vein in pregnancy

Overview

Varicose veins are swollen, twisted veins that appear just under the skin, most often in the legs. During pregnancy, they happen because your blood volume increases, your hormones relax the vein walls, and your growing womb presses on the veins in your pelvis. This makes it harder for blood in your legs to flow back up to your heart, so blood pools in the veins and they become enlarged.

Yes, very common. Many pregnant women notice varicose veins, especially in the later months. They can appear in the legs, vulva, or around the back passage (haemorrhoids).

Varicose veins in pregnancy can affect any pregnant woman, but they are more likely if you have had them before, if they run in your family, if you are over 30, or if you are overweight. They also become more common with each pregnancy.

Symptoms

Common symptoms

• Visible, bulging, blue or purple veins on the legs
• A heavy or achy feeling in the legs, especially after standing
• Swelling in the ankles and feet
• Itching or a burning sensation over the vein
• Mild throbbing or cramping in the lower legs

Symptoms in children

• Not applicable – pregnancy-related vein changes do not affect children.

Symptoms in older adults

• Not applicable – this condition is specific to pregnancy. However, older pregnant women (over 35) may notice more pronounced symptoms such as more swelling and achiness.

Causes

Main causes

• Increased blood volume – your body makes about 50% more blood during pregnancy, which fills the veins.
• Hormonal changes – pregnancy hormones relax the walls of the veins, making them stretch more easily.
• Pressure from the growing womb – the uterus presses on the large veins in the pelvis, slowing the return of blood from the legs.

Risk factors

• Having varicose veins before pregnancy
• A family history of varicose veins
• Being overweight or gaining a lot of weight in pregnancy
• Standing for long periods of time
• Having had multiple pregnancies
• Being over the age of 30

When to see a doctor

See a doctor urgently if:

• You have sudden, severe swelling, pain, and tenderness in one leg.
• You have chest pain or difficulty breathing.
• You have a bleeding varicose vein that you cannot stop with gentle pressure.

Book a routine appointment if:

• Your veins are painful, itchy, or uncomfortable.
• You notice skin changes near a vein, such as darkening, dryness, or a sore.
• You are worried about the appearance of your veins.

Diagnosis

A midwife, GP, or vascular specialist can usually diagnose varicose veins by looking at your legs and asking about your symptoms. In most cases, no tests are needed.

Tests that may be done

• Doppler ultrasound: a simple, painless scan that uses sound waves to check how blood flows through your veins.
• Sometimes a physical examination while standing is enough to confirm the diagnosis.

What to expect at your appointment

The examination is quick and simple. You may be asked to stand so the veins fill with blood and become easier to see. If an ultrasound is used, a small hand-held probe is moved over your leg – it does not hurt and is very safe in pregnancy.

Treatment

Treatment for varicose veins in pregnancy focuses on easing symptoms and improving blood flow from your legs. Doctors usually do not recommend active vein procedures during pregnancy because most veins improve after the baby is born. Your care team will support you with simple, safe self-care measures.

Self-care at home

• Put your legs up on a stool or cushion whenever you can, ideally above the level of your heart.
• Take short walks every day to keep blood moving.
• Avoid standing or sitting still for long periods – try to move every 30 minutes.
• Sleep on your left side to take pressure off the large vein in your pelvis.
• Ask your midwife or doctor about compression stockings – these gently squeeze your legs and help blood flow back up.
• Wear loose, comfortable clothing – avoid tight bands around the waist or thighs.

Medical treatments

If your symptoms are severe, a doctor may suggest medical compression stockings or other safe supportive therapies. Certain procedures like sclerotherapy or laser treatment are generally delayed until after pregnancy and breastfeeding. Your healthcare team will help you decide what is safe and appropriate for you.

When is surgery considered?

Surgery or keyhole treatments for varicose veins are usually postponed until after pregnancy and breastfeeding. If your veins remain painful or cause complications months after birth, a specialist may discuss these options with you.

Living with this condition

Most days, you can live comfortably with varicose veins by keeping your legs moving, taking rest breaks, and wearing supportive stockings if advised. Try not to cross your legs when sitting, as this can slow blood flow even more. Do not be alarmed by the way they look – they are a normal part of pregnancy for many women.

Lifestyle tips

• Keep active with gentle exercises like walking, swimming, or pregnancy yoga.
• Avoid heavy lifting or straining.
• Take regular breaks to elevate your legs at work or at home.
• Drink plenty of water to prevent constipation and straining.
• Sleep on your left side rather than your back.

Diet and exercise

Eat a healthy, balanced diet with plenty of fibre from fruits, vegetables, and wholegrains to avoid constipation. Include foods rich in vitamin C, like oranges and leafy greens, which help keep vein walls strong. Safe exercises like walking or swimming improve circulation and help your body manage pregnancy weight gain.

Mental health and emotional wellbeing

Seeing large veins on your legs can be upsetting, especially if they are uncomfortable. It may help to remind yourself that they are usually temporary and not caused by anything you did wrong. If you are worried about how your body looks, talking to your midwife, partner, or a trusted friend can make you feel supported.

Prevention

You may not be able to prevent varicose veins completely, especially if you are more likely to get them because of your genes. But you can reduce the risk of them becoming worse by staying active, avoiding long periods of standing, and keeping a healthy pregnancy weight.

Screening programmes

Screening for varicose veins is not routinely needed. However, your midwife will regularly check your legs for swelling or other changes during your antenatal appointments.

Complications

If left untreated

• A blood clot (deep vein thrombosis) – this is rare but serious, and needs emergency medical care.
• Skin changes near the veins, such as dark patches, dryness, or thinning of the skin.
• A painful skin ulcer or open sore, usually near the ankle.

Long-term outlook

For the vast majority of women, varicose veins shrink greatly or disappear within a few weeks of giving birth. Even if they do not go away completely, they usually become much less painful. If they still bother you months later, there are safe, effective treatments available. Your body has done an incredible thing – be patient and kind to it.

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