Varicose Veins in Pregnancy: Causes and Comfort
SaveVaricose veins in pregnancy are bulging, achy leg veins that appear as blood volume climbs and the uterus presses on the veins returning blood to the heart. They are usually harmless and often ease within months of delivery. Walking, elevating the legs, and wearing compression stockings help the heavy, tired feeling.
Last updated: July 2026
What causes varicose veins in pregnancy?
Two pregnancy changes team up to swell the veins. Blood volume climbs steadily, expanding by about 45% over the pregnancy, so the leg veins carry a heavier load. At the same time, the enlarging uterus presses on the large pelvic vein that returns blood from the legs, slowing that flow and raising pressure in the vein walls.
Progesterone also relaxes vein walls, letting them widen. The one-way valves inside the veins then struggle to keep blood moving upward, and it pools — producing the bulging, twisting veins most visible in the second and third trimesters, according to obstetric guidance 1Ref 1National Institute for Health and Care Excellence (2024).Antenatal care (NG201).Antenatal care guidance on common pregnancy symptoms including varicose veins, their causes in the growing uterus and rising blood volume, and reassurance-and-comfort measures..
Where do the veins show up, and who gets them?
Legs are the most common site, but pregnancy varicose veins are not limited to them. Bulging veins can appear on the calves and thighs, in the vulva as vulvar varicosities, and around the rectum, where they are known as hemorrhoids.
A family history of varicose veins, carrying twins, standing for long stretches, and each additional pregnancy all raise the odds. Spider veins — tiny red or blue threads — are a milder, mostly cosmetic version. Up to 4 in 10 pregnant people notice some varicose or spider veins, and the tendency often runs in families. According to antenatal guidance, they are a common and usually benign change 1Ref 1National Institute for Health and Care Excellence (2024).Antenatal care (NG201).Antenatal care guidance on common pregnancy symptoms including varicose veins, their causes in the growing uterus and rising blood volume, and reassurance-and-comfort measures..
What actually eases the aching and heaviness?
Comfort measures work by helping blood move against gravity. Walking and regularly flexing the ankles pump blood upward, the kind of movement obstetric guidelines encourage across pregnancy 2Ref 2American College of Obstetricians and Gynecologists (2020).Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804.Guidance that physical activity, movement, and leg elevation are encouraged across pregnancy and that gradual return to activity supports circulation and recovery in the postpartum period.. Elevating the legs above heart level for 10 to 15 minutes eases the pooling.
Graduated compression stockings, snuggest at the ankle, support the vein walls and are among the better-studied options for swollen, achy legs. Sleeping on the left side takes pressure off the main pelvic vein, and avoiding long stretches of standing or sitting still also helps. These steps do not erase the veins, but they reliably reduce the heavy, tired feeling by the end of the day.
Do pregnancy varicose veins go away after birth?
Most pregnancy varicose veins fade on their own once the pregnancy pressure lifts. Blood volume falls and the uterus shrinks after delivery, so many bulging veins improve over the first 3 to 4 months postpartum. Gradually returning to activity supports circulation and recovery in this period 2Ref 2American College of Obstetricians and Gynecologists (2020).Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804.Guidance that physical activity, movement, and leg elevation are encouraged across pregnancy and that gradual return to activity supports circulation and recovery in the postpartum period..
Some veins do not fully disappear, and each pregnancy can leave a few more; treatments such as sclerotherapy or laser are usually deferred until after birth and breastfeeding, when a vein specialist can assess what remains. Varicose veins also become more common with age and after menopause as vein walls lose elasticity, so what starts in pregnancy sometimes reflects a lifelong tendency.
When leg veins in pregnancy need a clinician
Most varicose veins are a comfort problem, but a few signs point to something that needs prompt attention. A blood clot in a deep leg vein (DVT) is uncommon but more likely in pregnancy, and it looks different from a varicose vein: sudden pain, swelling, warmth, or redness usually in one calf 3Ref 3American College of Obstetricians and Gynecologists (2018).ACOG Practice Bulletin No. 196: Thromboembolism in Pregnancy.Guidance that the risk of venous thromboembolism is higher in pregnancy and the postpartum period, and description of the warning signs of a deep-vein clot that distinguish it from a varicose vein..
Those blood-clot warning signs are a reason to seek urgent evaluation, and chest pain or breathlessness needs emergency care. Sudden, severe swelling of the face or hands is different again and can signal preeclampsia. Gale can help you tell everyday achiness from the signs worth flagging to your prenatal team.
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Vein changes in pregnancy worth flagging
- —Sudden pain, swelling, warmth, or redness in one calf is a reason to seek urgent evaluation for a possible blood clot.
- —Chest pain, shortness of breath, or coughing up blood is a reason to call 911 or go to the nearest emergency room.
- —A varicose vein that bleeds, or skin that breaks down over a vein, is a reason to arrange prompt clinician review.
- —Sudden, severe swelling of the face or hands is a reason to contact your prenatal team the same day.
Chest pain, trouble breathing, or coughing up blood can signal a blood clot in the lung — call 911 or go to the nearest emergency room right away.
This article is general health education, not medical advice. Whether a leg-vein change is a harmless varicose vein or a clot that needs treatment is decided by an obstetric clinician or a vascular specialist who can examine you.
References
- 1.National Institute for Health and Care Excellence (2024). Antenatal care (NG201). National Institute for Health and Care Excellence (NICE). link ✓Antenatal care guidance on common pregnancy symptoms including varicose veins, their causes in the growing uterus and rising blood volume, and reassurance-and-comfort measures.
- 2.American College of Obstetricians and Gynecologists (2020). Physical Activity and Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion, Number 804. Obstetrics & Gynecology. doi:10.1097/AOG.0000000000003772 ✓Guidance that physical activity, movement, and leg elevation are encouraged across pregnancy and that gradual return to activity supports circulation and recovery in the postpartum period.
- 3.American College of Obstetricians and Gynecologists (2018). ACOG Practice Bulletin No. 196: Thromboembolism in Pregnancy. Obstetrics & Gynecology. doi:10.1097/AOG.0000000000002706 ✓Guidance that the risk of venous thromboembolism is higher in pregnancy and the postpartum period, and description of the warning signs of a deep-vein clot that distinguish it from a varicose vein.
3 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — every citation independently verified. Editorial policy