Varicose veins

Varicose veins are blood vessels that have collected too much blood. They look blue and swollen. Up to 4 in 10 people who are pregnant get varicose veins. Varicose veins often start in the first trimester of pregnancy.

Healthy leg veins have one-way valves to help blood flow back to your heart (Opens in new tab). When you walk, your calf muscles pump the blood up towards your heart, and the valves stop it falling back down towards the lower parts of your body, such as your legs.

Varicose veins develop when these one-way valves don't work as well as they should. This means that your blood flows back down your legs and pools in your veins. This stretches the vein walls and causes the veins to swell, twist and bulge. If they become large enough, you can see them under your skin.

Pregnancy increases your chances of developing varicose veins for 3 main reasons:

• Throughout pregnancy, you produce more blood than usual. This increases the pressure in your veins.
• As your baby grows, your uterus gets bigger and presses on the veins that return blood from your legs to your heart.
• Your pregnancy hormones make the walls of your veins softer, and more likely to bulge.

Because of these effects, varicose veins can develop or get worse during pregnancy. Your risk goes up the older you are and the more full-term pregnancies you've had. You're also more likely to get varicose veins if they run in your family.

Varicose veins mainly develop in your legs. However, you can also get them in your vulva (the area at the opening of your vagina) or rectum (back passage). Varicose veins of the rectum are also known as haemorrhoids.

Varicose veins can cause aches and pains in your legs. Your legs might feel heavy or restless, and they might throb, burn or cramp. Some people find varicose veins are not painful and give them no problems.

You'll probably find that your symptoms are worse later in the day because you've been standing for longer. By the next morning, you'll usually feel better because you've been lying down and the pressure on your veins has eased.

If you have varicose veins, you're at higher risk of developing a deep vein thrombosis (DVT). If you're already at risk of DVT for other reasons, you might need treatment to prevent it. You can discuss this with your doctor or midwife.

Exercise helps your circulation generally. Specific exercises like calf raises and walking on the spot are good for helping blood flow in your legs.

Varicose veins might be less likely to develop if you:

• do ankle exercises to get your circulation going — bend each foot up and down and rotate it in circles
• shift your weight from foot to foot regularly while you're standing
• put your legs up (for example, on a foot stool or another chair) when you're resting or sitting
• avoid wearing anything tight around your waist or thighs

If you do develop varicose veins, they will usually get better without treatment by the time your baby is 3 to 4 months old. For this reason, laser and surgical treatments to remove varicose veins are not usually recommended while you're pregnant.

If you have varicose veins, you can relieve the pain in your legs by:

• exercising regularly, especially ankle exercises
• applying cold packs to the painful veins
• trying not to stand for too long
• sitting with your legs up as often as you can
• lying down on your left side
• not wearing tight clothes or high heels
• wearing compression stockings — these should be fitted professionally

Stretch marks are not the same as varicose veins. Stretch marks are thin pink or purple lines on the surface of the skin. You'll usually see them appear as your pregnancy progresses, since they are formed when your skin stretches. Varicose veins are different because it's your veins that are affected, not your skin.

Talk to your doctor or midwife if you are worried about varicose veins. They can give you more information and help you find the best way to relieve any symptoms you're experiencing.

You can also call Pregnancy, Birth and Baby for free advice, support and guidance from our maternal child health nurses.