Restless Leg Syndrome in Pregnancy
Medically reviewed by Dr. Lisa Okafor, MD, FACOG · Board-Certified OB-GYN
Content reviewed against published NIH, ACOG, NIH guidelines
Last reviewed:
Your health matters just as much as your baby's. If you are dealing with restless leg syndrome in pregnancy, here is what you need to know.
The short answer
Restless leg syndrome (RLS) affects up to 26% of pregnant people, making it about 2-3 times more common during pregnancy. It causes an irresistible urge to move the legs, often accompanied by uncomfortable sensations, and typically worsens at night. It may be related to iron or folate deficiency and usually resolves after delivery.
Key takeaways
- Restless leg syndrome (RLS) affects up to 26% of pregnant people, making it about 2-3 times more common during pregnancy. It causes an irresistible urge to move the legs, often accompanied by uncomfortable sensations, and typically worsens at night. It may be related to iron or folate deficiency and usually resolves after delivery.
- Usually normal when: An uncomfortable urge to move your legs that is worse at rest and improves with movement
- Call your doctor if: Symptoms are accompanied by severe leg pain, swelling, or discoloration, which could indicate a different condition
- Varies by age — see the age-by-age breakdown below
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What Parents Should Know
According to NIH, ACOG guidelines, restless leg syndrome (RLS) affects up to 26% of pregnant people, making it about 2-3 times more common during pregnancy. It causes an irresistible urge to move the legs, often accompanied by uncomfortable sensations, and typically worsens at night. It may be related to iron or folate deficiency and usually resolves after delivery. At Second trimester, rLS may begin or worsen in the second trimester. The uncomfortable sensations - often described as crawling, tingling, aching, or pulling - are temporarily relieved by movement. Your provider may check iron and ferritin levels, as iron deficiency is strongly associated with RLS. Gentle leg exercises before bed and avoiding caffeine can help. It is generally considered normal when an uncomfortable urge to move your legs that is worse at rest and improves with movement. However, you should contact your pediatrician promptly if symptoms are accompanied by severe leg pain, swelling, or discoloration, which could indicate a different condition.
Normal vs. Concerning
By Age
What to expect by age
Second trimester
RLS may begin or worsen in the second trimester. The uncomfortable sensations - often described as crawling, tingling, aching, or pulling - are temporarily relieved by movement. Your provider may check iron and ferritin levels, as iron deficiency is strongly associated with RLS. Gentle leg exercises before bed and avoiding caffeine can help.
Third trimester
RLS is most common and severe in the third trimester. It can significantly impact sleep quality. Warm baths before bed, leg massage, stretching, and maintaining regular sleep schedules may help. Iron supplementation (if levels are low) has been shown to improve symptoms. Avoid antihistamines and antiemetics that can worsen RLS.
Postpartum
RLS usually resolves within weeks of delivery for most people. If it persists, talk to your provider. Women who develop RLS during pregnancy have a higher risk of developing it again in future pregnancies or later in life.
What to Tell Your Pediatrician
- Describe when you first noticed restless leg syndrome in pregnancy and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if rLS is significantly affecting your sleep quality.
- Mention if you need help managing symptoms that are not improving with lifestyle changes.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- An uncomfortable urge to move your legs that is worse at rest and improves with movement
- Symptoms that are worse in the evening or at night
- Uncomfortable sensations in the legs described as crawling, tingling, or aching
- Symptoms that developed or worsened during pregnancy
- RLS is significantly affecting your sleep quality
- You need help managing symptoms that are not improving with lifestyle changes
- You want to discuss whether iron supplementation might help
- Symptoms are accompanied by severe leg pain, swelling, or discoloration, which could indicate a different condition
- RLS is causing severe sleep deprivation that affects your ability to function safely
What You Can Do at Home
- Keep track of when you notice restless leg syndrome in pregnancy — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that an uncomfortable urge to move your legs that is worse at rest and improves with movement — this is generally within the range of normal.
- At Second trimester, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Prioritize your own rest and nutrition. Accept help when offered, and do not hesitate to reach out to your healthcare provider.
- While monitoring at home, seek immediate care if symptoms are accompanied by severe leg pain, swelling, or discoloration, which could indicate a different condition.
Related Conditions
Leg Cramps During Pregnancy
Leg cramps, especially in the calves, are very common during pregnancy, affecting up to 50% of pregnant people. They are most frequent in the second and third trimesters and tend to occur at night. They may be caused by changes in blood circulation, extra weight on the legs, nerve compression, and possibly mineral imbalances.
Insomnia and Sleep Difficulties in Pregnancy
Insomnia affects up to 78% of pregnant people at some point during pregnancy. It can be caused by physical discomfort, frequent urination, hormonal changes, anxiety, and difficulty finding a comfortable sleeping position. While frustrating, it is very common and there are many strategies that can help improve sleep quality.
Anemia During Pregnancy
Anemia during pregnancy is very common, affecting up to 40% of pregnant people worldwide. It is most often caused by iron deficiency due to the increased blood volume and iron demands of pregnancy. Symptoms include extreme fatigue, weakness, pale skin, dizziness, and shortness of breath. It is treatable with iron supplementation and dietary changes.
Related Resources
Postpartum Recovery Guide
Week-by-week postpartum recovery timeline and warning signs.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is restless leg syndrome in pregnancy normal?
When should I call the doctor about restless leg syndrome in pregnancy?
When is restless leg syndrome in pregnancy normal?
What causes restless leg syndrome in pregnancy?
What should I mention to my pediatrician about restless leg syndrome in pregnancy?
Is restless leg syndrome in pregnancy normal at Second trimester?
Is restless leg syndrome in pregnancy normal at Third trimester?
Should I go to the ER for restless leg syndrome in pregnancy?
Does restless leg syndrome in pregnancy go away on its own?
References
- [1]National Institute of Neurological Disorders and Stroke. Restless Legs Syndrome Fact Sheet. NINDS, 2023. NIH
- [2]American College of Obstetricians and Gynecologists. Sleep During Pregnancy. ACOG, 2022. ACOG
- [3]National Library of Medicine. Restless Legs Syndrome in Pregnancy. Sleep Medicine Reviews, 2018. NIH
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Restless Leg Syndrome in Pregnancy.
Things to mention
- Describe when you first noticed restless leg syndrome in pregnancy and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if rLS is significantly affecting your sleep quality.
- Mention if you need help managing symptoms that are not improving with lifestyle changes.
- Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- RLS is significantly affecting your sleep quality
- You need help managing symptoms that are not improving with lifestyle changes
- You want to discuss whether iron supplementation might help
Urgent signs to report immediately
- Symptoms are accompanied by severe leg pain, swelling, or discoloration, which could indicate a different condition
- RLS is causing severe sleep deprivation that affects your ability to function safely
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of restless leg syndrome in pregnancy are normal. Talk to your pediatrician if symptoms are accompanied by severe leg pain, swelling, or discoloration, which could indicate a different condition.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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Leg Cramps During Pregnancy
Leg cramps, especially in the calves, are very common during pregnancy, affecting up to 50% of pregnant people. They are most frequent in the second and third trimesters and tend to occur at night. They may be caused by changes in blood circulation, extra weight on the legs, nerve compression, and possibly mineral imbalances.
Insomnia and Sleep Difficulties in Pregnancy
Insomnia affects up to 78% of pregnant people at some point during pregnancy. It can be caused by physical discomfort, frequent urination, hormonal changes, anxiety, and difficulty finding a comfortable sleeping position. While frustrating, it is very common and there are many strategies that can help improve sleep quality.
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