and the heart increasing the rate and volume of blood moved means improved removal of excess fluid from the body.  The balance every pregnant women needs to find is appropriate levels of exercise vs. prolonged time spent on her feet and/or too high of an intensity such that serves to increases inflammation and swelling

• Link to Guides!

• Maintain ankle mobility and calf strength— there is as reason why everybody is supposed to ankle pumps if they are in the hospital, on bed rest, after surgery etc. — the calf muscles are POWERFUL movers of fluid. The more mobile and strong your calves and ankles are, the better they will be able to do their job!Drink plenty of water

Drink plenty of water

• A dehydrated body will try to retain even more fluid.  Some women have found packets of powdered electrolytes made to add to water helpful for restoring fluid balance and getting rid of unwanted swelling

Decrease consumption caffeine and high-sodium (salty) processed foods

• Enough said.

Stay cool

• Hot weather will increase swelling, exercise in the AC to help combat this

Avoid prolonged standing

• Fluid moves down with gravity to pool in the lower limb

• Elevation (getting lets up!) will help with fluid return

Breathing

• A really good 360 degree expansion of the rib cage with an inhale creates a large downward movement of the diaphragm

• This creates a force within our body (negative pressure) that will help drive fluid back into the circulatory system.  Something that does NOT happen shallow breaths or belly-only breathing

Compression

• There are SO many awesome compression socks on the market.  While these are not always the most stylish look, it is impossible to overstate how much these can help. For women with particularly severe swelling, maternity compression that goes ALL the way up to your pelvis or waist can be even more helpful.    

• WATCH out for too-restrictive clothing: make sure your leggings/bra/socks are not created a tourniquet effect— if you see a deep line when you take off a piece of clothing—it is not helping your swelling 

• Truthfully, these are all probably good things to live by whether we are pregnant or not.  Having a body in balance will be helpful to avoid undue swelling at any point in the lifespan, but especially going into your postpartum period.   

POSTPARTUM SWELLING

Trauma from both vaginal and and c-section births can cause swelling postpartum. If its a second baby for you and you know you had some issues with postpartum swelling after your first-born, let your medical team know!  They may be able to manage any IVs differently and monitor you more closely for signs of fluid-overload. 

Compression

• Socks - Sockwell

• Postpartum leggings by Bao Bei

• Abdominal binders can be helpful and you should be able to request one if you give birth in a hospital.  We advocate that you use one as it is benefitting you but look to get rid of it when it is no longer serving a purpose.  Too much compression right around your middle is  like squeezing the toothpaste tube in the middle, the squished things tend to spill out over the top and/or bottom. 

Get up and move!

• You have to get up and move in the early days after birth.  Getting upright and moving is the main way to get swelling moving. If you’re having pain, minimize the tugging/pulling using techniques like log rolling to get in and out of bed

• Exhale from bottom up, don’t bear down and put pressure on your sore abdomen or perineum! 

• Still need to allow time for rest— but this is a great time you can elevate your legs and get in your muscle pumps. 

Muscle pumps

• If hospitalized, use your pneumatic boot

• Ankle pumps- use yoga strap for resistance— amp up your ankle pumps, adding resistance will get that muscle working better

• C-section moms: do pelvic floor quick flicks

• Vaginal birth moms: TA contractions

Ice, ice baby

• for local swelling either on perineum for vaginal births or on abdomen for c-section

Breathing

• back body breathing— not belly-only breathing

Hydrate

• need lots of water to restore fluid balance while you are healing. Dehydration is going to make your body want to retain more water. 

Keep your diet “clean” and anti-inflammatory

• High salt/high processed carb diet will make you more inclined to retain fluid

• More potassium to your diet, like bananas, squash, spinach, sweet potatoes, avocados, coconut water may help to more quickly restore your normal fluid balance

NSAIDS

• consult your doctor or potentially a supplement such as Curcumin

• Curcumin is a biologically active polyphenolic compound found in turmeric

In the postpartum period, we worry more about blood clots  (DVT or pulmonary embolism)

Symptoms of a blood clot:

Hot, red, painful swelling in your calf

PE symptoms include shortness of breath, chest pain, and cough.