Women seem to get selective amnesia after holding their newborn baby in their arms. They forget the pain of childbirth, the health concerns and the nervous anticipation of pregnancy. But the one thing they do not forget is the discomfort of their poor pregnant feet!

Pamela Kock, mother of two from Springboro, Ohio, remembers all too well her chronic foot pain. "My feet ached quite a bit during both of my pregnancies; it felt as though I'd been standing all day, right as soon as I got out of bed," says Kock. "The doctor just stated the obvious, that it would help to sit down with my feet propped up as much as possible. It didn't help much, basically because I am not very good at sitting still for long!"

Dr. John Viscovich, a podiatrist in Mt. Kisco, N.Y., says there are many causes for foot swelling during pregnancy. "Hormonal imbalances, venous congestion, decrease in activity, fluid retention and laxity are all reasons for swelling," he says.

• Hormonal imbalances create a disparity in the osmotic pressures that will cause fluid to rest outside the cells.
• Venous congestion can be due to weight gain that does not allow the veins in the legs to function properly, allowing water to escape out into the free space between the cells.
• Decrease in activity causes the leg pump that brings fluid back to the heart not to function as well.
• Fluid retention is really related to hormonal imbalances.
• Laxity is due to the hormones that allow the female body to stretch (the belly getting bigger), which also work on the collagen that maintains the firmness in the legs, allowing the skin in the legs to stretch with fluid.

Swelling isn't the only thing that can happen to your feet while pregnant. Foot collapse is also quite common.

"Because of this, I see a lot of plantar fasciitis during pregnancy," Dr. Viscovich says. "Plantar fasciitis, also known as policeman's heel, causes severe pain in the flat part of the heel. This condition is hard to treat in the first two trimesters since the baby is developing. No one really wants to give a pregnant woman any meds during these stages. I have given several injections into the heel in the third trimester. During the first two trimesters I tend to provide physical therapy modalities and orthotics."

Dr. Ronald M. Caplan, author of Your Pregnancy: Reassuring Answers to the Questions of Mothers-To-Be (Quill, 1992), says that avoiding foot discomfort takes a little common sense. "Exercise during pregnancy is taught in all good prenatal classes," he says. "Such exercises are designed to avoid interference with proper blood circulation during pregnancy."

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