What should you know about postnatal leg swelling?

After pregnancy, the body gradually moves extra fluid back into the circulation and removes it through urination and sweating. Swelling may affect both feet and ankles and can be more noticeable after standing. It should not be assumed to be harmless when one leg becomes much larger, warm, red or tender. Other health problems, including varicose veins, obesity, heart failure or chronic kidney disease, can also contribute to fluid retention. Swollen ankles may be a useful description to share with a clinician.

Rest with your legs supported, change position regularly and avoid remaining still for long periods. Gentle walking, if comfortable and medically allowed, can support circulation. Wear comfortable footwear and keep hydrated unless a clinician has told you to limit fluids. Do not start water tablets or compression garments without advice, particularly after a caesarean birth or if one leg is affected. Arrange a postnatal review if swelling persists, interferes with walking or is getting worse.

Seek urgent medical help for one-sided leg swelling with calf pain, warmth or redness; chest pain; sudden breathlessness; coughing blood; fainting; severe headache; vision changes; or upper abdominal pain. These symptoms can signal a clot or a blood-pressure complication after birth. Contact a clinician promptly for swelling with reduced urination, marked tiredness or a rapid change in both legs.

Ask whether the pattern and timing of swelling fit normal postnatal fluid changes, whether your blood pressure and urine need checking, and whether medicines, a clot assessment or follow-up monitoring are appropriate.