Varicose veins in pregnancy: why veins struggle and what helps

2026-11-02

• Hormones, extra blood volume and pressure from the growing womb make leg veins more vulnerable.
• Daily walks, resting with your legs raised and sleeping on your side ease heaviness and swelling.
• In pregnancy, use compression stockings and any medicines only on a doctor's advice.
• Phlebodia 600 is contraindicated in the first trimester; later, only on a doctor's recommendation.
• Sudden swelling and pain in one leg, breathlessness or chest pain: call 103 straight away.

By evening your favourite shoes suddenly feel tight, your socks leave deep marks around the ankles, and behind your knee there is a bluish, twisting vein that was never there before. Many mums-to-be notice changes like these even before their bump shows, and it is natural to feel anxious.

Varicose veins in pregnancy are common, and in most cases you can live with them comfortably by following a few simple rules. Let's look at why veins become more vulnerable at this time, which measures are safe, what you should know about medicines and which signs need urgent help.

Why are veins so vulnerable during pregnancy?

Pregnancy is a time when your whole body adapts for the baby, and the veins in your legs have to work harder. Several factors usually act at once:

• Hormones. Progesterone relaxes smooth muscle, including the muscle in vein walls. Veins stretch more easily, the valves inside them close less well, and blood pools in the legs more readily.
• More blood. The volume of circulating blood rises considerably, so your veins have to hold and move more fluid.
• Pressure from the growing womb. In the second half of pregnancy the womb presses on the large veins of the pelvis and abdomen, making it harder for blood to flow back from the legs.
• Less movement and weight gain. Tiredness, morning sickness, summer heat or icy winter pavements reduce activity, and without walking the calf muscle pump works less well.
• Family history and previous pregnancies. If your mother or grandmother had varicose veins, and in second and later pregnancies, veins tend to cause more trouble.

It is important to know that you have done nothing wrong. These are natural changes that you can influence, and there is no reason to blame yourself for them.

What do varicose veins in pregnancy look and feel like?

Signs can appear as early as the first trimester, but more often they build up in the second half of pregnancy. Look out for:

• heaviness, tiredness and a bursting feeling in your legs by evening;
• swelling around the ankles and feet, especially after standing for a long time or in hot weather;
• enlarged, twisting veins on your calves and thighs, and spider veins;
• night cramps in the calves and itchy skin over the veins;
• a heavy, full feeling around the labia, where veins can also widen; this is worth mentioning to your obstetrician;
• haemorrhoids, which are also widened veins, only around the rectum; constipation in pregnancy makes them more likely.

Mild swelling of the feet in the evening is common in late pregnancy, but a doctor should assess it. Mention any changes at your routine check-up: if needed, your obstetrician will refer you to a phlebologist and for a vein ultrasound.

Are varicose veins dangerous for mother and baby?

Varicose veins in the legs do not usually harm the baby: for the mother, the main problems are discomfort, heaviness and swelling. But there is one important point. During pregnancy and for the first weeks after birth, blood clots more easily, which is how the body prepares to protect itself from blood loss during delivery. This means the risk of thrombosis is higher at this time, and it is worth every expectant mother knowing the warning signs.

What helps your veins day to day?

Simple measures without medicines are the foundation of care for varicose veins in pregnancy. They are safe unless your doctor has advised otherwise:

1. Walk every day. Calm walks at a comfortable pace switch on the calf muscle pump. In a Tashkent summer, choose the morning or evening when the heat eases; in winter, look for paths that are not slippery and wear shoes with a stable sole.
2. Rest with your legs raised. Several times a day, lie down for 10–15 minutes with your legs on a pillow or bolster.
3. Sleep on your side. In the second half of pregnancy doctors usually advise sleeping on your side, often the left, so that the womb puts less pressure on the large veins. A pillow between your knees makes it more comfortable.
4. Avoid standing or sitting still for long. If you work behind a counter or at a desk, shift your weight, rise onto your toes or 'pedal' your feet every 30–60 minutes. On a long trip to see family in another region, stop regularly and get out for a short walk.
5. Choose comfortable shoes and loose clothing: a low, stable heel, socks without tight bands and no tight belts.
6. Drink enough water and eat plenty of vegetables, fruit and grains. This helps prevent constipation, which puts extra strain on the veins and contributes to haemorrhoids.
7. Avoid overheating: hot baths, saunas and the bathhouse are generally not recommended in pregnancy, and prolonged heat widens the veins.

Water is a great ally too: swimming and aqua aerobics for expectant mothers take the load off your veins and joints. We explain how to exercise in the pool in our article on swimming with varicose veins; agree any exercise during pregnancy with your obstetrician.

Do pregnant women need compression stockings?

Compression stockings or tights are one of the most common pieces of advice for varicose veins during pregnancy. Many women find they reduce swelling and heaviness, although there are few studies in pregnant women specifically and the evidence is limited. Special maternity tights with a stretchy panel for the bump are available.

Only a doctor should choose the compression class and size, and compression is not suitable for some arterial diseases, so start wearing it after consulting a doctor. It is easiest to put on in the morning while you are still lying in bed, before your legs have a chance to swell. Read more in our guide to choosing compression stockings.

Can veins be treated with medicines during pregnancy?

At this time, any medicine, including creams, gels and 'natural' remedies, should only be used if prescribed by the doctor looking after your pregnancy. Don't start anything on the advice of friends or the internet. Sclerotherapy, laser and surgical vein treatment are generally not carried out during pregnancy and are postponed until after the birth, when it becomes clear how much has changed.

If you have seen venotonic medicines at the pharmacy, it helps to know what the instruction leaflet says. Phlebodia 600 (diosmin 600 mg) is contraindicated in the first trimester of pregnancy, as experience of its use is limited. Later in pregnancy it is used only on a doctor's recommendation, and it is not recommended while breastfeeding. Full details are in the official instruction. Before use, read the instruction leaflet and consult a specialist.

What happens to your veins after the birth?

The good news is that once hormone levels settle and the pressure from the womb is gone, veins often shrink noticeably over the months after birth. This does not always happen, though, and varicose veins often become more pronounced with each subsequent pregnancy.

• The risk of thrombosis remains in the first weeks after birth: get up and walk as soon as your doctor allows, and keep the warning signs in mind.
• If your veins have not settled, book an appointment with a phlebologist a few months after the birth and have a vein ultrasound, so the doctor can assess whether treatment is needed and when it is best done.
• Planning another baby? Discuss your veins with a phlebologist before you become pregnant.

You can read more about how pregnancy and vein disease are connected in our article pregnancy and chronic venous disease of the legs are closely linked.

The main points

Varicose veins in pregnancy are a common and understandable companion to expecting a baby, not a reason for fear. More walking, resting with your legs up, sleeping on your side, comfortable shoes and knowing the warning signs are often enough to help your legs feel lighter. Discuss everything else, from compression to medicines, with your doctor, and allow yourself a little more rest and care.

Sources: 1. National Institute for Health and Care Excellence (NICE). Varicose veins: diagnosis and management. Clinical guideline CG168, 2013. 2. Smyth RM, Aflaifel N, Bamigboye AA. Interventions for varicose veins and leg oedema in pregnancy. Cochrane Database Syst Rev. 2015;(10):CD001066. 3. Instructions for medical use of Phlebodia 600 (Republic of Uzbekistan).

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