Postpartum edema (swelling) is a common condition characterized by swelling around the face, belly, and ankles. But what are the causes of edema? Some women may also experience swollen hands, legs, and feet (1). It may persist until a week or beyond after delivery. One may also notice swelling around the incision if they underwent a cesarean section (C–section) or episiotomy (2). The swelling may be accompanied by pain or tenderness and may cause discomfort and inconvenience. Read this post to learn more about the causes, symptoms, management, and prevention of postpartum edema.
Causes Of Edema
You produce more blood during pregnancy to nourish and protect both you and your baby. Also, a low concentration of proteins and dilution of blood might lead to low hemoglobin concentration and accumulation of fluids. During the delivery, not all the extra blood may leave the body. A combination of this extra blood, hormonal changes, and fluid retention may cause swelling post-pregnancy. It may sometimes lead to a condition called pitting edema (3).
If the swelling does not subside on its own, you may follow some remedies that will help in easing the swelling after pregnancy.
How To Reduce Swelling After Pregnancy?
Here is a comprehensive list of remedies that might help in alleviating or eliminating postpartum edema.
1. Healthy diet
When you eat properly, you are likely to flush out the extra fluids from the body and provide higher energy levels for your baby. Eat foods rich in protein, fresh fruits, and veggies, and complex carbohydrates. Also, eat foods rich in potassium as they might help alleviate the swelling. Stay away from processed foods as they contain sodium that may cause bloating.
2. Consume more fluids
Drinking excess fluids will signal the body to flush out the fluids that it has been holding in. It may greatly help to relieve swelling. Ensure that you drink a lot of water and empty your bladder often.
3. Keep your hands and feet elevated
Rest your hands and feet in an uplifted position for about 30 minutes every day. They should be raised above the level of your heart so that the blood flows into these areas properly. It might, therefore, reduce swelling in the extremities.
4. Moderate exercise
Perform moderate exercises and activities as they may help improve circulation and remove excess fluids from the body through sweat. Taking care of your newborn is also an exercise as it makes your heart pump efficiently. But do get your doctor’s approval before you begin anything.
Foot and leg massage is another way to ease the swelling post-pregnancy if you do not experience pain. It is good for circulation and cuts off excess fluid build-up.
- Ask your partner to massage your legs and feet gently, starting from the bottom and working upwards.
- You might use base oils such as grape seed oil for massaging.
- But you should avoid aromatherapy essential oils.
- Watch this video to understand ways of massaging during and post pregnancy.
6. Proper posture and rest
Avoid crossing the legs and standing for a long duration. While lying down, place the feet at an elevation above the hips. Put your feet up high, above the level of your heart. It could improve circulation and ease the swelling.
7. Soak your feet
Soak your feet in a mixture of aromatherapy oil and water. To improve the blood flow and prevent varicose veins, you may use cypress oil. Lavender or chamomile oil may also mitigate discomfort.
8. Herbal tea
Have herbal teas in moderation during and after pregnancy. Dandelion tea is a good choice as it might help in preventing fluid retention. Avoid them if you have gall bladder problems.
9. Cabbage leaves
Placing green or white cabbage leaves over the swollen area might relieve the swelling and discomfort. Some anecdotal studies show that this is effective in reducing the pain of breast engorgement (4) and hence the belief that this remedy might work on swollen legs and ankles too.
10. Acupuncture and foot reflexology
Contemporary therapies like acupuncture and foot reflexology may help in easing swelling and discomfort. Acupuncture, a key component of traditional Chinese medicine, may help by re-balancing the internal energies as well as improving kidney function and circulation.
11. Stay cool
Stay at cool places as possible because the heat could worsen the swelling. As you are a new mom, stay indoors, and ensure you have good airflow in the room.
12. Some other tips
- Do not wear tight-fitting clothes or any accessories as they might prevent the blood flow, causing swelling.
- You may take a relaxing bath if your doctor has given you approval. It could also help relieve swelling.
