Is Postpartum Swelling Normal?
Do you feel like your body is swollen while recovering from delivery? That’s likely postpartum edema. Don’t panic, mama, because most cases of postpartum swelling are normal, painless, and go away on their own. (1)
As many as 8 in 10 pregnant women may have edema. That’s because their bodies produce 50% more body fluids, including blood, to meet their baby’s needs. (1)(2)
To put that in perspective, you gain some 30+ lbs in a normal, singleton pregnancy. Around 25% of this pregnancy weight gain is from extra bodily fluids: (3)(4)
- Around 4 lbs of extra blood
- Another 4-6 lbs of body fluids
These extra fluids don’t just magically disappear after childbirth. Plus, other factors can increase your body fluids, especially during delivery. Examples are added IV fluids and pressure during delivery that can push fluids to your extremities. (1)
What’s Postpartum Swelling?
During the first weeks of the postpartum period (right after birth to around six months), many parts of your body might be swelling. It can happen whether you had a C-section or vaginal birth.
Postpartum swelling is normal. It’s often caused by water retention or having plenty of water (or other fluids) in your body. Some of your skin can look shiny or stretched if you’re very swollen. (5)
Water retention usually occurs in these parts: (5)
- Legs
- Ankles
- Feet
- Hands
- Face
- Arms
- Vulva
Types Of Postpartum Swelling
- Water retention
- Breast engorgement
- Hemorrhoids (worsened by constipation)
- Deep vein thrombosis (swelling due to a blood clot)
- Possible allergic reaction to medicines used during and after labor or delivery
What Do Swollen Feet After A C-section Mean?
Swollen feet after a C-section can be due to water retention from the excess fluids from pregnancy and the added ones (IV fluids) during delivery.
Signs & Symptoms: What Does Postpartum Swelling Feel Like?
Postpartum edema shouldn’t be painful. Instead, you might have some puffy parts that can quickly shrink within the first two weeks of postpartum recovery.
Losing the excess fluids doesn’t hurt, but you’ll notice that you might be peeing more frequently than usual. Studies show that new moms can have a urinary output of around 3.17 quarts (12 cups) per day. (4)
Typical signs of postpartum edema can include: (1)(2)
- Puffiness under the skin in your legs, feet, face, and ankles
- Skin looks stretched
- Indentations appear when you press your skin for a few seconds
- Quick weight gain over just a few days
Causes
The most common causes of your puffy post-pregnancy look: (1)(2)
- Leftover pregnancy fluids
- Extra fluids received during labor, particularly IV fluids – Moms who gave birth through C-section can experience more fluid retention.
- Pressure during delivery – The natural pressure created while pushing can also push the fluids towards the extremities.
- Water retention from being sedentary – Moving around helps your body get rid of fluids. Being sedentary for a long time during the first weeks postpartum can lead to swelling.
- Hormones – Increased progesterone levels during pregnancy can lead to extra water retention. (4)
Swelling Due To Pitocin & Other Labor Medicines
Proper use of labor medicines like Pitocin (administered via IV fluids) and Cervidil (inserted vaginally) isn’t likely to cause swelling, but misuse can. (6)
Swelling from these medicines and Oxytocin can be due to an allergic reaction. It can be serious. Call your doctor immediately if you experience these symptoms: (7)
- Swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
- Rash
- Hives
- Itching
- Fast heartbeat
- Unusual bleeding
- Difficulty breathing
- Difficulty swallowing
An epidural isn’t expected to cause postpartum swelling. (8)
Who’s At Risk For Postpartum Swelling?
Some of the most common postpartum edema risk factors: (1)
- Cesarean birth (the longer hospital stay means more IV fluids might have been used)
- Edema or swelling during pregnancy
- Standing for a long time
- Low potassium diet
- High caffeine consumption
- High sodium intake
- Hot temperatures at home
- Possible side effects of labor medicines (rare) (6)(7)
Prevention
You can use the holistic and natural coping methods below to prevent or minimize postpartum swelling.
How Do I Get Rid Of Postpartum Swelling?
25 Ways To Find Postpartum Swelling Relief
1. Wear Compression Stockings Or Socks
Studies show that compression socks may help prevent and ease lower limb edema and venous thrombosis (vein blockage from a blood clot). (9)(10)
2. Drink Lots Of Water
Although it sounds counterintuitive to drink more water when you’re already dealing with excessive fluids, it’s important to drink more because dehydration makes your body retain more water. (11)
3. Get A Postpartum Massage
A postpartum massage can have these benefits: (12)
- Reduced swelling
- Hormone regulation
- Better sleep
- Improved breastfeeding
- Stress reduction
- Relaxation
- Pain relief
- Speeds up postpartum recovery
4. Relax With Aromatherapy
Some essential oils can help improve circulation and blood flow. These might also reduce swelling. Examples can include: (12)
- Ginger essential oil
- Wintergreen essential oil
- Black pepper essential oil
5. Elevate Your Feet
While in bed, elevate your feet on some pillows or up against the wall.
