Swollen Feet in Pregnancy: Causes, Relief & When to Worry

• Swelling of both feet and ankles that builds through the day and eases after rest is usually normal pregnancy edema, most common after 28 weeks.
• Elevation, walking, graduated compression stockings, cooler feet and steady hydration relieve it far better than any single trick.
• Do not drink less water because your feet are swollen — dehydration usually makes fluid retention worse, not better.
• Sudden facial or hand puffiness with headache, vision changes or upper-tummy pain — or a BP of 140/90 mmHg or more — can signal preeclampsia and needs same-day care.
• One leg that is clearly more swollen, warm, red or painful is a DVT until proven otherwise — this is an emergency, not a home remedy.

Swollen feet in pregnancy are usually normal edema — excess fluid collecting in the tissues, not an infection or injury. At least half of pregnant women notice it by late pregnancy, and the pattern is familiar: feet look nearly normal in the morning, then grow heavier, tighter and puffier as the day goes on. Ankles lose their outline, slipper straps leave marks, and toes feel crowded in shoes that fit a few weeks earlier.

This happens because pregnancy changes fluid balance throughout the body. Blood volume rises substantially to support the placenta and baby, hormones nudge the kidneys to hold on to sodium and water, and some of that fluid shifts out of the blood vessels into surrounding tissues. The feet and ankles show it first because gravity keeps pulling fluid downward whenever you sit or stand.

The growing uterus adds a second force. As pregnancy advances it presses on the large pelvic veins and the inferior vena cava — the main vein carrying blood back from the lower body to the heart. When that return flow slows, pressure builds in the leg veins and fluid leaks out into nearby tissue, producing soft, puffy swelling. This is why edema typically becomes obvious after 28 weeks and is most common in the last few weeks before delivery. It is also why swelling worsens after long commutes, standing at work or cooking for hours — and why lying down or putting your feet up usually improves it.

Normal edema has a recognisable pattern. It is usually bilateral — both feet and ankles — though one side can look slightly worse depending on posture or varicose veins. It develops gradually rather than over a few hours. It feels tight and heavy but is not sharply painful. The skin may look stretched, and pressing a finger into the shin or ankle may briefly leave a dent, called pitting edema.

None of this automatically means disease. In a healthy pregnancy, ordinary edema is common — especially in warm weather, after salty meals, after a physically demanding day, in twin pregnancies, or in women working long shifts on their feet. Some women also notice rings getting tighter or mild finger puffiness, though the feet remain the classic site. The extra fluid is part of the same normal process behind steady third-trimester weight gain.

What normal edema should not do is come with a cluster of warning signs. It should not bring a severe headache, vision changes, chest pain, breathlessness at rest, severe pain under the right ribs, or very high blood pressure. It should not make one leg suddenly hotter, redder and far more painful than the other. And it should not make you feel generally unwell.

Understanding this boundary prevents both unnecessary panic and dangerous dismissal. Ordinary pregnancy swelling is a comfort problem, not a failure of care or a sign you have done something wrong. It is a physiological effect of fluid retention plus the mechanical pressure of the uterus on the veins — one of many reasons the third trimester feels physically heavy even when everything is medically fine. Women often say their feet look acceptable at breakfast and much larger by bedtime; if it settles with elevation and rest and there are no systemic red flags, it still fits the normal pattern.

Heat makes pregnancy swelling worse, which is why many women in India find swollen feet far more bothersome in summer, during humid monsoon weeks, or in hot cities with long commutes and prolonged standing. When the body gets warm, blood vessels near the skin widen to release heat. That helps cooling, but it also lets more fluid leave the circulation and pool in tissue. In pregnancy, where fluid retention is already higher, this extra widening makes feet and ankles visibly puffier by evening. The effect is strongest in gravity-dependent areas — the ankles and feet show it first, but hands and even the face can look puffier on very hot days.

The built environment matters too. An hour each way in a crowded bus, metro, auto or car with no chance to raise your feet causes more swelling than moving between cooler spaces with regular breaks. Desk jobs contribute through long stretches of sitting still, while teaching, nursing, retail, kitchen and household work worsen edema through prolonged standing. In many families, late pregnancy does not reliably reduce the physical workload expected of women: standing to cook, wash, host visitors or manage other children keeps the calf muscles static for hours. Since those calf muscles act like a pump that pushes blood back up the legs, not using them means more pooling and more end-of-day swelling. The combination of climate, posture and workload often matters as much as the pregnancy itself.