- Lie down towards your side as it improves blood circulation and may reduce swelling.
- You may wear supportive socks.
What Causes Swelling After Pregnancy?
Most women experience swelling during pregnancy, which may increase postpartum and cause pain or general discomfort that might interfere with the responsibilities of motherhood. Even if you do not experience any swelling during pregnancy, you are likely to have swollen hands and feet after labor.
Some common causes of pregnancy include:
The body produces a large amount of progesterone during pregnancy. The excess progesterone may cause water and sodium retention in the body, which could cause swelling after the birth of the baby (5).
2. Expanding uterus
When the uterus expands with the growing baby, the pressure is exerted over the veins towards the legs. It might, therefore, restrict the flow of blood to the lower body. Since there is a build-up of fluid throughout pregnancy (6), it could take a certain time for the fluids to subside post-pregnancy.
3. The delivery process
The natural pressure created during pregnancy causes swollenness. Along with it, pushing the body to give birth brings in more blood and fluids to the extremities. It might, therefore, lead to swelling in the fingers, hands, legs, feet, and the face.
4. IV fluids
Women who undergo a C-section usually receive medications and anesthesia through IV, and those who give birth vaginally receive medications, such as oxytocin, and certain fluids. These extra fluids may accumulate in the body and take several days to get flushed out.
Symptoms Of Postpartum Edema
Swelling in the hands and legs could be mild, moderate, or extreme.
- The skin on hands, legs, and other parts appear inflamed, stretched, shiny, and puffy.
- Skin sinks if you press it.
- Swelling may also affect the abdomen apart from hands and legs.
Does Swelling Subside On Its Own?
The first thing to remember is that you need to relax, as swelling during pregnancy is mostly normal.
- Swelling in familiar areas such as hands, legs, feet, face, and lower back should reduce in a week’s time.
- During this time, your kidneys would be subjected to overwork to eliminate the excess fluids from your body, and you are likely to urinate more.
- The extra fluids could also be expiated as sweat through your pores.
Dealing With Incision Swelling After Giving Birth
Sometimes, there might be a painful swelling at the incision areas. Swelling in legs and feet is common in the initial days after C-section, making it difficult for you to care for your little one. There may also be additional bruising and swelling at the perineum if you experience a vaginal tearing or episiotomy.
Ice compresses could be of help for edema in legs and relieve swelling at the C-section and perineum incisions. You should wipe both the areas as directed by your healthcare provider. You may also take a warm shower to get some relief. Do not apply any lotion or creams containing vitamin E until the area heals completely.
When to Worry About Swelling After Pregnancy?
Edema after pregnancy is not a sign of serious illness and usually subsides on its own. However, in some cases, the swelling does not curb in a week’s time.
In some cases, the edema may be associated with other symptoms such as pain, breathing trouble, palpitations, generalized swelling in the body, low urine output, etc. Consult your physician as a swollen body could sometimes indicate serious complications.
A few of the risk factors of edema that you should be aware of include:
1. Deep vein thrombosis (DVT)
DVT might cause death within hours. It’s an emergency requiring administering anticoagulants (anti-clotting) medications and immediate hospitalization. If you notice the following symptoms, consult your doctor (7).
- Swollen ankles or legs
- Pain or tenderness in one or both the legs
- Red skin in the affected leg
- Visible veins
- Leg fatigue
2. Postpartum cardiomyopathy (PPCM)
A rare, life-threatening heart disease, PPCM comes suddenly and could be fatal. It may even happen in women who were previously healthy. One of the major symptoms of PPCM is postpartum edema. Other symptoms include (8):
- Chest pain
- Shortness of breath
- Increased urination at night
3. Postpartum preeclampsia
Preeclampsia (elevated blood pressure associated with a leak of proteins in the urine) is not rare during pregnancy. It may be complicated by eclampsia, which is the occurrence of generalized seizures. But it could happen after childbirth too. Postpartum eclampsia might strike as soon as you give birth or four to six days post-delivery. Symptoms of postpartum eclampsia include (9):
- Swelling in the extremities
- High blood pressure
- Excess protein in the urine
- Severe headaches
- Changes in vision
- Upper abdominal pain
- Decreased urination
- Seizures onset
Do not take any vitamin supplements until your doctors prescribe because they may increase your chances of getting preeclampsia after delivery. If you have the above symptoms, do check your blood pressure too.
