Have you noticed a sudden crop of purplish blue, squiggly worms on your legs, just below the surface of the skin? These are enlarged, swollen veins called varicose veins. Due to a potent combination of physiological factors, many women develop varicose veins during pregnancy. When severe, they can lead to heavy, aching legs and other painful physical symptoms far worse than the aesthetic annoyance they inflict. Varicosities occur most commonly in the legs because of the physical challenge inherent in pumping blood from the lower legs and feet all the way back up, against gravity, to the heart. Other common sites for varicose veins include the vulva and the rectum (these are called hemorrhoids).
Varicose veins sometimes feed increased pressure into the capillaries causing spider veins, tiny blood vessels near the surface of the skin that often appear in a sunburst pattern. These don’t cause discomfort and they usually disappear after delivery.
We’re particularly vulnerable to developing varicose veins during pregnancy because elevated progesterone levels cause blood vessel walls and valves to relax, which makes blood pooling more likely. Second, total blood volume increases about 50% during pregnancy. This means a lot more blood to potentially pool in those soft, relaxed vessels. Finally, the growing uterus exerts pressure on the inferior vena cava, the large vein that carries de-oxygenated blood from the lower half of the body into the right atrium of the heart. When the vena cava is compressed, it restricts venous return from the legs.
The good news is that understanding the source of varicose veins reveals key strategies to prevent them. In large part, varicosities can be prevented and/or minimized during pregnancy with the following simple steps:
Circulation is key – get moving!
Exercise daily. It can be as simple as a brisk walk for 25 minutes to stimulate healthy circulation. For even greater impact, try a prenatal workout in The Dia Method series. The 25-minute workouts keep you moving in and out of multiple body positions while safely elevating your heat rate through sustained, targeted resistance training that pumps blood through every muscle of your body.
To promote healthy circulation, avoid crossing your legs or ankles while sitting. Also avoid sitting and standing for long periods of time. When it’s unavoidable, schedule ‘movement breaks’ for yourself every 30-45 minutes to change your body position and move around. Stretch gently if you like, walk, perform a set of squats, march in place. Do whatever you can to keep blood pumping effectively. Continue your movement of choice until you feel a gentle wave of warmth surge through your body. That warmth indicates you’ve given your circulation the needed kick in the butt.
Put your feet up. Often.
Elevate your legs and feet as much as possible. Prop your feet on a comfy stool while sitting; place a pillow under your knees and another under your feet while reclining in bed. Elevate for at least 10 minutes a day, preferably in the afternoon or evening.
Avoid lying flat on your back as this can restrict blood flow to the vena cava, which further restricts blood flow to and from the legs. Instead, lie on your left side with a pillow between your knees and another between your feet (or use a body pillow to provide similar support). Switch sides as needed to keep your hips comfortable, but start on the left side when you can because this further decreases pressure on the vena cava.
Another great tip is to slightly elevate the foot of your bed. Even an inch or two can improve venous return while you sleep. Try propping the foot of your bed on secure, solid supports about 2 inches high – scrap wood from a local hardware store should do the trick.
Compression tights really work!
Wear compression stockings. I particularly recommend graduated compressions stockings. They’re designed to be tightest at the foot/ankle and offer increasingly light support as they travel up the leg. This ideally promotes venous return from your extremities back to the heart, which minimizes swelling and can both prevent and improve varicose veins. Compression tights are available at most drug stores, and you can also buy them online. One great site with a range of affordable options is www.TheraWear.com. They also carry compression leggings in a variety of fun colors if that’s more up your alley than glorified pantyhose. For best results, put the tights on first thing in the morning, while still lying in bed. And keep them on all day. Compression stocking are remarkably effective, and they’re an absolute necessity if you already suffer symptoms of varicose veins.
If you have a family history or personal history of varicose veins before pregnancy, I recommend exploring light to medium grade compression tights early in the pregnancy, before you see any signs of increased stress on your veins.
Keep weight gain in a healthy range.
Do your best to stay within your doctor’s weight gain recommendations. For most singleton pregnancies, that’s 25-35 pounds. If you find you’re gaining too quickly, cut out empty carbs (sugars, refined flours, processed foods). If you’re struggling to put on adequate weight, add more fruit and dairy to your daily meals/snacks.
What about those other varicose veins?
A quick word about hemorrhoids (varicose veins in and around the rectum) and vulvar varicosities. The constipation common to pregnancy combined with the circulation issues described above dramatically heightens the risk of developing varicose veins in these sensitive areas. In addition to following the above tips, you can also lessen pressure on the veins in these sensitive areas by following the elimination techniques I outline here. You’ll not only avoid enlarged, painful veins but also prepare yourself to push with safe, effective technique on the big day. Poop better to push better.
All of the above steps will do wonders to promote healthy circulation during pregnancy to keep you looking and feeling your best. Varicose veins often disappear on their own a few months after delivery, but sometimes it takes longer and sometimes they never go away (especially after multiple pregnancies). I for one would rather do what I can to prevent and minimize these unpleasant conditions instead of waiting for them to clear up on their own. You can follow the same tips post-pregnancy to promote recovery. If basic healing support is not sufficient to resolve the condition within a reasonable timeframe, talk with your doctor about a range of effective medical treatments.