Why are my legs and hands so swollen?

Ah, the joys of pregnancy! If constipation, hemorrhoids, and heartburn weren’t enough to make you feel glorious, just wait until your legs start swelling.

Most swelling or edema in pregnancy is normal. Swelling is common; about 60% of women will have significant lower extremity swelling and a large number of these women will also have swelling in their hands that make rings too tight and wrists hurt. Much of the conventional wisdom about swelling during pregnancy is related to a concern for the development of preeclampsia, but swelling is so common that in most cases this is not a concern at all. Your doctor checks your blood pressure at your regular visits to make sure that you’re not developing hypertension, which is the chief sign of preeclampsia.

Most leg swelling is related to the uterus blocking the return of blood from your legs. As the uterus gets bigger, it blocks the veins that drain blood from the legs back up to the heart, and gravity doesn’t help with this process. Since there are no pumps in the legs, the blood tends to pool and this leads to swelling. You may be able to make this temporarily better by elevating your legs, particularly while laying on your side. But for most women who are up and working throughout the day, there is little opportunity for this. Wearing a pair of support hose, compression stockings, or compression socks may help tremendously.

If your hands are swelling, you may have symptoms of carpal tunnel syndrome which is also very common during pregnancy. Wearing an over-the-counter wrist splint at night on one or both wrists will lead to significant improvement of these painful symptoms.

One common myth about swelling is that a woman should drink more water when she is swelling to make the swelling better. This is simply untrue. If you’re having significant swelling in your legs, you may also find that you are lightheaded or having woozy episodes because your water content has left your blood vessels and gone into your soft tissues; in this case, drinking more water may help you not feel as dizzy, but it will not affect how swollen you are.

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