By Mary M. Murry, R.N., C.N.M.
I remember the day I happened to look in the mirror behind me as I was trying on clothes in a local department store. How had my legs turned into my grandmother's legs? I was shocked. I guess I hadn't paid much attention to the backs of my knees — although I'm not sure why I thought I'd gotten through life and pregnancies without some varicose veins.
Pregnancy itself is one of the major risk factors for varicose veins. Your body increases blood volume during pregnancy. It also decreases the speed that your blood returns from your legs to your pelvis. This increases the pressure on those veins. A higher level of the hormone progestin also contributes to varicose veins by causing the veins to be more dilated or open.
Varicose veins during pregnancy aren't limited to your legs, though. Varicose veins can also occur in your vulva. They can be small and barely noticeable, or they can be quite large and somewhat disfiguring. Your vulva can feel sore and swollen, and it can be uncomfortable to sit. One of my patients once described it as sitting on catamarans.
Hemorrhoids — swollen and inflamed veins in your anus and lower rectum — are another form of varicose veins. The most common risk factors include pregnancy and constipation, so being pregnant and constipated almost seems like a set up for hemorrhoids!
You can't control a family history of varicose veins or the changes in your circulation or hormones during pregnancy. Still, you can take steps to help prevent or lessen the effects of varicose veins during pregnancy.
- Elevate your legs. Raising your legs higher than the level of your heart can help promote circulation. When there's a chance to rest with your feet up, take it. You might even place a firm pillow between the mattress and box spring at the foot of your bed to raise your legs while you sleep.
- Change position. If you tend to stand for long periods of time, take frequent breaks to sit. If you tend to sit a lot, take frequent breaks to walk around.
- Monitor your weight. Gaining a large amount of weight in a short period of time is especially hard on your veins.
- Get support. Try support pantyhose or thigh high support hose. Sometimes knee high support hose or socks can actually be too constrictive. If you're struggling with discomfort in your vulva, try a support garment designed specifically for varicose veins in the vulva.
- Keep constipation at bay. To prevent hemorrhoids, drink plenty of fluids, add extra fiber to your diet and, if needed, ask your health care provider about a stool softener.
It's also important to be patient. The varicose veins that develop during pregnancy often disappear within a few months to a year after delivery — when you've recovered from the vascular and hormonal changes of pregnancy. In the meantime, don't hesitate to discuss your concerns or discomforts with your health care provider.