Yes, feet do frequently require larger sizes after delivery, but they do not actually grow —more on that later! After 30 years of practicing Podiatry, I would like to share some of my podiatric wisdom regarding the importance of, and how to maintain, healthy feet during your pregnancy.

Early in your pregnancy, you may notice frequent cramping in your feet and legs. This is due to the rapidly changing hormones in your body. These can be quite annoying and painful, especially if they occur at night as they often do. However, have peace of mind knowing that these cramps are rarely serious. They also tend to diminish as the first trimester ends.

One of my favorite pearls is to tell a pregnant woman, early on, that she is entitled to at least two rest periods every day. She should have a seat in her favorite chair with feet elevated at least parallel to the ground (she can also choose to lie down) for at least 30 minutes. During this time, I instruct her to draw the alphabet with her feet, toes pointed and moving the whole foot at the ankle to draw each letter. Writing or printing is permissible (bad joke). This simple exercise takes all of the muscles of the lower leg through a full range of motion. If one can do this more than two times a day – great. Resting like this and pumping the leg muscles is one of the best ways to prevent varicose veins from developing, as well as controlling the swelling!

Now, I would like to talk about skin care. Dryness is very common during pregnancy, especially during the winter months. This is easily treated by applying an inexpensive over-the-counter skin moisturizer. It is important to keep the skin moisturized because dry skin is susceptible to breakdown, opening the door for a variety of infections. If one suspects an infection of any type, characterized by redness, swelling and/or drainage, contact professional help immediately. Remember, an infection in your body can travel to the baby!

Thus, foot hygiene is especially important throughout the entire pregnancy. Disease-causing organisms hide in the hard to reach areas – especially between the toes. These areas also become harder and harder to reach. This was one of the main reasons I thought the Pregnancy Pamper and Foot Care Kit would be so valuable to the expecting moms! Gestational Diabetes, which all pregnant women are screened for via a glucose tolerance blood test, is a very serious condition that can develop during pregnancy. Everyone who is familiar with diabetes knows how important foot health is to them. All of the diabetic foot warnings apply to these women 100% during their pregnancy.

Now, the reason feet “grow” during pregnancy is a hormonal one. The hormones that are released to loosen the cervical ligaments to allow for delivery also loosen the other ligaments in the body. This is especially true in the feet where the extra weight easily stretches the relaxed ligaments. Thus, feet really stretch, not grow after pregnancy, and often a larger shoe size is necessary and also permanent!

One of the best ways to prevent this is to get into the habit from day one of wearing the best supportive shoes available. My strong feeling here is that one cannot do better than to simply wear a quality running shoe. This is especially true for expectant women who have to be on their feet most of the day. I have a hard time thinking of a situation that would be important enough to choose style over substance in this situation. I know, you are still a woman and style matters, so I will settle for 75% of the time as a compromise.

As the pregnancy progresses, aches and pains and swelling are very common. There are pregnancy-related reasons for this, and being aware of the cause will help you understand the proper treatment and prevention. I was surprised early in my career when I had the opportunity to review x-rays of women who recently gave birth. The bones are extremely osteoporotic (lacking calcium). They remind you of the bones of a 60 or even 70 year old woman. The cause is the developing fetus taking calcium from anywhere he can get it. Evolution has made his development the number one priority.

Aches then begin to develop when heavier and heavier bodies are being supported by weaker and weaker bones. Stress fractures are quite common in the third trimester and for about nine months after delivery. The bones then begin to return to normal strength. Until then, supportive shoes are a must.

So ladies, respect and care for your feet during this most exciting time of your life, and I promise it will pay dividends. I will be in touch soon with more pearls.

Peter M. Joseph DPM