This helps move retained fluids in your legs and feet back to the rest of your body for your sweat glands and kidneys to process and remove. You can also try the Legs-Up-The-Wall yoga pose.
6. Make Circular Motions With Your Ankles
Move both your ankles ten times each in counterclockwise and clockwise directions. These can also improve circulation and remove fluid retention from your feet.
7. Raise Your Hands & Arms
For swollen arms and upper extremities, raise them above your head for a few minutes. Like elevating your feet, these can also help move the excess fluids to the rest of your body.
8. Wear Comfortable Shoes
Shoes that constrict your feet can increase swelling. It’s also good to avoid wearing high heels if you can.
9. Wear Loose-fitting Clothes
Choose clothes with a loose fit that won’t restrict your circulation. Avoid those that are tight around your ankles or wrists.
10. Use Natural Diuretics Instead of Water Pills
Peeing is one of the most effective ways your body gets rid of excess fluids. Diuretics increase the sodium (salt) and water flushed out in your urine. (4)
Prescription water pills or diuretics are strongly discouraged during pregnancy and after childbirth. These natural diuretics can be a better alternative:
- Apples
- Citrus fruits
- Watercress
- Cucumbers
- Lemons
- Celery
- Parsley
- Cranberry juice
- Dandelion leaf
- Corn silk
- Horsetail
Ask your healthcare provider whether herbal diuretics (like cornsilk and dandelion leaf) are safe for you to use, especially if you’re on any medications.
11. Use Cold Compress
A cold pack can help reduce the swelling in the affected areas. You can apply the cold compress for 15-20 minutes, but make sure to put a towel between the ice pack and your skin.
12. Use Witch Hazel
Some studies have shown that using witch hazel, an astringent, may help reduce swelling, bruising, and inflammation, especially in the perineal area (from your genitals to the anus). (13)(14)
Put some witch hazel on a maternity pad or some cotton balls. Freeze for a few hours or overnight. You can press these on your perineum.
13. Use Cabbage Leaves
You can also opt to freeze cabbage leaves and apply them to the swollen areas, especially if you’re dealing with breast engorgement. The cold leaves can also help reduce swelling in the affected area. (15)
Studies show that cabbage leaves may also help reduce pain and inflammation in these parts. (16)(17)
14. Relax & Exercise Your Legs In The Pool
A 2017 Phlebology journal study showed that specifically designed pool exercises might help reduce chronic leg swelling. (18)
The American Pregnancy Association also recommends exercising and relaxing your legs in a pool. You can talk to your healthcare provider (such as your OB-GYN) about your options. (1)
However, remember that you should wait seven days after the last day of lochia (normal bleeding after childbirth) before fully swimming in the pool. But dipping your legs in can be fine.
15. Use A Foam Roller
A foam roller can help improve circulation, so this might help ease swelling from excess fluids in your body.
16. Acupuncture
This traditional Chinese medicine may help ease swelling and engorgement. It may also help increase milk supply and fight inflammation. (19)(20)(21)
17. Foot Reflexology
Studies show that foot reflexology or a foot massage can help ease swelling and discomfort in the foot and lower leg edema during late pregnancy. These benefits might also extend to the postpartum period. (22)(23)
18. Avoid Prolonged Standing Or Sitting
Both of these can cause blood and fluids to pool in your legs.
19. Do Light Exercises
New moms are encouraged to move around to prevent blood clots and water retention during the first week of recovering from delivery. Even moms who had a C-section should move even a few steps a day. (24)
Light exercise that can help improve circulation and flush the excess fluids:
- Walking
- Gentle yoga
- Pilates
You don’t have to go out of the house for a walk.
Moving around the house, walking from the bedroom to your living room or your baby’s room, or just walking from your bed to a chair can already be considered light exercises for new moms. (24)
20. Eat Potassium-Rich Foods
Low potassium levels can increase swelling and edema. That’s why medications to treat swelling include potassium. (25)
Some potassium-rich foods: (25)
- Bananas
- Potatoes
- Avocados
- Spinach
- Apricots
- Spinach
- Baked beans
- Lentils
- Yogurt
- Peanut butter
- Sweet potatoes
- Orange juice
- Dried prunes or raisins
- Tomatoes
- Broccoli
- Lentils
- Kidney beans
21. Eat Vitamin B-Rich Foods
Vitamins B6 (pyridoxine) and B5 (pantothenic acid) may help reduce cases of mild fluid retention. (26)
Foods rich in vitamin B6: (27)
- Beef liver
- Salmon
- Chickpeas
- Poultry
- Bananas
- Papayas
- Oranges
- Cantaloupe
- Dark leafy greens
Food rich in vitamin B5: (28)
- Beef
- Chicken breast
- Organ meats (e.g., liver)
- Mushrooms
- Avocado
- Nuts
- Seeds
- Eggs
- Brown rice
- Dairy milk
- Yogurt
- Potatoes
- Broccoli
- Oats
22. Reduce Caffeine Intake
Coffee, tea, energy drinks, soda, and other caffeine-containing beverages can worsen dehydration, which can increase swelling. (29)
23. Avoid Salt Or Salty Foods
Too much sodium (salt) in your body can cause dehydration because your body pulls water from the cells to regain its water balance. (30)
24. Avoid Processed Foods
Processed food contains high sodium levels, which can aggravate postpartum swelling. (31)(32)
Instead, it’s good to eat nutritious foods with lean meat and plenty of fruits and veggies because these can also help speed up postpartum recovery. (33)
25. Avoid Too Much Sugar
Sugary drinks can also increase dehydration as your body tries to produce more urine to get rid of the excess sugar. (34)
How Long Does Postpartum Swelling Last?
