How Pregnancy Affects the Feet

For every pregnancy journey, a mother or mother-to-be naturally experiences feelings of excitement and apprehension. In this 40-week period, a woman’s body goes through so many phases of change. Visible changes of increasing waistline and digits on the weighing scale are often coupled with swelling in the ankles and the presence of stretch marks. Internal observations will show pregnancy’s effects on metabolism, respiration, bone density, and the digestive system, to name a few.

As the body accommodates a nurturing and developing fetus, stark changes in the anatomy and physiology of a woman will occur. Throughout the course of these 9 months, such changes actually have an impact on every organ system in the body.

In this article, we will cover how pregnancy affects the feet. Swelling is a common occurrence during this phase. Also known as oedema, swelling can occur in different parts of the body though it largely occurs in the ankle region. Puffiness in the face or the hands is occasionally present. Dark spider veins, also known as varicose veins, often cause aesthetic concerns in women. Pregnancy is presumed to be a major contributing factor in its increased prevalence. Aside from its undesirable sight, this can also lead to cramps, heaviness, aching or numbness in the feet and calves.

As the stages of pregnancy progress, a woman’s foot changes in length, width, and volume. This occurs when the hormone called relaxine is released seven to tenfold, causing ligamentous laxity. As a result, the arch in the foot loses or lowers its height, and pronation is increased. Pronation refers to the inward movement of the foot as you walk or run. Your foot normally rolls a bit inward with each step. A skew in the foot’s alignment starts, causing a knock-on misalignment effect to the feet, knees, hips, and back.

Weight gain during this period is also taken into account, which contributes to more strain on the already abnormally lax ligaments. With a more prominent baby bump, the risk of falls increases as well as the prevalence of joint pain in women. This is related to the biomechanical and anatomical changes during this period. In attempts to increase stability and reduce the loss of balance, a decreased step-length and wider step-width are observed. A woman will adopt a “penguin” gait or unconsciously “waddle” which changes the position of the knees and the pelvis. This alteration in gait is seen up to six weeks post-pregnancy.
In Malaysia, most overlook the importance of supportive footwear. During pregnancy, the right shoes play a crucial role in the prevention of lower limb pain and pathologies. When carrying out any weight-bearing activities (indoors and outdoors) ensure the feet have adequate support.

Footwear features to note:

  • Firm base – the sole of shoes when worn, functions as the foundation of the entire body. Ensure that a solid base is present, instead of a soft and malleable base.
  • Adjustable fastening – as swelling in the foot and ankle can occur, ensure to avoid slip-on style footwear. Instead, opt for footwear with adjustable straps and laces. Ensure to adjust it when the feet expand in size.
  • Suitable size – when the arch of the foot lowers during pregnancy, the foot length increases. It is common to experience changes in shoe size. The changes can range from half a size to a size up. While many mothers do account for the changes in foot length (as measured by the footwear size), they often neglect the increase in width. Take note of footwear with wider cuts for the toes areas. Some women with a wider forefoot will need a pair of shoes with the appropriate width for better foot health.

As the risk of falls is increased with an enlarged tummy, high heels should generally be avoided. Flip flops provide a lack of support for the joints and should not be worn.

Avoid leather-type materials as they do not expand well and can cause excessive friction against the skin. Typically, a pair of sports shoes or sneakers are the healthiest option for the feet. Certain sandal-style options can also be considered.

Preserving the joints of the feet, knees, hips, and back are important in a smoother pregnancy experience. Prevention of problems as listed above in pregnancy’s early stages is important for a healthy mother and baby. You may want to consider wearing appropriate sandals even indoors to provide adequate support for your ankles and reduce strain on the feet. Other simple preventative measures include compression stockings, custom orthotics, and specific exercises to be carried out throughout this journey.

To print a pdf copy of this article, click HERE

Article contributed by

Ms Emily Mah

Clinical Podiatrist

Subang Jaya Medical Centre

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Contraception – Male condom

The main purpose of contraception (or birth control) is to prevent an unplanned pregnancy. You should know and understand the different types of methods available to you, the risks and benefits of each, and any possible side effects, so that both you and your partner can able to make an informed choice. Contraception can be broadly divided into:

  1. Temporary or permanent methods – permanent birth control is accomplished through sterilization (tying or removal of the fallopian tubes) or hysterectomy (removal of womb / uterus). The rest of the methods are classified as temporary or reversible.
  2. Short term or long-term methods – short term methods are condoms and oral pills. Long term methods are injectables, intrauterine device and hormonal implants.