How To Prevent Postpartum Edema?
Though it is not possible to prevent postpartum edema, you may reduce its severity. It means your feet and legs may become less tender and painful. One possible way to reduce swelling is to have a healthy balanced diet during pregnancy so that you do not gain excess weight.
- Include lean protein in every meal. Some of the good sources include meat, poultry, legumes, beans, and eggs.
- Consume about five portions of healthy food that includes fruits and veggies.
- Reduce the intake of sugar, salt, and fat foods and take in more water. It might help the kidneys to flush out excess liquids from the body.
- You might include natural diuretics as they help you to flush out excess fluids, thereby helping you to reduce the swelling. Natural diuretics include apples, citrus fruits, watercress, celery, and parsley.
- Include onion and garlic in your diet as they may help improve circulation.
- Avoid processed and pre-packaged foods as they might increase fluid content in the system because of their excess salt and additives.
- Eat foods that contain vitamin C and E. For vitamin C, take cabbage, broccoli, tomatoes, strawberries, melons, potatoes, bell peppers (red and green), and citrus fruits. For vitamin E, take almonds, cashews, corn oil margarine, wheat germ, sweet corn, vegetable oils (corn, wheat germ, and soy), and sunflower seeds.
- Quit smoking as it is not safe for your little one’s health and could prevent your postpartum swelling from healing (10).
Postpartum edema should not be a cause of great worry or confusion. Getting back to your former figure after childbirth could be a mammoth task, but as Sylvia Brown, co-author of The Post-Pregnancy Handbook, says, “A well-informed woman can use this time to heal her body properly and give it the rest and care that it needs.”
Frequently Asked Questions
1. Will my feet get back their pre-pregnancy size?
You may sometimes feel that your feet are large even after the swelling subsides. It may be because of the loosening of the ligaments, which may make your feet spread. This resolves on its own. Do not worry unnecessarily because this is a typical condition that may remain for a month after pregnancy.
2. Why is only one foot swollen postpartum?
If you notice swelling on only one of the feet or ankles, it is advised that you consult with the doctor immediately as this might be a sign of a blood clot (11).
Postpartum edema or swelling is a common condition and seldom a concerning issue. While some women accept it and let it subside on its own, others may want to learn how to cure postpartum edema. Either way, it is okay, and the key is to stay calm and healthy. You may try some preventive measures such as eating healthy to include the necessary nutrients and avoiding unsafe food options after consulting your ob/gyn. However, do not ignore it if the condition persists for longer, as it may indicate an underlying issue requiring medical intervention.
2. Postpartum Pain Management; Newton-Wellesley Hospital
3. Concerns about swollen legs; Harvard Health Publishing (2018)
4. Boi B et al.; The effectiveness of cabbage leaf application (treatment) on pain and hardness in breast engorgement and its effect on the duration of breastfeeding; JBI Libr Syst Rev (2012)
5. Recovering from Delivery (Postpartum Recovery); American Academy of Family Physicians; familydoctor.org (2017)
6. Swollen ankles, feet and fingers in pregnancy; NHS (2018)
7. 3.4 Deep vein thrombosis (DVT); The Open University
8. Denise Hilfiker-Kleiner, et al.; Postpartum Cardiomyopathy; Dtsch Arztebl Int. (2008)
9. High Blood Pressure in Pregnancy; U.S. Department of Health and Human Services National Institutes of Health (2018)
10. Nutrition For New Mothers; Beaumont Health
11. Problems in the week after the birth; New Zealand Ministry of Health