circulation in pregnancy

Overview

Circulation is the flow of blood through your heart and blood vessels. During pregnancy, your body makes more blood and your heart pumps harder to bring oxygen and nutrients to your growing baby. Most changes in circulation are a normal part of pregnancy, and your maternity team will check how your heart and blood vessels are doing at your appointments.

Yes. Every pregnant person experiences changes in circulation. It is a normal, expected part of pregnancy, though some people develop conditions like high blood pressure or varicose veins.

It affects all pregnant people, usually becoming more noticeable in the second and third trimesters. It can affect people of any age, but some people are at higher risk for circulation problems, such as those with a history of high blood pressure, diabetes, or a previous pregnancy with complications.

Symptoms

Common symptoms

• Mild swelling in your feet, ankles, and hands (especially later in the day)
• Dizziness or light-headedness when standing up quickly
• Feeling warmer than usual, especially on your skin
• Visible blue or purple veins in your legs
• Varicose veins — swollen, twisted veins on your legs
• Low blood pressure, which may make you feel faint

Symptoms in children

• Not applicable — this topic is about the pregnant person’s circulation. The baby has its own circulation and receives oxygen through the placenta.

Symptoms in older adults

• Pregnant people over 35 may be more likely to develop high blood pressure in pregnancy, but the symptoms are the same as those listed above.

Causes

Main causes

• Your body makes extra blood and fluid to support your baby
• Your heart works harder to pump this extra blood
• Pregnancy hormones relax and widen your blood vessels
• Your growing uterus presses on the large vein that returns blood from your lower body to your heart

Risk factors

• Being pregnant with more than one baby
• Having high blood pressure or kidney disease before pregnancy
• Being overweight before pregnancy
• A previous pregnancy with pre-eclampsia or other circulation problems
• Being older than 35
• Having a family history of blood clots or circulation problems

When to see a doctor

See a doctor urgently if:

• Call your local emergency number if you have any of the emergency symptoms listed above.
• Contact your maternity unit or doctor today if you have sudden swelling of your face, hands, or feet, or if you have new pain, redness, or swelling in one leg.

Book a routine appointment if:

• Tell your midwife or doctor if you notice swelling that does not go away, or if you have concerns about varicose veins.
• Attend all your antenatal appointments — they include blood pressure and urine checks that help spot circulation problems early.

Diagnosis

Your healthcare team checks your circulation at routine antenatal appointments. They measure your blood pressure, test your urine for protein, and ask about your symptoms. If there are concerns, they may refer you for further tests.

Tests that may be done

• Blood pressure measurement — taken at every appointment
• Urine test to check for protein, which can be a sign of pre-eclampsia
• Blood tests to check your blood counts and organ function
• An ultrasound scan, in some cases, to check blood flow through your placenta
• An electrocardiogram (ECG) or echocardiogram — painless heart tracing or scan — if your healthcare team is concerned about your heart

What to expect at your appointment

Most tests are simple and quick. Your maternity team will explain each test and why it is useful. You will usually get results within a few minutes for blood pressure and urine tests, while blood and ultrasound results may take a little longer.

Treatment

Treatment depends on what is causing the circulation problem. For normal pregnancy changes, simple self-care is usually enough. If you develop high blood pressure, pre-eclampsia, or a blood clot, your healthcare team will manage you closely and may recommend safe medicines to keep you and your baby well.

Self-care at home

• Rest on your left side to improve blood flow back to your heart
• Elevate your feet whenever you can
• Avoid standing for long periods
• Move regularly — short walks and gentle activity help your circulation
• Avoid crossing your legs when sitting
• Wear comfortable shoes and loose clothing, and consider maternity compression stockings if your midwife suggests them
• Stay hydrated — drink plenty of water
• Take breaks and sit down if you feel dizzy or faint

Medical treatments

If you need treatment, your healthcare team may prescribe medicines to lower blood pressure or to reduce the risk of seizures in pre-eclampsia. They may also offer anticoagulant medicines (sometimes called blood thinners) if you develop a blood clot. These treatments are chosen to be as safe as possible in pregnancy, and your team will explain the benefits and risks to you.

When is surgery considered?

Surgery is rarely needed during pregnancy for circulation problems. For example, varicose veins can usually wait until after pregnancy. If you have severe blood clots that cannot be treated with medicine alone, a surgeon may need to remove them, but this is very rare and only considered when medications are not suitable or effective.

Living with this condition

You can live well during pregnancy with a few simple adjustments. Rest when you need to, keep moving gently, and pay attention to your body's warning signs. Going to every antenatal appointment is the best way to make sure any circulation changes are caught early.

Lifestyle tips

• Sleep on your side, especially your left side, after the first trimester
• Take short walks during the day to keep blood flowing
• Raise your legs on a stool or pillows when sitting
• Avoid standing still for too long
• Wear comfortable, supportive footwear
• Elevate your feet and wiggle your toes when sitting down

Diet and exercise

Eat a balanced diet with plenty of fruit, vegetables, whole grains, and lean protein. Try to limit very salty foods, which can make swelling worse. Gentle exercises like walking, swimming, and prenatal yoga are usually safe — ask your midwife or doctor before starting any new activity.

Mental health and emotional wellbeing

Pregnancy can bring many emotions, and worries about your health or your baby's health are normal. Changes in your body may be uncomfortable or unexpected. It can help to talk about your feelings with your midwife, doctor, or a trusted friend. You do not have to cope alone.

Prevention

Most circulation changes cannot be prevented — they are a natural part of pregnancy. But staying active, eating well, and attending your antenatal appointments can help keep problems from becoming serious. If you have risk factors, your healthcare team may watch you more closely.

Vaccines

Some vaccines are recommended during pregnancy to protect you and your baby — for example, the flu vaccine and whooping cough vaccine. Ask your midwife or doctor which vaccines are recommended for you and when to have them.

Screening programmes

Routine antenatal care includes blood pressure checks, urine tests, and sometimes blood tests. These are simple ways to spot circulation problems early, so keep every appointment.

Complications

If left untreated

• High blood pressure can worsen and become pre-eclampsia, which can affect your kidneys and placenta
• Pre-eclampsia can lead to seizures (eclampsia), which is a medical emergency
• Blood clots can form in your legs (deep vein thrombosis) and may travel to your lungs, which is life-threatening
• Reduced blood flow to the placenta can affect your baby's growth and health

Long-term outlook

Most circulation changes in pregnancy are harmless and return to normal after your baby is born. Even when problems like high blood pressure or blood clots develop, they can usually be treated safely when found early. With good prenatal care, the vast majority of pregnancies and babies are healthy.

Find support

Local organisations

• Your local midwifery or maternity team · Your hospital or local health service

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