Humidity adds to the discomfort even when it causes no harm. When sweat does not evaporate, the body stays warmer and women feel heavier. Tight footwear becomes more uncomfortable, and if a woman moves less because she is exhausted or overheated, swelling can increase further. Saltier convenience foods often creep in too — packaged namkeen during travel, restaurant meals on workdays, achar and papad at home because cooking feels exhausting in the heat — quietly raising sodium intake. Then a woman is often told by family to drink less water because her feet are swollen, which is exactly the wrong direction: hot climates increase fluid loss through sweat, and inadequate hydration worsens the body's tendency to hold on to sodium and water.

The practical takeaway is not that Indian summers create dangerous swelling on their own, but that they amplify ordinary edema and make daily management more important. Air circulation, cool foot soaks, movement breaks, hydration and compression all matter more in May than in December. Long wedding events, temple visits, market trips and summer train journeys can combine heat, salt, immobility and shoe pressure in a single day, so a woman may suddenly feel her swelling has become unmanageable even though her blood pressure is normal and the pregnancy is healthy. The question is never simply whether swelling exists, but whether its pattern still fits normal edema rather than preeclampsia or DVT. Climate-sensitive care here is not cosmetic advice — it is practical maternal comfort.

The most important question with swollen feet is not how dramatic the ankles look, but whether the swelling follows a benign pattern or comes with features of preeclampsia — a serious complication marked by new high blood pressure after 20 weeks plus evidence of organ involvement. Swelling alone does not diagnose preeclampsia, and many women with ordinary edema never develop it. But swelling should not be dismissed when its pattern changes. The red-flag cluster matters far more than the size of the feet. If swelling is suddenly worse — especially puffiness around the eyes, or hands becoming rapidly tight — together with headache, vision changes, upper-abdominal pain or rising blood pressure, treat it as an emergency, not a comfort problem. A clear, in-depth guide to the condition is here: preeclampsia in pregnancy.

The practical warning signs are specific: new and obvious facial puffiness; a severe or persistent headache that does not settle; blurred vision, flashing lights or spots; pain under the right ribs or in the upper-middle abdomen; nausea or vomiting that returns later in pregnancy; and a blood pressure reading of 140/90 mmHg or higher. If these appear together, assume possible preeclampsia until a doctor rules it out. Women often fixate on the feet because they are visible and ignore systemic symptoms because they seem unrelated — that is the mistake to avoid. Preeclampsia is not primarily a foot problem. It is a blood pressure and placental disorder that can affect the brain, liver, kidneys, lungs and baby; the swelling only matters as one possible visible clue.

There are false reassurances to avoid in both directions. A woman can have preeclampsia with little swelling, and she can have dramatic swelling with a perfectly normal blood pressure. That is why the number matters so much. If you have a home monitor and readings are elevated — especially repeated readings at or above 140/90 mmHg — do not wait for the swelling to become extreme. If you are unsure how to measure it reliably, see checking your blood pressure at home. Equally, a puffy face with a severe headache is not made safe by normal-looking ankles. Upper-abdominal or epigastric pain deserves special respect because families often mislabel it as acidity or gas; in pregnancy, epigastric pain with headache, visual symptoms or swelling can be a sign of severe preeclampsia.

The right response is urgent medical assessment, not home experimentation — contact your obstetrician, go to the labour ward, or use emergency transport if symptoms are severe. In India, 108 is the main emergency ambulance number in most states, while 102 services under the National Health Mission and Janani Express-type referral systems help pregnant women reach facilities in many states. If there is new facial puffiness with headache or vision changes, or a BP above 140/90 mmHg, assume emergency rather than next-routine-visit. Doctors will check blood pressure, urine protein, blood tests and the baby's wellbeing.

Time-course is another useful clue. Normal edema worsens over days to weeks and clearly tracks posture and heat. Preeclampsia-related swelling often feels abrupt or out of proportion to the day — a woman may wake with a markedly puffy face, find rings that suddenly no longer fit, or feel her body has changed over a day or two rather than over the previous month. That pattern does not diagnose preeclampsia by itself, but it should shorten the time to evaluation. Teach family members this too, because they are often the ones deciding whether symptoms are worth acting on.