The condom is a sheath that looks like a small, elongated balloon and is usually made of thin latex rubber, polyurethane or natural membranes. The man wears this sheath over the erect penis during intercourse. The sheath will prevent the sperm from being deposited in the vagina following ejaculation. The condom may also be effective in preventing spread of some sexually transmitted infections (STIs) such as human immunodeficiency virus (HIV), chlamydia, gonorrhoea, genital warts etc. It is the only form of temporary birth control available for men.


  • Generally effective for contraceptive use (88-98%), provided it is use in a proper and consistent way.
  • It is readily available, inexpensive, and easy to use. Women can buy and carry condoms.
  • No medical consultation is required to start using it. It can be purchase easily and widely available.
  • It provides good protection against some STIs.
  • There are no systemic side effects from condom use.
  • Since the condom prevent the deposition of semen in the vagina, the woman will have less leaking (discharge) following intercourse.


  • There is a need for the condom to be available and the extra time and effort required to put in on prior to intercourse. This may decrease the spontaneity of sex for some couples.
  • It may lessen the women or male’s sensation since the penis does not touch the vaginal walls directly.
  • It may irritate the woman’s vagina due to the friction from the condom. The lubricant may or may not help in relieving it.
  • Some women or men can be allergic to the material used to manufacture the condom.
  • The condom may break or leak, resulting in unplanned pregnancy

General instructions for use

  • There are many brands of condoms and you should try to find the best fit for you. You should check the expiry date before using it. Be careful when opening the condom packet. You should not use teeth, sharp fingernails, scissors, or other sharp instruments to open it as these may damage the condom. Push the condom to one side and gently tear along the corner or edge. It should be easy to open the pack.
  • Once you remove the condom from the pack, check for defects such as holes, tears or if it feels unusual (stickiness), do not use it. Open another pack and repeat the steps above. You should not unroll the condom to check it because this could damage it and make it difficult to put it on.
    Use a new condom for every act of intercourse. Put the condom on after the penis is erect and before any contact is made between the penis and any part of the partner’s body.
  • If using a spermicide, put some inside the condom tip.
  • The teat end should be pointing up and you should always pinch the tip enough to leave a small space for semen to collect when you start rolling the rim of the condom over the penis until the base. The pinching will make sure to eliminate any air in the tip to help keep the condom from breaking.
  • If you are using water-based lubricant, you may put more on the outside of the condom.
  • After ejaculation and before the penis gets soft, hold the rim of the condom, and carefully withdraw the penis.
  • To remove the condom, gently pull it off the penis and make sure the semen does not spill out.
  • Dispose it in a proper way. Because condoms may cause problems in sewers, do not flush it down the toilet.
  • If the condom breaks, there is a chance you can become pregnant. You should consider taking emergency contraception or see your doctor immediately for advice. You should also get tested for STIs if you are not sure of your partner’s infective status.

To print a pdf copy, click HERE



This is a microscopic examination of the cervix, vagina, or vulva. It is used to diagnose potential abnormalities of these areas, which sometimes cannot be seen with the naked eyes. The colposcope can magnify the tissue by up to 30 times, thus making it clearer and much more accurate in terms of surface evaluation. Therefore, the biopsy of the abnormal areas performed with a colposcopic examination is more accurate than those done without the use of a colposcope.

Why do I need a colposcopy evaluation?

  • It is usually recommended if you have an abnormal Pap smear (Thin Prep) test or when pre-cancerous lesion is suspected in the vagina or labia area.

Read moreColposcopy

First visit to the gynaecologist – what you should know

Health screening as a person ages is especially important. It should be your top priority even if you are healthy. In women, this will include a visit to the gynaecologist’s clinic and will help in identifying if the woman has increased risks for developing a disease or already has the disease or condition that was not previously known about. Early identification of risks factors can help in counselling and instituting remedial or preventive measures to reduce that risk. This may in fact help to prevent the disease from occurring. Likewise, early detection of disease and starting treatment as soon as possible will results in a better outcome and lower the risks of complications. For example, many women with ovarian cancer do not have symptoms until it is too late. However, prompt diagnosis at an early stage of ovarian cancer will give excellent outcome with surgery alone and may not even need chemotherapy at all.
Many women feel nervous or even afraid to see the gynaecologist, especially if it is their first visit. Seeing a gynaecologist is just like seeing any other doctor in other specialities such as your dentist or general practitioner. They are there to help you and you should take this as an opportunity to seek their help in taking care of your health.

