While the joy of motherhood may be one of life's most precious gifts, expectant mothers have to endure the rigors of pregnancy before they can experience the joy of motherhood and baby bliss.  As a woman's waistline expands, healthy weight gain during pregnancy can alter her center of gravity causing a sway-backed posture called lordosis.  

This new posture, coupled with the weight gain, creates pressure on the knees, legs, ankles and feet, and everyday movements such as lifting, sitting, standing and walking are affected.  Increased hormone levels results in fluid retention which leads to leg swelling, which also relaxes the ligaments in your feet, leading to flat feet (fallen arches).  This loosening of ligaments can also increase the woman's shoe size during pregnancy and she may have to wear a half or whole size larger after giving birth.

Some of the most common foot ailments mothers-to-be may face are swollen feet, flat feet, and cramps which can lead to pain in the heel, arch and ball of the feet.   Many women may also experience leg cramping and varicose veins due to weight gain.  Due to these common complaints, it is important for all pregnant women to learn about foot healthcare so their feet can be as comfortable as possible during their pregnancy.

Flat feet

Causes: The arch of the foot becomes flattened out with bearing of extra weight and the foot over pronates (roll inwards) while walking.  This can cause severe strain or even inflammation on the plantar fascia and result in pain on the ball of your feet and plantar fasciitis (intense heel pain).

Prevention: Choose and wear comfortable, properly-fitted footwear that provides extra arch support and shock absorption such as athletic shoes.  Try to avoid standing for long periods of time and walking barefoot.  Take a break when you can, and sit down and elevate your feet.

Swelling

Causes: Edema (swelling) is an increase in fluid in the tissues of your body.  Swelling in your feet and ankles during pregnancy is very common especially in the last trimester.  It is caused by increased blood volume and hormonal changes in the blood vessels.  Increases in foot size that are due to swelling are common.  However, swelling of the face or around the eyes are not normal and you should see your obstetrician right away if that occurs.

Prevention/Treatment: Walking gets your calf muscles working, which helps pump some of the extra fluid out of your legs and feet.  Elevating your feet as much as possible when sitting down will also help.  Drink plenty of water throughout the day and try to avoid foods that are high in salt, as they will increase your fluid retention.  Always wear the correct shoe size for your feet.  If the swelling persists, your obstetrician or podiatrist may recommend wearing compression stockings to help decrease the swelling.

Foot and leg cramps

Causes: Cramps are painful spasms of the calf or feet.  Their cause is not clear, but it is believed that they are due to changes in calcium levels or pressure from the growing uterus on the blood vessels and nerves.  Cramps appear to be more common during the second trimester and at night.

Prevention/treatment: Stretching and massaging the muscles in your legs and feet can help relax a cramp.  Exercising, walking it out or taking a warm bath can also relax a cramp.  Drink lots of water throughout the day to prevent dehydration.  Talk to your doctor about taking supplements such as calcium, magnesium, etc.

Varicose Veins

Causes: Varicose veins are veins that are enlarged and visible through the skin.  They develop in the lower legs and ankles because of the hormonal changes in the blood vessels and the increased weight of the growing uterus and baby putting pressure on blood vessels.

Prevention/treatment: Do not stand for long periods of time and try not to cross your legs when sitting.  Walking keeps the blood flowing to your muscles, which helps to push the blood back toward your heart.  If driving for a long distances, stop frequently to stretch and exercise your legs.

Ingrown toenails

Causes: Toenails tend to grow faster during pregnancy due to the hormones and extra vitamins and nutrients.  Often there are nail changes such as brittleness, ridges or grooves across the nail or dark lines/streaks in the nail bed.  A nail might even become loose and fall off.  These nail changes will usually go away after your pregnancy.  Because of the swollen toes, ingrown toenails (corners of a toenail curl down and dig into the side of the toe) often occur during the pregnancy or shortly after delivery.  Often patients present with redness, pain and drainage to the toe.

Prevention/treatment: Do not wear shoes or socks that are too tight because they put extra pressure on the skin around the nails causing them to become ingrown.  Do not trim your toenails too short or have your spouse trim your toenails if you are not able to see or reach your feet.  Soaking in vinegar and cold water may give some relief however, if symptoms persist, see your podiatrist for treatment.

General ideas for good foot health during pregnancy

A good pair of shoes can prevent lots of foot pain especially in pregnancy.  Wear comfortable, well fitted low to moderate heel shoes and avoid high heel shoes during your pregnancy.  Choose shoes with a square or round toe, avoid pointy-toed and pencil-heeled shoes.

Shop for new shoes later in the day as your feet tend to swell as the day goes on which will help you purchase the right size shoe.  Try on the shoe and make sure it fits before you leave the store.

A foot massage can do great wonders for tired and aching feet, have your feet massaged regularly. If the pain, swelling, cramps, ingrown toenails nail and varicose veins persist, see your podiatrist who can evaluate your feet and treat them in a manner that is safe for the baby and the mother-to-be.
 
For more information or to see a podiatrist visit Bahamas Foot Centre Rosetta Street, 325-2996; Bahamas Surgical Associates, Albury Lane, 394-5820 or e-mail at foothealth242@hotmail.com or visit www.apma.org.

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