Most swollen feet need no medication — they need circulation support, positioning and consistency. The simplest tool is elevation. Resting with your feet above the level of your heart for 20 to 30 minutes, several times a day, helps pooled fluid move back into circulation. It works best lying down, not just with your feet on a low stool; two or three pillows under the calves is enough. A short late-morning session, one in the afternoon and one in the evening beats a single long session after the swelling is already severe. Lying on your left side helps especially, because it eases uterine pressure on the major veins and improves venous return from the legs.

Movement is the second pillar. Gentle walking activates the calf muscles, the main pump pushing blood and fluid back upward. Several short walks through the day help more than one ambitious walk followed by hours of sitting still. If you sit for work, set a timer to stand and move every hour. If you stand for work, find moments to sit and circle the ankles, flex and point the feet, or do heel raises holding a support. Pregnancy-safe activity also helps bowel function, sleep and mood — see this trimester-by-trimester exercise guide. The goal is not performance; it is fluid circulation.

Graduated compression stockings are one of the most effective non-drug tools, especially when swelling becomes routine by midday. They apply the most pressure at the ankle and less higher up, helping prevent fluid from pooling. Many women in India buy random "tight socks", find no benefit, and conclude compression does not work — proper graduated stockings are different. A mild-to-moderate strength, often around 20–30 mmHg if recommended by a clinician, is commonly used. They are easiest to put on first thing in the morning, before swelling builds. Availability varies, but practical options in India often fall in the broad range of about Rs 500 to Rs 2,500 depending on material and brand, sold online and in orthopedic stores. They should feel supportive, never painfully constricting.

Cooling measures help comfort, especially in Indian heat. A cool foot bath for 10 to 15 minutes in the evening reduces heaviness, and some women like to do gentle ankle pumps while soaking. Aim for cool, not icy — very cold exposure is uncomfortable and unnecessary. Sleeping with a small pillow under the calves, or raising the foot of the mattress slightly, can also help. Avoid prolonged cross-legged sitting and tight ankle elastics, and do not ignore footwear that has become too narrow.

The best mindset is to treat swelling proactively rather than reactively. If you know your feet tighten every afternoon, start earlier in the day: put compression on in the morning, take a short mid-morning walk, hydrate before you feel thirsty, and plan one period of elevation before the feet are throbbing. The measures are simple, but consistency matters more than intensity.

Pregnancy swelling is not caused only by salt, but excess sodium can make ordinary edema noticeably worse — and many common Indian foods are far saltier than people realise. The obvious culprits are papad, namkeen, chips, achar, instant noodles, packaged soups, bakery snacks, processed chutneys, restaurant gravies and ready-made spice mixes. Less obvious sources include biscuits, bread, sauces and "healthy" roasted mixtures that are still heavily salted. When a woman is tired, queasy from the heat or too busy to eat a full meal, these foods can quietly become a big part of the day, leading to more thirst, more sodium retention and more swelling by evening. Moderation does not mean bland food or removing all salt from cooking — it means spotting the high-salt extras and cutting those first, because they are the easiest wins.

Look at patterns rather than single foods. If breakfast is packaged toast with spread, lunch comes with achar or papad, tea-time includes namkeen, and dinner is takeaway, the sodium load adds up even though each item seems small. Home-cooked dal, sabzi, roti, rice, curd, fruit and lightly salted snacks are far easier to balance. Family advice can backfire here, because some households push salty, crunchy foods when a woman has low appetite. If your feet swell daily, it is reasonable to cut papad, packaged mixtures, pickles, instant foods and heavily salted restaurant meals for a week and watch the difference — most women notice at least some improvement.

Potassium-rich foods help, because they support normal fluid balance: banana, coconut water, papaya, mosambi, orange, curd, spinach, beans and several dals fit naturally into Indian meals. Coconut water, often around Rs 40 to Rs 80 depending on city and season, is hydrating and usually better than reaching for salty snacks or sugary soft drinks. None of these foods "cure" edema, but together they support how the kidneys handle sodium and may ease that puffy, heavy end-of-day feeling — our guide to nourishing Indian pregnancy foods has more ideas. Women with gestational diabetes, kidney disease or specific dietary instructions should individualise choices with their doctor.

The important caution is against extreme restriction. Cutting salt too hard is unnecessary and can make food intolerable when appetite is already fragile. Swelling management is not a punishment diet — the goal is moderation, not austerity. Reduce clearly processed, clearly salty foods first, keep meals regular, and include fruit, curd and fresh food more often than packaged snacks. It often helps to think in substitutions: swap evening namkeen for fruit and curd, instant soup for homemade dal or light rasam, and treat achar as a small condiment rather than the main flavour. When eating out, simpler meals with fewer sauces and fried sides reduce the sodium load without impossible discipline.

