Restless legs in pregnancy

It’s 10pm, you’re finally horizontal, and your legs have other plans — a crawling, fizzing, itchy-deep-in-the-muscles feeling and an urge to move that simply will not be ignored. That’s restless legs syndrome (RLS), it’s very common in pregnancy (roughly one in five pregnant people get it, mostly in the third trimester), and while it’s harmless, anyone who’s had it knows “harmless” undersells how maddening it is.

What it feels like. People reach for creative words — creeping, tingling, buzzing, ants-under-the-skin — but the signature is the same: it strikes when you’re still (evenings, bedtime, long car trips), and moving makes it better, briefly. That evening-and-rest pattern is what separates RLS from leg cramps (a sudden painful muscle seizure, usually a calf) and from ordinary pregnancy aches.

Why pregnancy brings it on. No one fully knows, but the leading suspects are hormones (oestrogen, peaking right when RLS does), low iron — which your growing baby draws on heavily — and possibly folate levels. The iron link is the practical one: it’s the most fixable cause, which is why RLS is worth mentioning at an appointment rather than just enduring. Your midwife or GP can check your ferritin (iron stores) with a simple blood test and treat a deficiency if there is one — don’t start iron tablets on your own initiative, though; the dose and the need should be confirmed first.

What actually helps in the moment: getting up and walking until the sensation settles (annoying, but it works); stretching your calves before bed; massaging your legs, or recruiting someone who owes you a favour; a warm bath in the evening or a heat pack on your legs — some people swear by cold instead, and you have full permission to experiment; and gentle, regular exercise during the day, which reliably reduces evening symptoms. Keeping your bedtime consistent helps too, since exhaustion makes RLS louder.

What makes it worse: caffeine (especially later in the day — worth trimming if you’ve kept a habit), long stretches of sitting still in the evening, and being overtired. If a work-from-the-couch evening routine is feeding it, breaking the stillness with a stretch every half hour genuinely helps.

A reassuring note about your baby: RLS is miserable for you but does no harm to them. And it has an excellent prognosis — for the large majority of people it disappears within days of giving birth, packed off along with the heartburn.

If your legs are wrecking your sleep night after night, don’t file it under “just pregnancy” — tell your midwife or GP. Between an iron check and the tricks above, most people can get it down to a manageable hum, and decent sleep in the third trimester is worth pursuing on principle.