How Pregnancy Changes Your Feet (and What to Do About It)

Somewhere around the second trimester, many women notice something unexpected: their shoes don't fit. Not just because of swelling — their feet have actually changed shape. It's one of the lesser-discussed physical changes of pregnancy, and for some women, it's permanent.

Understanding what's happening and why can help you manage the discomfort and know when something needs medical attention versus when it's a normal part of the process.

What Pregnancy Does to Your Feet

Swelling (Edema)

Swollen feet and ankles during pregnancy are extremely common, especially in the third trimester. The body produces about 50% more blood and fluid during pregnancy, and gravity pulls that extra fluid downward. Progesterone also causes blood vessels to relax and dilate, contributing to fluid accumulation in the lower extremities.

Normal pregnancy swelling is bilateral (both feet equally), worse at the end of the day, and improves with elevation. It's uncomfortable but not dangerous in most cases.

Flat Feet and Arch Collapse

The hormone relaxin — which loosens the ligaments of the pelvis to prepare for delivery — doesn't just affect the pelvis. It loosens ligaments throughout the body, including the ones that support the arch of the foot. Combined with the additional weight of pregnancy, this can cause the arch to flatten and the foot to lengthen and widen.

Research shows that a significant percentage of women experience a measurable increase in foot length and decrease in arch height during their first pregnancy — and for many, the change is permanent. This is why shoes from before pregnancy sometimes never fit again.

Plantar Fasciitis

The combination of weight gain, loosened ligaments, and altered gait makes pregnant women particularly susceptible to plantar fasciitis. That sharp morning heel pain affects many women during the second and third trimesters and can persist postpartum if not addressed.

What Helps

Supportive shoes matter more than ever. This is not the time for flat sandals or unsupportive flats. Shoes with arch support, cushioning, and a wide toe box reduce strain on the already-compromised ligaments. Many patients find that wearing supportive shoes around the house — not just when going out — makes a significant difference.

Elevation and movement. Elevate your feet when resting, avoid standing in one position for extended periods, and keep moving — gentle walking helps circulation and reduces fluid pooling. Ankle pumps (flexing and pointing the feet) throughout the day help push fluid back up.

Compression socks. Graduated compression stockings can help manage swelling, especially if you're on your feet for work. Put them on first thing in the morning before swelling starts.

Orthotics. For women developing significant arch pain or plantar fasciitis during pregnancy, custom orthotics provide the structural support that loosened ligaments can no longer maintain. These can be used during pregnancy and continue to be valuable postpartum if the arch changes persist.

When to See a Doctor

Most pregnancy-related foot changes are manageable and expected. But see a doctor promptly if you experience sudden or severe swelling in one leg only (could indicate a blood clot), swelling accompanied by headache, vision changes, or upper abdominal pain (signs of preeclampsia), persistent heel or arch pain that limits your ability to walk, or numbness or tingling that doesn't resolve with position changes.

The Bottom Line

Your feet go through a lot during pregnancy. Most of the changes are manageable with the right shoes, elevation, and awareness. If heel pain, arch collapse, or persistent swelling is making it hard to stay active and comfortable, a podiatric evaluation can help — and treatment is safe during pregnancy. Call (760) 728-4800 to schedule.