OEDEMA
Pregnancy often involves a vast array of aches, pains, and discomforts, but oedema, or swelling, seems like one of the most annoying. Your actual body needs to get bigger at a distracting rate to grow a baby, but this excessive and unhelpful retention of fluids just seems like one enlargement too many. Plus, oedema is uncomfortable! Those swollen ankles can really ache.
What is Oedema
Oedema (or edema) is swelling that can occur in your extremities during pregnancy, most often in the ankles. Some people just get mildly swollen ankles, and some people get extremely puffy ankles and feet, sometimes even calves and knees, so that shoes, or even socks or pants, don’t fit. Oedema can also occur in the fingers, hands, wrists, and face. Often it gets worse towards the end of pregnancy, and some people experience it in all these places at once.
Oedema is often uncomfortable. It can be itchy. It can cause an aching feeling in the swollen parts. It can make it harder to walk or stand, as the swelling makes your body parts feel weak. It can even be hard to sit or lie down comfortably. It can be an especially irksome addition to all the changes and growth your body is already experiencing.
What Causes Oedema
Oedema is fundamentally a circulation issue. When you’re pregnant, you have 50% more blood in your body, which is there to serve the baby’s needs as well as your own. Your blood circulates your own oxygen and hormones throughout your body, but now also carries the baby’s life support to the placenta. All the baby’s resources have to come through your body first, before travelling to the baby. Your blood works as a conveyance system for these resources.
Because we have so much additional blood, our heart has to work harder to keep it all moving. Sometimes, the fluids get pumped all the way to our extremities, but our system struggles to summon them back to headquarters: poor venous return. It is these excess fluids stuck in our wrists or ankles that causes the puffy, swollen, annoying oedema.
Remedies for Oedema
Some people are more predisposed to oedema than others. But regardless of our susceptibility, there are things everyone can do to lessen the severity and discomfort. Here are seven things you can do to help if you are experiencing pregnancy-related oedema.
1, Drink more fluids
Drinking more fluids helps hydrate the body’s circulation system. Our blood and body fluids get thick, or sludgy, when our water intake is too low, which makes venous return slow and lethargic. Thicker fluids flow more slowly and require more effort from our heart. When we increase our hydration, it allows our bodily fluids to flow more quickly, and travel more easily back from our extremities. Drinking more liquid can reduce oedema because we’re less likely to retain water in our wrists, face, and ankles when our fluids are circulating with speed and efficiency.
2. Exercise
Exercise can reduce oedema because movement gets the blood flowing. Inviting our heart to work a little harder coaxes all those sludgy fluids through our extremities, gets things moving, and redistributes our body’s liquids so we don’t get pooling in the wrists or ankles. You can focus on the problem areas, such as ankle rotations or alternating flexing and pointing your toes, or you can engage in overall movement such as walking, swimming, or dancing. Any physical activity serves our entire circulation system. Sometimes exercise makes the most affected areas ache while you’re doing it, so go lightly, and start slow, but the net effect will be one of relief and benefit. So go ahead and get moving.
3. Compression stockings
You can find compression stockings at most drug stories. They provide a snug fit from foot to knee, and they physically support your swollen ankles from the outside. For some people this feels like relief–as the stocking is gently holding your leg, preventing the swelling from settling around the ankles, and encouraging the blood flow to remain even. But for some people compression stockings feel tight and constrictive. You can try a different size, but only use these if they’re comfortable. If they make the situation feel worse, try a different approach instead.
4. Calcium/Magnesium/Potsassium
A remedy that some people find helpful is taking extra calcium and magnesium. You can take a nightly supplement such as CALM (which can also alleviate pregnancy insomnia), or add magnesium to your bath, as it is absorbed equally well by the skin. You can also eat foods high in potassium, such as bananas, figs and cabbage, as these are known to help with fluid circulation.
5. Soaking, Pool-walking
Another remedy for pregnancy oedema is soaking or pool walking. Walking upright in a swimming pool can promote circulation by changing the gravity factor during exercise, and also because the water provides extra hydration. We can also spend time soaking in a pool or even a bathtub, which accomplishes everything except the movement component.
6. Massage
A favourite way to alleviate oedema is massage. Massage is great during pregnancy for many reasons, but one of its benefits is assisting and improving circulation, and thus lessening swelling. You can get a professional massage from an RMT with prenatal training (recommended) and you can also rub your own feet and legs using your hands or a skin brush. All these things can help improve your circulation, although a professional massage can also help with relaxation, body aches, and integration of the rapid changes in your body.
7. Heat/Cold
Another remedy for swelling that most athletes know well, is alternating heat & cold on the affected areas. You can use a hot pack followed by a cold pack, hot water bottle and frozen peas, or hot water/cold water. It’s the classic sauna to snow combination, which has long been used as a method of jump-starting the circulation system. It works wonders on swollen ankles.
Some people prefer the full body immersion method, which you can do at home simply by following your warm shower with gradually cooling water. You don’t have to shock yourself with sudden ice water (unless you enjoy it), as it works just as well to turn down the temperature incrementally as you get used to it, so that you never feel uncomfortable under the cooling stream. This can help your whole body with circulation, head to toe.
Advice to avoid
If you are searching for tips for oedema relief, you might come across some outdated advice alongside the more helpful suggestions. One that I still see frequently is the advice to limit your fluid intake. This used to be a common practice based on the understanding that oedema is caused by fluid retention. However, restricting your fluids makes it worse, not better. We need more liquid–not less–to get our fluids flowing efficiently. Picture a stream with lots of water versus a stream with too little, and imagine the fast flowing abundance versus the thick, muddy trickle. To relieve oedema, drink more fluid, not less.
Another outdated piece of advice is to limit salt. But we actually need increased salt during pregnancy to balance our electrolytes and help us with all that additional fluid. You may have noticed you crave salt more than usual. This is normal, and appropriate. Salt is important for keeping fluids circulating in our blood instead of getting stagnant in our tissue. But, and this is where it gets confusing, the type of salt that is beneficial is real sea salt with minerals, and not the cheap sodium found in most processed foods, which can actually make oedema worse. So when you see a warning about lowering your sodium intake, it is both true and false at the same time. Go ahead and eat salt to taste. Don’t hold back. Eat as much salt as you wish, which is usually more than pre-pregnancy, but try to prioritize real sea salt, which is the kind that helps rather than hinders your circulation.
Cautions
Sudden swelling, particularly towards the end of pregnancy, and often accompanied by headaches, can sometimes be a sign of pre-eclampsia, or dangerously rising blood-pressure. If you have any concerns, always consult your midwife or doctor so they can rule out anything more dangerous, or provide treatment as required. Odds are that it’s just normal pregnancy swelling, but better safe than sorry.
Conclusion
Swollen feet and ankles–oedema–is a very common pregnancy discomfort. There are a few things you can do to provide relief, but it doesn’t usually resolve completely until after the baby is born. In the meantime, indulge in as much soaking, massage, and self-care as you can. These treatments not only help with the swelling, but can support your body and mental health in other ways. Pregnancy is a lot of work! Put your feet up whenever you can.
Stephanie Ondrack has been with The Childbearing Society since 2003. She lives in East Van with one partner, four kids, four chickens, and five cats. You can read more of her rants on birth, parenting, and learning at www.thesmallsteph.com