One last myth: women often ask whether rock salt, pink salt or sea salt are somehow exempt. They are not. Different salts taste different and carry trace minerals, but for swelling the issue is still sodium. Changing the type of salt while keeping the total amount high does not meaningfully improve edema.

One of the most persistent pregnancy myths is that swollen feet mean you should drink less water. The opposite is usually closer to the truth. When the body senses too little fluid coming in, it conserves sodium and water more aggressively — and in pregnancy, where fluid regulation is already altered, that can mean more retention, not less. Adequate hydration supports the kidneys in clearing excess sodium and helps the circulation work efficiently. Many obstetricians advise most pregnant women to aim for roughly 3 litres or more of total fluids across the day unless told otherwise for a medical reason. The exact amount varies with body size, climate and activity, but the principle holds: dehydration usually makes swollen feet feel worse. There is more on getting this right in our pregnancy hydration guide.

This matters especially in India, where heat, humidity and commuting increase fluid loss while frequent urination makes some women deliberately drink less — worried about toilet access at work, on the road or at night. The result is a cycle of relative dehydration, salt retention, fatigue and worsening edema: the urine turns darker, the mouth drier and the feet no better. Sipping steadily through the day works better than gulping large amounts in the evening. Plain water is the foundation, but fluids also include buttermilk, lemon water with a little salt, unsweetened soups, milk and coconut water. Very sugary drinks are less useful. If you have vomiting, diarrhoea, fever or are outdoors in heat, your fluid needs rise further.

The paradox makes sense physiologically. Swelling in pregnancy is not simply "water sitting in the feet" because too much has been drunk. It is fluid distribution plus venous pressure plus hormonal retention. Drinking enough does not force fluid into the ankles the way many families imagine — instead, it often helps the kidneys release retained sodium and maintain blood volume without triggering conservation signals. It also reduces constipation, dehydration headaches and heat exhaustion, all of which make late pregnancy feel worse. Some women find that after two or three days of deliberate hydration, their rings feel looser in the morning and their feet less painfully tight at night.

Hydration still has limits. If you have preeclampsia, kidney disease, heart disease or significant breathlessness, do not self-prescribe very high fluid intake without medical advice. And sudden severe swelling with headache or breathlessness is never something to "treat with water" at home. But for routine third-trimester edema in an otherwise healthy pregnancy, drinking enough is part of management, not the cause of the problem. The practical rule is simple: do not intentionally restrict fluids because your feet are swollen unless your doctor has given a specific medical reason.

A useful self-check is whether your intake is even. If you skip water most of the day and try to catch up at night, you stay thirsty and uncomfortable without the steady kidney benefit. Keep a bottle nearby, lean on buttermilk or lemon water in hot afternoons, and drink before and after walks. Lighter-coloured urine, less evening thirst and fewer heat headaches often signal that hydration is improving even before the ankle swelling changes. For women who dislike plain water, rotating between simple fluids makes the habit far easier to keep.

Footwear becomes a real quality-of-life issue once swelling is established. Shoes that are technically the right size but have a narrow toe box, stiff upper or tight ankle strap can turn mild edema into a full day of discomfort. The most useful change is simple: choose footwear with room. A wider toe box reduces pressure on swollen forefeet, and soft uppers accommodate day-to-day changes in size. Many women need to go up half a size or a full size temporarily in late pregnancy, especially in hot weather. This is not indulgence — it is a practical adaptation to fluid retention. Tight shoes worsen pain, create friction and make walking less likely, which then worsens swelling further.

Lower heels beat elevated heels: they improve balance and reduce strain on an already altered posture, which is also why this stage often brings low back pain. Flat shoes are not automatically ideal if they are unsupportive, but very high heels are a poor match for swollen pregnant feet. Soft sandals, supportive floaters or roomy walking shoes usually help more than fashion footwear. Gel insoles can improve pressure distribution and make standing more tolerable, particularly for women working long shifts; they do not remove edema but reduce the burning or heaviness under the feet. If you already have flat feet, plantar pain or heel pain, a supportive insole matters even more, because pregnancy weight gain already increases load on the feet.

