Swelling, cramps and late-pregnancy aches

As pregnancy progresses, your body holds more fluid and carries more weight, and your circulation works harder — so a bit of swelling in the feet and ankles, the odd night-time leg cramp, and a collection of new aches are all very common, especially in the third trimester and at the end of long, hot days. Most of it is normal and eases after birth, but a few signs are worth knowing so you can tell the everyday niggles from the things that need checking.

Swelling (oedema) in the feet, ankles and hands tends to build through the day. To ease it, put your feet up whenever you can, avoid standing still for long stretches, keep your fluids up (drinking more genuinely helps rather than makes it worse), and choose comfortable, non-restrictive shoes and socks. A gentle walk or a swim gets things moving, and resting on your side takes pressure off the big blood vessels so fluid drains more easily. Compression socks can help if you’re on your feet a lot.

Leg cramps, often at night, are common and harmless if uncomfortable. Stretching your calves before bed helps, as does staying hydrated and keeping magnesium-rich foods — nuts, seeds, wholegrains, leafy greens — in your diet. If a cramp strikes, flex your foot upward toward your shin and massage the muscle until it eases.

Late pregnancy throws up other aches too. Round ligament pain — a sharp tug low on one side when you move or sneeze — comes from the ligaments stretching to support your growing uterus. Rib and upper-back soreness is common as your ribcage expands and the baby pushes up. And some people get tingling or numbness in the hands (a bit like carpal tunnel) from fluid retention. Heat packs, gentle movement, good posture and changing position regularly all help; mention anything persistent to your midwife.

Now the important part — the signs that mean get checked promptly, because some serious conditions first show up as “just” swelling or aches:

• Sudden or severe swelling of your face and hands, especially with a bad headache, vision changes (blurring, flashing lights) or pain just under your ribs — this can signal pre-eclampsia and needs urgent assessment.
• One leg much more swollen, hot, red or painful than the other — treat this as urgent, as it can be a blood clot (DVT).
• Severe or constant tummy pain, a noticeable drop in your baby’s movements, or any bleeding — always call your midwife or maternity unit.

A few more everyday comforts are worth knowing. A cool foot bath or a cool compress can soothe hot, puffy feet at the end of the day, and resting your legs up on a pillow — or slightly raising the foot of your bed — helps fluid drain while you sleep. If your fingers swell, take rings off early rather than waiting until they’re stuck. And if aching, restless legs make it hard to settle in the evening — an irresistible urge to move them — mention it to your midwife, as it’s common in pregnancy and sometimes linked to low iron, which is easily checked.

When something feels different, sudden or severe, trust that instinct and ring your care team — they’d much rather check and reassure you. But for the everyday puffy ankles and the odd 3am calf cramp, rest, movement, water and a little patience are usually all it takes.