Varicose Veins in Pregnancy
The short answer
Varicose veins are swollen, twisted veins that commonly appear in the legs during pregnancy. They affect up to 40% of pregnant people and are caused by increased blood volume, hormonal changes that relax vein walls, and pressure from the growing uterus on pelvic veins. They are usually a cosmetic concern but can cause aching or discomfort.
Parents everywhere have the same worry. You are doing the right thing by looking into it.
By Age
What to expect by age
Varicose veins rarely appear this early, but rising progesterone begins to relax vein walls. If you had varicose veins in a previous pregnancy, they may appear earlier. Wearing graduated compression stockings and staying active can help prevent them.
Varicose veins often become noticeable in the second trimester as blood volume increases by up to 50%. They may appear in the legs, vulva, or rectum (hemorrhoids). Elevating your legs when resting, avoiding standing for long periods, sleeping on your left side, and wearing compression stockings can help manage symptoms.
Varicose veins are typically most prominent in the third trimester. Vulvar varicosities may cause pressure and discomfort. Continue with compression stockings, leg elevation, and regular gentle exercise. Most pregnancy-related varicose veins improve significantly within 3-12 months after delivery.
Varicose veins usually improve after delivery but may not disappear completely, especially after multiple pregnancies. If veins remain bothersome after recovery, treatment options like sclerotherapy or laser therapy can be discussed with your provider.
What Should You Do?
When to take action
- Visible blue or purple veins in the legs that may be twisted or bulging
- Mild aching, heaviness, or itching around affected veins, especially after standing
- Spider veins (smaller, flat, web-like veins) appearing on legs or face
- Symptoms improve with elevation, compression stockings, or exercise
- Varicose veins are causing significant pain, throbbing, or swelling
- You develop vulvar varicosities that cause discomfort
- Skin over the veins becomes discolored, dry, or irritated
- A varicose vein becomes hard, hot, red, and very painful, which could indicate a blood clot (superficial thrombophlebitis)
- You develop sudden swelling, pain, and warmth in one leg, especially the calf, which could indicate deep vein thrombosis (DVT)
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
Worrying about your baby means you care. That is a good thing.
Related Maternal Concerns
Hemorrhoids During Pregnancy
Hemorrhoids are swollen blood vessels in the rectal area that affect up to 35% of pregnant people. They are caused by increased blood volume, pressure from the growing uterus, constipation, and straining. While uncomfortable, they are very common and usually treatable with conservative measures.
Swelling in Feet, Ankles, and Hands During Pregnancy
Mild to moderate swelling (edema) in the feet, ankles, and hands is very common in pregnancy, affecting about 80% of pregnant people. It is caused by increased blood volume and fluid retention, and it is usually harmless. However, sudden or severe swelling, especially in the face and hands, can be a warning sign of preeclampsia.
Blood Clot Risk During Pregnancy (DVT)
Pregnancy increases the risk of blood clots (venous thromboembolism or VTE) by 4-5 times due to increased clotting factors, slower blood flow, and vein compression from the growing uterus. While the overall risk is still low (about 1-2 per 1,000 pregnancies), awareness of symptoms is important because blood clots can be life-threatening if untreated.
Dealing with Abnormal Prenatal Screening Results
An abnormal prenatal screening result can be terrifying, but it is important to understand that screening tests are designed to cast a wide net and have significant false-positive rates. Most people with abnormal screening results go on to have healthy babies after further testing confirms the baby is fine. An abnormal screening is a reason for more information, not a diagnosis.
Pregnancy Over 35 (Advanced Maternal Age)
While pregnancy after 35 carries some increased risks (including chromosomal abnormalities, gestational diabetes, and hypertension), the vast majority of people over 35 have healthy pregnancies and healthy babies. The term "geriatric pregnancy" is outdated and does not reflect reality. With appropriate prenatal care and monitoring, outcomes are excellent.
Amniocentesis Questions and Fears
Amniocentesis is a diagnostic test performed between 15-20 weeks that analyzes amniotic fluid to detect chromosomal conditions and genetic disorders with over 99% accuracy. The risk of pregnancy loss from the procedure is approximately 1 in 500-1,000 when performed by an experienced provider. Understanding the actual risks can help you make an informed decision.