Compression socks belong in the footwear conversation, because they are often more effective than changing shoes alone. For many women, knee-high graduated compression in the 20–30 mmHg range is the sweet spot between support and tolerability, though some may start lower on a clinician's advice. Wear them through the day and remove them at night; morning is the easiest time to put them on, before fluid accumulates. Avoid buying them blindly if you have known peripheral vascular disease, severe skin problems or marked discomfort, but for straightforward pregnancy edema they are usually safe and helpful. The idea that compression harms the baby is medically unfounded — the pressure is on the legs, not the uterus.

Some signs tell you the footwear itself is the problem: deep, persistent marks from straps, numb toes, rubbing at the heel, worsening swelling only where a shoe band sits, and reluctance to walk because shoes have become intolerable. These are not things to "push through" — they mean the footwear needs to change. One of the easiest third-trimester upgrades is a pair of comfortable, wider shoes or sandals, plus compression support where useful. Women often delay because buying footwear for a temporary stage feels wasteful, but the comfort gain usually justifies it: better shoes make walking easier, reduce skin irritation and prevent that trapped, throbbing evening feeling.

There is a safety angle too. Swollen feet plus altered balance in late pregnancy raise the risk of slipping, especially on wet floors, stairs or uneven outdoor surfaces. Supportive soles, a secure fit without tightness, and avoiding unstable heels make daily walking safer as well as more comfortable. Even keeping one well-fitting indoor pair and one outdoor pair reduces friction and helps you keep moving through the day — which, in turn, keeps the swelling down.

Many pregnant women in India already have access to some form of leg or foot massage through family routines, a partner's help, or the broader idea of malish. Done gently, this is a useful comfort measure for ordinary swelling — and gently is the key word. Light strokes from the feet upward toward the calves can ease the heavy, tight feeling of edema and may support lymphatic drainage. It should feel soothing, not bruising. Hard pressing on swollen tissue, aggressive kneading of the calf, or painful deep massage is not a good idea in pregnancy, especially if there is any concern about a clot. For routine bilateral edema without red flags, a short evening massage after a cool foot soak can ease discomfort and help you settle to sleep — our pregnancy massage safety guide explains what is and isn't safe.

Some women use acupressure or reflexology. Evidence for dramatic fluid reduction is limited, but gentle techniques around the feet and ankles may improve comfort and relaxation. What is reasonable is low-force touch, ankle circles, toe mobility and calf relaxation. What is not reasonable is using pain as proof the massage is "working". Partner massage is especially helpful because it turns swelling care into shared care: a partner can do light upward strokes, apply moisturiser, or simply support ankle rotations and calf stretches — practical help that matters when bending toward your own feet becomes physically difficult.

Ankle rotations and foot pumps are simple and worth doing several times a day. Rotate each ankle slowly 10 times clockwise and 10 times anticlockwise. Flex the foot upward, then point it downward, 10 to 15 times. Spread the toes and relax them. These movements activate the muscles around the ankle and calf, helping circulation without a full walk, and are ideal during desk work, travel or TV time. They also ease the night-time leg cramps that often accompany late pregnancy. Relief from edema is usually less about one powerful trick than about repeating low-effort measures often enough.

Two cautions matter. First, avoid massage if there is one-sided swelling, warmth, redness, marked tenderness or unexplained calf pain — that pattern needs assessment for DVT, not home manipulation. Second, avoid herbal oils or strong topical products that irritate skin already stretched or itchy from swelling; a plain oil or fragrance-free moisturiser is safer. Used sensibly, the Indian instinct toward supportive touch is genuinely helpful here.

Massage also offers something beyond circulation: it lowers stress. Late-pregnancy discomfort feels worse when a woman is tired, overheated and carrying the mental load of work and household planning. A calm 10-minute foot-care routine may not change the measured circumference of the ankles, but it can reduce pain perception and improve sleep. Shorter and more frequent beats one long session — five to ten minutes of gentle upward strokes followed by ankle rotations and calf relaxation is enough for most women. The routine should finish with the legs feeling lighter, not sorer.

Not all leg swelling in pregnancy is benign edema. The most important dangerous alternative is deep vein thrombosis (DVT) — a blood clot in a deep leg vein. Pregnancy increases clotting tendency as part of normal physiology, and the risk continues into the weeks after birth. Because ordinary edema is so common, women and families sometimes miss the pattern that should alarm them: swelling that is clearly worse in one leg, especially with warmth, tenderness, redness or calf pain. The classic DVT leg feels different, not just larger — more tense, more painful to touch, more uncomfortable when walking. Sometimes the calf feels heavy or achy before any visible swelling. A full explanation is here: DVT and blood clots.

