The most painful pregnant condition

Pregnancy can do funny things to your body. Just about everyone has heard of things like “morning” sickness, fluid retention and swelling, joint pain, and heartburn.

But there is a condition that may be the most painful side effect of pregnancy which is not talked about as often: vaginal and vulval varicose veins. In hindsight, I know that I developed this condition during the last few weeks of my second pregnancy. I didn’t realize it at the time and never got a mirror to check, but near the end I felt a lot of pressure down low in my groin and was particularly uncomfortable sitting for long periods of time.

With my third pregnancy I began to notice that uncomfortable feeling of too much pressure down low at 25 weeks. That seemed strange, the baby was not big enough to be causing that much pressure. I had trouble sitting for more than 15 minutes at a time and at first I thought it was just hip pain. Changing position seemed to help. The pain quickly became severe enough that I had to check out what in the world was going on down there.

I held a small mirror in position and when I saw my groin I almost dropped the mirror in shock. The entire external genital area was swollen to about three times its normal size and grotesquely large veins bulged out over the labia, looking as if they’d been stuffed with walnut halves. I had never heard of anything like this happening with pregnancy. I called two physicians whom I knew and soon had an explanation:

Vaginal or vulval varicose veins were caused by the expanding uterus interfering with the blood return from the legs. They were more common with “multips” (people who had experienced more than one pregnancy) and might be associated with inactivity or poor muscle tone. (I had experienced 2 months of almost complete inactivity earlier in the pregnancy, courtesy of the swine flu and a bad bought of nausea and fatigue).

Would they cause any problems with delivery? No.

Would they go away after I delivered? Yes. Immediately.

Would they continue to get worse as the uterus grew in size? Most likely.

Could they be this painful? Yes. They were VERY painful.

Was there anything I could do about it? Any treatment? No. I could spend more time lying down.

After this explanation from the physicians and a rather non-helpful visit to my own OBGYN where he confirmed what I already knew and said, “Wow. That’s a really big one. So is that one over there. Boy, that one’s huge. You’ve got a bad case.”, I began to probe the reservoir of womanly knowledge contained in my friends and acquaintances.

This condition was not as uncommon as I would have thought. I found a dozen or so people who I knew directly or indirectly who had experienced these “varicosities.” Those who had experienced it found it so painful that they crawled on their hands and knees around their house rather that walk. One said she got an epidural when she was in labor just to have relief from the varicose veins; her contractions were nothing compared to them. And with every single women I talked to, the pregnancy where the varicies developed was her last pregnancy.

The good news was that everyone I talked to recovered. Very soon after delivery they said they felt fine and could stand without pain. In the mean time, it seemed that the only thing I could do was to spend more time laying down.

When the pain got to be too much I was able to get complete relief if I positioned myself so that my heart was lower than my pelvis. In the beginning weeks I reverted to this position several times a day:Despite what I had heard, I was hopeful I wouldn’t have to lay down all day every day. We ordered a prenatal cradle with V-brace support and tried it out:It would have helped if the varicose veins had not been quite as severe and if I did not have internal swelling as well (a puffy painful area in the lower left quadrant of my abdomen that only hurt when I was upright or standing). If I had been 36 weeks instead of 26 weeks pregnant, perhaps I would have worn it all day every day and been able to be upright more. But as my belly grew so did the swelling and accompanying pain. Within a few weeks it was ineffective.

By 30 weeks I gave up and decided I had to be on almost complete bed rest. I had about 5 minutes of “up” time for every 5 hours laying down. If I was up more than that I developed referred pain in my back and abdomen and was in constant pain for at least a day. If I respected my limits, then at least I wasn’t in pain while laying down.

Each time I stood up there was a half second pause as the tissue swelled and then the pain hit. It was a strong enough pain that I had to breathe through it to keep from gasping or crying out. That level of pain continued until I returned to a horizontal position.

There was one thing that did help: exercise. I could tell from one day to the next that my pain was more tolerable if I exercised. And when my heart rate was sufficiently elevated I could be moving around without the swelling. It was such a positive thing for me mentally to be upright without that pain. Here’s a picture of my son doing “side crunches” with me: As the weeks went by I had to modify my exercise routines with more and more “downward facing dog” poses or other “hip above heart” positions to relieve the swelling and pain, and then I developed trouble breathing and had to stop exercising completely (different story). Three days after I stopped exercising I noticed the eruption of 6 additional large varicose veins. There is no question in my mind that exercise helps tremendously to prevent this condition and if you develop it, then exercise helps to moderate the pain and swelling.

The last 5 weeks of the pregnancy I was pretty miserable. I only got out of bed to go to the bathroom or visit the doctor’s office or my weekly massage appointment with a massage therapist who lived 2 miles away from home. The massages helped and it was a nice thing to look forward to each week.

During that last month, I was never upright for more than 5 minutes at a time. I crawled to the bathroom rather than walk. I wondered if I had developed some strange psychological hyper-sensitivity to pain. It seemed to me that there was no other physical condition in the modern world where I could be in this much pain. Anything else would entitle me to some powerful pain killers, but being pregnant I was told I could try ibuprofen. It was like blowing in the wind; acetaminophen couldn’t touch this.

I tried my best to appreciate the quiet time being on full bed rest provided. I read lots of books to my two young kids:We put a mattress downstairs and once a day I got up and had a change of scenery. The kids enjoyed more cuddle time and mom attention. I was always available now and never busy doing laundry or cooking dinner. Church members came in shifts and took care of us while my husband was away from home, and my mom came 3 weeks before the baby was born to help full time.When I went into labor my husband Serge joked that labor would be nothing compared to what I’d been through already just being pregnant. That might have been true if I had not also been pregnant while experiencing labor. The varicies were still there, and I could only tolerate being upright for 5 to 10 minutes at a time.Here we are checking into labor and delivery. This was my standard “out in public” pose. For doctor’s visits the last couple months of the pregnancy I would walk where I needed to, and then find a chair and lean forward like this for relief from the pain. Or I would lay on the floor. I didn’t care at all what other people thought about this behavior; it was too painful to stand or sit.

A lot of my labor was spent leaning over the birth ball and laying on my side in bed. Labor this third time was long: 25 hours, with most of it spent stalled at 8 to 9 cm dilation. I didn’t have an epidural, partly because of personal quirky prejudice (thought of a needle in my back creeps me out), partly because I felt it would be better for us medically to be unmedicated (my blood pressure was low during the pregnancy (80/40) and the strange breathing issues I’d had made me a little nervous to introduce any additional risks), and partly because I felt the need for some assurance that I still had a decent pain tolerance.

I delivered in a side laying position with my mom holding my right leg so I wouldn’t need to expend energy holding it up. There were no complications from the varicies and I only had a very minor tear along the perineum where I had torn in previous deliveries.

Our baby was born healthy and beautiful and it was such a relief to be holding her in my arms! I was weak and exhausted, but now very hopeful that sometime soon I would be able to stand up without feeling like I’d been smacked in the groin with a baseball bat.

The two days postpartum that I was in the hospital, the nurses came every four hours to do vital signs and check out my bottom. Standard practice to make sure that any stitches are healing well and to also look at bleeding. Every nurse that looked at me gave a little gasp of surprise and exclaimed “Wow. You’re really swollen.”

I checked the view with a mirror and it was the same picture I’d seen the last couple months, which terrified me. Why wasn’t it getting better? Every doctor had told me it would go away as soon as the baby delivered. Had the interruption of venous flow been so severe that I would be permanently handicapped and never able to stand or sit without pain? I could only wait and see.

Three days postpartum: the situation remained unchanged. The area was very swollen and I had a huge onslaught of pain every time I stood up (which was not often, I only got out of bed to use the bathroom).

Four days postpartum: the varicose veins and swelling were still there. I wondered if I’d ever recover.

Five days postpartum: a significant improvement. Still painful, but not nearly as bad.

Six days postpartum: The magic moment came. I stood up in the morning to pee, and there was no pain. I could hardly believe it. No swelling, no pain. I was standing, and I was not in pain! It seemed miraculous, and completely amazing.

Since then, I have had no discomfort or problems associated with my groin, but I’ve known some women who have had perpetual troubles after a bad bought of vulval or vaginal varicose veins. The two women I know who still had difficulties years later didn’t go on bed”rest.” They continued to be upright and “toughed it out.” I think it’s better to listen to your body. If the pain is that severe, then lie down. You might be able to get by pretty well by spacing your “up time.” For example: four 5-minute intervals of standing would be much better tolerated than 20 minutes of continuous standing.