Postpartum edema usually goes down naturally within the first week after childbirth. However, the actual duration can vary among moms, with some taking around two weeks to resolve. (1)
The recovery also depends on:
- The amount of retained fluids
- Your activity
- Your water intake
- Your food choices
When Should I Worry About Postpartum Swelling?
Call your doctor if you notice:
Signs of blood clot or DVT (deep vein thrombosis): (35)
- One leg is more swollen than the other
- Pain when you walk
- Red hot area (particularly in one leg)
- Discoloration in some parts
Signs of postpartum preeclampsia:
- High blood pressure (higher than 130/80 mm Hg)
- Intense pain in your legs
- Frequent headaches
- Blurred vision
- Quick weight gain (over 4 lbs a week)
- Abdominal pain or cramping
- Dizziness
- Light sensitivity
Signs of postpartum cardiomyopathy (a life-threatening heart condition) or blood clot in your lungs: (36)
- Severe swelling
- Chest pain
- Shortness of breath
Signs of infection from your cesarean incisions or episiotomy (a surgical cut made during vaginal delivery): (37)
- Red, painful swelling
- Fever
- Leaking pus
- Foul-smelling discharge
Diagnosis
If your doctor suspects that your swelling is due to an underlying condition, they might do these diagnostic tests to find the best treatment options: (26)
- Physical examination
- Medical history
- Family history
- Questioning about the fluid retention symptoms, when it started, factors that worsened the swelling, options you tried to alleviate the swelling, etc.
- Urine tests
- Blood tests
- Liver function tests
- Kidney function tests
- Chest x-ray
- ECG (electrocardiogram) and other heart function tests
REFERENCES
(1) https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/swelling-during-pregnancy/
(2) https://pubmed.ncbi.nlm.nih.gov/9185112/
(3) https://texaswic.org/health-nutrition/women/where-does-pregnancy-weight-go
(4) https://www.ncbi.nlm.nih.gov/books/NBK555904/
(5) https://medlineplus.gov/postpartumcare.html
(6) https://www.birthinjuryhelpcenter.org/pitocin-faq.html
(7) https://medlineplus.gov/druginfo/meds/a682685.html
(8) https://www.asahq.org/madeforthismoment/pain-management/techniques/epidural/
(9) https://www.liebertpub.com/doi/abs/10.1089/lrb.2016.0038?journalCode=lrb
(10) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4081237/
(11) https://www.cdc.gov/healthyweight/healthy_eating/water-and-healthier-drinks.html
(12) https://americanpregnancy.org/healthy-pregnancy/first-year-of-life/postpartum-massage/
(13) https://www.ncbi.nlm.nih.gov/books/NBK72402/
(14) https://www.sciencedirect.com/topics/medicine-and-dentistry/witch-hazel
(15) https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/pages/Engorgement.aspx
(16) https://pubmed.ncbi.nlm.nih.gov/27820535/
(17) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4723919/
(18) https://pubmed.ncbi.nlm.nih.gov/27756859/
(19) https://www.ncbi.nlm.nih.gov/books/NBK501890/
(20) https://pubmed.ncbi.nlm.nih.gov/8791904/
(21) https://news.harvard.edu/gazette/story/2021/11/researchers-pinpoint-how-acupuncture-targets-inflammation/
(22) https://pubmed.ncbi.nlm.nih.gov/20854342/
(23) https://pubmed.ncbi.nlm.nih.gov/25822028/
(24) https://utswmed.org/medblog/blood-clots-after-delivery/
(25) https://ods.od.nih.gov/factsheets/Potassium-Consumer/
(26) https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/Fluid-retention-oedema
(27) https://www.hsph.harvard.edu/nutritionsource/vitamin-b6/
(28) https://www.hsph.harvard.edu/nutritionsource/pantothenic-acid-vitamin-b5/
(29) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6282244/
(30) https://vitalrecord.tamhsc.edu/what-happens-when-you-eat-too-much-salt
(31) https://www.cdc.gov/salt/role_of_sodium.htm
(32) https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1687516
(33) https://lilynicholsrdn.com/real-food-postpartum-recovery-meals/
(34) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6195650/
(35) https://www.cdc.gov/ncbddd/dvt/facts.html
(36) https://www.umcvc.org/conditions-treatments/peripartum-cardiomyopathy-ppcm
(37) https://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf