Swollen Legs, Feet, & Ankles

One common issue in pregnancy is swollen legs, feet and ankles after flying.  Actually, this is very common during pregnancy. About two thirds of women will have edema while pregnant, whether flying or not.

The Causes

Being pregnant and finding your legs swollen after flying has several causes.

Even early in pregnancy, your body begins to increase its blood volume for the sake of the baby. This increases the pressure in your veins and causes fluid to leak out into the surrounding tissues. You may first notice this especially at the end of the day or in the summertime.

As the pregnancy progresses your growing uterus exerts pressure on your vena cava, the main vein that returns blood to your heart from your legs and pelvis. This added pressure also causes fluid to leak out into your tissues. This is especially true if you are carrying twins or other multiples, or if you have an increased amount of fluid in your uterus (a condition known as polyhydramnios).

One thing other than edema that may cause your shoes to no longer fit, is a hormone called relaxin, which increases during pregnancy. This relaxes the ligaments in your body and may allow the bones in your feet to separate.

The feet swelling intensifies just by simply flying in an airplane. Plane travel means that you are apt to be sitting for a long time. Also, the cabin air is quite dry and once again, causes your kidneys to retain fluid. Swollen legs and feet after a long flight is often an unavoidable consequence of travel.


There are several things you can do to reduce or prevent swollen feet after flight. One is to move about whenever you get a chance. This is easier if you have chosen an aisle seat. If you cannot get out of your seat, then at least pump your calf muscles. Stay well hydrated. This feels like the opposite of what you need, but it will keep your kidneys active removing extra fluid. On the other hand, avoid caffeine. Even though it has a diuretic effect, it leads to dehydration that then stimulates the kidneys to retain fluid.

You might consider wearing support stockings but they are somewhat of a mixed blessing. They do temporarily reduce swelling but they are cumbersome to put on and take off. And the American Congress of Obstetricians and Gynecologists (ACOG) points out that they are of no proven benefit in preventing blood clots. Finally, unless you have purposely worn loose or stretchable shoes, it may be best to keep your shoes on or you may not be able to get them on at the end of the flight. Putting shoes on swollen feet on a plane can be difficult.

Something you can do when you are not flying is to keep your feet elevated. Also, sleep on your left side. The vena cava is on the right side of your pelvis, so sleeping on your left keeps your uterus off the vena cava. Finally, a foot massage may be of benefit, if not physically then at least emotionally.

Warning Signs

There are times, however, when the swelling has some medical significance and should generate a call to your doctor.

If, for instance, you have only one swollen foot after flying or find your leg swelling after the flight, especially if it is painful, it could indicate a blood clot in your leg. Both pregnancy and immobility are risk factors for this. These clots can sometimes break loose and travel to your lungs, which may even be fatal.

Also, swelling may sometimes be a sign of a life-threatening complication called pre-eclampsia (toxemia in days gone by). Normal pregnancy swelling usually occurs in the third trimester, so if edema occurs prior to 27 weeks gestation it may indicate a problem.

Other indications of pre-eclampsia are if the swelling comes on rapidly or if it involves the face and hands. Accompanying signs such as headache, visual abnormalities or upper abdominal pain are important and you should call your doctor.

The next time you find your feet swelling on an airplane, don’t worry. For the most part this is simply a discomfort and inconvenience and should not interfere with your travel plans.

Safe travels… until next time!

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