Read moreFirst visit to the gynaecologist – what you should know

Contraception – Hormonal implant (Implanon)

The main purpose of contraception (or birth control) is to prevent an unplanned pregnancy. You should know and understand the different types of methods available to you, the risks and benefits of each, and any possible side effects so that both you and your partner can able to make an informed choice. Contraception can be broadly divided into:

  1. Temporary or permanent methods – permanent birth control is accomplished through sterilization (tying or removal of the fallopian tubes) or hysterectomy (removal of womb/uterus). The rest of the methods are classified as temporary or reversible.
  2. Short term or long-term methods – short term methods are condoms and oral pills. Long term methods are injectables, intrauterine device and hormonal implants.

Hormone implant currently available is Implanon NXT®. It consists of a single plastic rod measuring 4 cm and contain a progestogen hormone called etonogestrel. Implanon is inserted surgically, just under the skin of the upper arm. The implant will release a minute amount of this hormone every day for 3 years. It works by preventing the monthly ovulation (the release of an egg from the ovary) during your menstrual cycle. It also thickens the vaginal mucus to prevent sperm from reaching the egg (fertilization). Continuous effect of the hormone will thin out the lining of the uterus (womb) to prevent attachment of a fertilized egg. Implanon does not contain any oestrogen.

Read moreContraception – Hormonal implant (Implanon)


Trichomoniasis (or Trichomonas vaginalis, TV) is an infection of the vagina and is caused by a parasite (a flagellate protozoan) that lives in the lower genitourinary tract. The disorder can involve the vagina, urethra and bladder in women. In men, it can affect the prostate gland and urethra.


Symptoms and signs

The symptoms varies from women to women. Some may not have any symptoms at all and may not be aware of this infection. Infected men may have no symptoms as well. Typical symptoms are:

  • Vaginal discharge which is foul-smelling, frothy and it is most noticeable after sexual intercourse or after menses.  The discharge color may be greenish or yellowish.
  • Vaginal itching and discomfort.
  • Redness of the vaginal lips (the labia) and vagina.
  • Painful urination especially if the labia is inflamed and the urine touches the surrounding area.


This is due to a parasite called Trichomonas vaginalis. The transmission from person to person is almost exclusively via sexual intercourse. It may live in its host without producing symptoms. Since it is usually transmitted sexually, both the sexual partners must receive treatment to eliminate it completely.


Read moreTrichomoniasis

Endometrial Hyperplasia

Endometrial hyperplasia is an overgrowth of endometrial tissue (which is the inner lining of the uterus which shed every month as menstrual blood flow). It is not cancerous. However, there is a form of severe hyperplasia which can be precancerous (especially when there is presence of abnormal cells called atypia). Classification of the hyperplasia includes:

  1. simple or complex (adenomatous) hyperplasia without atypia, or
  2. simple or complex (adenomatous) hyperplasia with atypia.

Patients who have endometrial hyperplasia without atypia usually respond well to progestogen therapy and are not at increased risk for uterine cancer. The progression of hyperplasia to endometrial cancer increases as the abnormal cells (atypia) of the hyperplasia develops.

Read moreEndometrial Hyperplasia

Bone mineral density testing (BMD)

This test is done to measure the density of bones and this is able to predict the risk of fractures. Bone density decreases in both men and women with age, but in women, the decrease is more rapid and more severe following menopause when the ovaries stop producing the oestrogen hormone. BMD testing can show whether there is significant bone loss, resulting in low bone mass. This is a major cause of osteoporosis and of bone fractures (partic­ularly the hip, spine or forearm) in men and women over the age of 40.

Osteoporosis is a reduction in the amount of bone mass resulting in the loss of bone strength. This will predispose it to fracture. Osteopenia refers to a decrease in bone mineral density and is less severe form compared to osteoporosis. Eventually, it is likely to lead to osteoporosis if no treatment is given.

Read moreBone mineral density testing (BMD)