Pregnancy is such a special and transformative time in our lives, but as health professionals we also understand there are a lot of uncertainties.

You feel a random pain or weird sensation, and you think – is this normal because I’m pregnant? What sensations are not-normal? 

Here at Her, we fully get that sometimes you just have no idea what you should and shouldn’t be freaked out by. A common concern we get in pregnancy is heaviness and vaginal pressure. On one hand, you have the weight of a growing baby, uterus, placenta, extra fluid and blood etc. – so we can expect some extra pressure right? But when does it become something to see us about?

I wanted to share with you a client story of this amazing second-time mama that I’ve seen recently.

She presented to the clinic quite concerned about the potential of having a uterine prolapse early in her pregnancy, she felt a lot of heaviness and vaginal pressure, which she felt with her first but it wasn’t this early on.

On assessment, I found it wasn’t a prolapse but actually a vulval varicosity/varicose vein!

Varicose veins are somewhat normal and harmless for the pregnancy, although, despite that, they can be extremely painful and uncomfortable for the mother. They are more common in summer (we love our Sunny Coast but this does not help us out!), due to increased pressure on the vascular system.

When it comes to varicose veins, unfortunately, we cannot get rid of them or stop them; it is more about managing them to reduce the discomfort experienced, and riding them out until after birth, where they usually just disappear again with the reduced load on the vascular system. They behave a lot like other venous conditions – pressure, gravity, and pelvic blood flow all influence how ‘full’, swollen, or symptomatic they feel. 

To help ease the discomfort for this mumma, we implemented the below management:

• Avoiding positions that increase venous pressure and decrease drainage:
  • Prolonged standing (gravity increases pooling in pelvic and vulval veins)
  • Sitting upright – especially on firm surfaces (direct pressure on perineum reduces venous return)
  • Deep squatting (compresses pelvic veins and increases intra-abdominal pressure)
  • Hip flexion-heavy positions (curled sitting/leaning forward)
  • Lying flat on back (uterus compresses inferior vena cava -> worsens venous congestion)
  • End of day/fatigue (cumulative venous pooling)
• Implement positions that decrease venous pressure and increase drainage:
  • Left side-lying (reduce vena cava compression -> improves venous return)
  • Side-lying with pillow support between legs (offloads direct vulval pressure)
  • Modified child’s pose (knees wide and chest supported – encourages pelvic drainage without compression)
  • Leg elevation (assists venous return, better for leg varicosities but still helps!)
  • All fours/hands and knees (takes pressure off perineum and pelvic veins)
  • Gentle walking (muscle pump improves circulation = better than static standing)
• Using ice on the area, at certain times and certain ways, is also helpful to reduce the swelling and ‘bulging’ sensation
• Perineal compression undies and shorts can drastically reduce the heaviness of the circulation to the area, especially because she was working a job where she had to be upright a lot – these were game changing! Use our code HER15 for a discount on Everform compression shorts/leggings

I hope you enjoyed that interesting snippet of a more taboo topic in pregnancy. It just goes to show something is not always as it seems, and your best bet is to always mention your symptoms to us, no matter how normal or non-normal they may be!

If you have anything ‘strange’ or ‘different’ going on in your pelvic area or vagina, we are your go-to girls – never assume – it is always worth the check. 

Book a FREE discovery call with us here if you’re unsure it’s something we can help with, or book your pelvic health appointment with one of our amazing Women’s Health physios today, we have many different specialties you can read here.

Book your appointment here.

Love you all, and thankyou for supporting us here at Her x