What Every Mom Needs to Know about Swelling after Birth

fourth trimester kankles leg swelling after birth postpartum postpartum recovery postpartum swelling swelling after birth swollen ankles Sep 14, 2022

Ok, so it’s been at least two months since I last saw my ankles, and now it feels like a very mean trick that after birth my ankles are even more swollen than they were two weeks ago when I spent four hours walking around Disney at 38 weeks pregnant.

WHAAATTT?? WHHHYYYYYY is this happening, and will I ever see my ankles again???

Swelling during pregnancy is very normal especially towards the end of the third trimester. This is due to changes in the amount of fluid in your blood vessels during pregnancy. In fact, the amount of fluid running through your blood vessels increases by 50% in pregnancy! Our blood vessels often handle this extra fluid by allowing it to collect outside the blood vessels. The swelling usually occurs gradually over time and is most obvious in your feet and ankles for two main reasons. One, gravity pulls that extra fluid down into your lower legs, and two it is hard to get that blood back up to your heart with the enlarged uterus putting pressure on some of those main blood vessels moving blood from your lower half to your heart.

Ok that all makes sense in pregnancy, so why does the swelling get worse AFTER birth?

When you remove the placenta after birth, all of the extra blood and fluid that was moving through the placenta and to the baby has no where else to go, so some of it leaks out of your vessels into the tissue under your skin. The swelling is at its worst in the first 24-72 hours after birth. This is process is very normal. Be aware that some people will experience more significant swelling after birth than others. But, there is end in site! The swelling will go away, and you will see your ankles again. It will take about 2 weeks for the swelling to completely resolve.

How Can I help the process?

There are several actions you can take to help the swelling after birth:

  1. Drink plenty of water – if you are breastfeeding, this means at least 1200 ounces (somewhere between four to six 32oz bottles) a day. Remember, it needs to be water, not soda or juice. You can add fruit to the water for flavor. The water helps your kidneys process the fluid that is sitting under your skin.
  2. Move around – walking around helps your muscles squeeze the blood up to your heart to help get the extra fluid removed.
  3. Avoid sitting with your legs dangling for long periods of time. This position increases the effects of gravity. Gravity will pull extra fluid into your lower legs and feet.
  4. Light compression stockings that go above the knees can help move blood back towards the heart from your lower legs. Avoid compression stockings that stop below the knee as these can act like a tourniquet just below the knee. Avoid wearing the compression stockings all the time, try just during the day while you are awake.

When should I be worried?

  1. One leg is more swollen than the other.
  2. The swelling is associated with pain in your calf.
  3. There is a change in color of the skin over the swelling.
  4. You are experiencing shortness of breath or difficulty breathing.
  5. Your blood pressures are high (higher than 140 on the top number or 90 on the bottom number).
  6. It continues to worsen instead of improve after the first 72 postpartum hours.

If you are concerned about your swelling, always reach out to your physician or midwife for further evaluation and management.

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