varicose veins in pregnancy

Overview

Varicose veins are swollen, twisted veins that you can see just under the surface of your skin. They often look blue or dark purple. During pregnancy, they most often appear on the legs, but they can also appear on the vulva, vagina, or around the anus (as piles, also called haemorrhoids).

Yes, varicose veins are common in pregnancy. About 40% of pregnant women develop them.

They can affect any pregnant woman, but you are more likely to get them if you have a family history of varicose veins, are over 35, are expecting twins or more, have had multiple pregnancies, or are overweight.

Symptoms

Common symptoms

• Visible bulging, twisted veins that look blue or dark purple
• Aching, heavy, or tired legs
• Swelling in the ankles and feet
• Itching, burning, or throbbing around the veins
• Pain that gets worse after standing or sitting for a long time

Causes

Main causes

• The growing womb (uterus) presses on the large veins in the pelvis, which increases pressure in the leg veins.
• Hormone changes during pregnancy relax the walls of the veins, making it harder for them to push blood back to the heart.
• The total amount of blood in your body increases during pregnancy, which puts extra strain on your veins.

Risk factors

• Having a close relative with varicose veins
• Being overweight or gaining a lot of weight during pregnancy
• Standing for long periods of time
• Having more than one baby (twins or more)
• Having had several pregnancies
• Being over 35 years old

When to see a doctor

See a doctor urgently if:

• Severe pain, swelling, or redness in one leg – especially if it is sudden
• A painful, red, warm area on the leg that feels hard
• Bleeding from a varicose vein that does not stop with firm pressure
• Chest pain or difficulty breathing – call your local emergency number immediately

Book a routine appointment if:

• Your varicose veins are causing discomfort that bothers you
• The skin over your veins becomes sore, itchy, or changes colour
• You notice a sore or ulcer near a varicose vein
• You have concerns about how they look or feel

Diagnosis

Usually, a doctor or midwife can diagnose varicose veins by simply looking at your legs. They may feel the veins and ask about your symptoms. Sometimes, an ultrasound scan of the veins is done to check blood flow and rule out other problems.

Tests that may be done

• Physical examination of your legs
• Doppler ultrasound – a quick, painless scan that looks at blood flow in your veins

What to expect at your appointment

Diagnosis is simple. Your healthcare provider will look at and feel your legs. If needed, they will refer you for a short ultrasound test. This is not the same as your pregnancy baby scan; it just checks the veins in your legs. There are no needles, X-rays, or special preparations involved.

Treatment

Treatment for varicose veins during pregnancy focuses on managing symptoms and improving comfort, not on curing them. There is no safe cure during pregnancy, so medical procedures are usually delayed until after childbirth. Self-care and compression stockings are the main approaches.

Self-care at home

• Put your feet up and rest them on a stool or cushion whenever you can
• Avoid standing or sitting for long periods – move around every 30 minutes
• Sleep on your left side to reduce pressure on the large vein in your pelvis
• Wear maternity support tights or compression stockings – ask your midwife or pharmacist for advice
• Keep your legs raised when resting, ideally above hip level

Medical treatments

During pregnancy, injections, laser treatment, or surgery are not usually recommended because of potential risks to you and your baby. After you have given birth, if your varicose veins are still troublesome, there are several effective treatments available. These include compression therapy, laser treatment, and other keyhole procedures. Your healthcare provider will explain the options. No medication is needed to treat varicose veins directly.

When is surgery considered?

Surgery for varicose veins is very rarely done during pregnancy. It is almost always delayed until several months after childbirth, when your hormones and blood volume have returned to normal.

Living with this condition

You can live well with varicose veins during pregnancy by taking simple steps to ease your symptoms. Wear loose clothing, keep active with gentle exercises like walking and swimming, and put your feet up whenever possible. The veins may look worse at the end of the day, but they often feel better in the morning after a good night’s rest.

Lifestyle tips

• Take short walks every day
• Avoid crossing your legs when sitting
• Elevate your legs above your heart for 15 minutes a day
• Try pregnancy-safe swimming or water aerobics
• Ask your doctor or midwife about safe exercises for you

Diet and exercise

Eating a balanced diet with plenty of fibre can help prevent constipation, which can make haemorrhoids (piles) worse. Staying well hydrated and limiting salt can also reduce swelling. Gentle exercise, such as walking, swimming, and prenatal yoga, can help keep your blood moving and reduce discomfort.

Mental health and emotional wellbeing

Dealing with changes to your body during pregnancy can be stressful. Varicose veins can make you feel self-conscious or worried, but they are very common and usually not a health risk. If you feel anxious or low, talk to your midwife or doctor. They can offer support. If you are having thoughts of harming yourself or your baby, please seek urgent help from a healthcare professional or your local emergency service.

Prevention

You cannot always prevent varicose veins, especially if they run in your family. However, regular movement, avoiding long periods of standing, elevating your legs, and wearing loose clothing can help reduce your chances of developing them or stop them from getting worse.

Vaccines

There is no vaccine for varicose veins.

Screening programmes

There is no routine screening for varicose veins. They are usually noticed during normal pregnancy check-ups, when your midwife or doctor may ask to look at your legs.

Complications

If left untreated

• In most cases, there are no complications, and varicose veins get better on their own after pregnancy.
• Possible but uncommon complications include bleeding from the vein, inflammation (swelling and pain) around the vein, or skin ulcers (open sores) in the affected area.
• Varicose veins slightly increase the risk of blood clots in the deep veins of the leg (deep vein thrombosis).

Long-term outlook

The great news is that for most women, varicose veins during pregnancy are temporary. They often fade and shrink within 3 to 4 months after giving birth. If they do not, there are safe and effective treatments available later. With the right self-care and support, you can manage your symptoms and stay comfortable during your pregnancy.

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