The one-sided pattern is the key. Ordinary pregnancy edema is usually fairly symmetrical; mild day-to-day asymmetry can happen, but marked asymmetry with pain should never be dismissed as "just swelling". If the skin is warm, the calf tender, or one leg looks redder than the other, stop thinking in terms of home remedies. A DVT can break off and travel to the lungs as a pulmonary embolism, which can be life-threatening — so this is an emergency. Do not massage the leg, do not wait for the next clinic appointment, and do not try internet tricks. Go for urgent assessment. In India, use 108 emergency services where available, and in many states 102 referral transport or Janani Express-type systems help pregnant women reach care when private transport is difficult.

Risk rises further with prolonged immobilisation, obesity, smoking, prior clots, known thrombophilia, severe varicose veins, recent hospitalisation, dehydration or a long journey with little movement. Women with an inherited clotting tendency need especially close attention. But a lack of obvious risk factors does not rule DVT out — pregnancy itself is reason enough to take one-sided swelling seriously. Doctors usually confirm DVT with compression ultrasonography or a Doppler scan of the leg, and treatment commonly involves anticoagulation that is used safely in pregnancy under supervision. What matters first is getting to care.

A simple memory tool: bilateral and gradual is usually edema; unilateral and painful is DVT until proven otherwise. Warmth, tenderness, redness and one leg clearly larger than the other are not watch-and-wait signs. If chest pain, sudden breathlessness or coughing up blood are added, the emergency is greater still, because pulmonary embolism becomes a concern.

Families sometimes misread DVT because the swelling may start after travel, bed rest or an unusually inactive day, and they assume it will improve by morning — exactly the delay to avoid. A clot does not improve because someone lies down with pillows, and applying heat or pressing the tight calf hard is not a safe experiment. This stays true after delivery, when many assume the danger has passed: clot risk remains elevated postpartum, so if one leg becomes painful and swollen after a caesarean, prolonged bed rest or a difficult recovery, the logic is the same — urgent assessment, not home treatment. When in doubt, compare both legs in good light, trust the woman's own sense that something feels wrong, and seek care early. Delay adds risk; fast assessment is far safer than hopeful waiting.

The threshold for medical review is lower than many families think — you do not need to wait until swelling is dramatic or disabling. Routine bilateral swelling that improves with rest can simply be raised at your next antenatal visit, especially if it is new and you want advice on compression or footwear. But some patterns should trigger earlier action. Sudden severe swelling, particularly if it comes on within a day rather than over weeks, deserves a call. Facial puffiness with headache, visual symptoms or upper-abdominal pain deserves same-day assessment for possible preeclampsia. One-sided leg swelling with pain or warmth deserves emergency assessment for DVT. These are not symptoms to monitor at home for a week.

Persistence matters too. If swelling is still pronounced after 24 hours of rest, elevation, hydration and reduced heat exposure — and especially if it is getting worse rather than stabilising — it is reasonable to seek input. Some women normalise a lot of discomfort because everyone around them says pregnancy is supposed to be hard, which delays help unnecessarily. Doctors may check blood pressure, urine, weight trend and whether swelling is part of a larger issue such as preeclampsia, anaemia with fatigue, severe varicosities or skin infection. Persistent swelling is not always dangerous, but it is worth contextualising.

Symptoms beyond the feet should change the timeline. Breathlessness at rest, chest pain, reduced urine output, sudden rapid weight gain, severe itching with swelling, or swelling alongside feeling unwell all deserve prompt medical contact. If the skin becomes very tight, shiny, itchy or too painful for shoes, a doctor may still find no dangerous cause — but the visit is worthwhile because practical care can be optimised. Women who already have hypertension, kidney disease, diabetes, lupus or clotting disorders should have an even lower threshold for reporting swelling changes, because their baseline risk is different.

• NHS — Swollen ankles, feet and fingers in pregnancy
• ACOG — Preeclampsia and High Blood Pressure During Pregnancy
• WHO — Recommendations on antenatal care for a positive pregnancy experience
• Royal College of Obstetricians and Gynaecologists — Thrombosis and Embolism during Pregnancy and the Puerperium
• FOGSI — Federation of Obstetric and Gynaecological Societies of India
• Ministry of Health & Family Welfare, India — National Health Mission (maternal health, 102/108 services)