When I was pregnant, the only information I found online about vaginal varicose veins were occasional notes on midwifery forums and a few odd references. There was not much to glean from the internet. I did some searching tonight and found a lot more references, but still, this isn’t an issue that’s easy to find information about.

I’m hoping that this post will reach someone who has just learned that they’ve developed this condition. I would have loved to have read this when I was first searching for help and information two years ago. I would have wanted to hear this reassurance:

Yes, it is VERY painful. But you’ll be OK! Hang in there and figure out a way to spend more time in bed. Ask for help from neighbors and family. Ignore what you read about varicose veins in the legs unless you also have varicose veins there.

The pain is all positional: if your heart is above your pelvis then you will be hurting, if it’s even or below then you should feel fine (as long as you respect your body’s limits and lay down often). Exercise will help. I recommend DVDs over walking because it’s easier to modify them with downward dog or stop and rest as needed. If your heart rate is increased and the muscles in your legs are contracting then they push the blood though the veins and keep them from distending as greatly. This is why exercise provides pain relief (to a point). If you have access to a pool, swimming is ideal because you are in a supine position but also have the benefit of increased circulation.

Massage also helps, quite a bit. I went for weekly massages the last two months of the pregnancy and asked my massage therapist to work the entire hour on my hips, upper legs, and lower back. When I stood up after the massage it was like I’d been moved back in time a few weeks. The pain was much less! This relief only lasted a couple of hours, but it was still very nice.

A V-brace type of support to provide counter pressure to the groin might help, but if you have internal swelling too then this will not be a solution. Internal swelling in deeper veins often accompanies a bad case of external varicose veins. You will know you have this as well if the pain is severe and pressing your hand (or a special support) against the external veins doesn’t completely relieve the pain. Listen to your body and lie down. You don’t want to have issues for years to come. Bed rest for a couple of months is better than chronic pain following the pregnancy. The chance of perpetual issues is slight, but it can happen.

This condition will not affect your delivery much (apart from making upright laboring positions more painful) but you should not have an episiotomy because there is a potential risk of increased bleeding if a varicose vein is cut before the head comes through and deflates it. If your varicose veins are on the mild side (which still can be very painful) you might be pain free while standing the day after delivery. If they are more severe it will take longer. Be patient and rest. It will heal.

And lastly, you’re not alone. More people have experienced this than you would think, but it’s not talked about as openly as heart burn or vomiting, simply because of its location.


26 thoughts on “The most painful pregnant condition

  1. Thank you!
    This reading was very helpful to me! I should have exercised since the beginning of my pregnancy, but I thought that taking care of my first baby would be enough. In addition I got pregnant only 6 months after. Anyway, it was great to read this!

  2. Thank you so much for this advice and reassurance. I am 33 weeks with my third baby, had vv’s towards the end of my second (with no help or advice whatsoever) and from 13 weeks with v2 supporter and reduced activity this time. I’m rubbish at resting so you have inspired me to try harder to do so! Thank you and God Bless x

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  4. Thank you, thank you, thank you. I’m in a similar boat just shy of 20 weeks into my second pregnancy. The discomfort started early, around 12 weeks, and I thought I had a pelvic floor prolapse. When I had a doctor take a look and she said my pelvic floor looked great, I was relieved and confused. Later, I took a look with a mirror and saw the severe swelling on the left side, and sure enough I have spider veins and some bulges going down my left leg as well. I have a very active job, so I hope I’m not too stubborn and able to respect my body’s needs. 20ish more weeks to go, so I guess we’ll see! Also, I totally appreciated the comment about epidurals, I had my first daughter naturally and plan on the same for this one because I also find a needle in my back to be scarier than labor:-D

  5. OMG I think I am getting something like this. My inner lips have swollen to the point where they protrude more than my outer lips. I am 6 months pregnant.

    I do not see any veins or irritation when I look in the mirror but when walking the edges of the lips are very sore. At first I thought it was an allergic reaction to my pantyshield but there is no visible sign of irritation at all.

    At home I walk with my legs open but at work I take really small steps so no one notices too much.. I really hope it does not get worse. The funny thing is I am quite active. I go to the gym regularly. However at exactly 6 months I am getting this sore swollen feeling of my inner lips down there. So uncomfortable. aaah… I can sit but walking feels like I am having major friction down there.

  6. Thank you for writing about this
    I am only 5 weeks into my second pregnancy. I’m not over weight. I don’t eat bad but I don’t eat very well either. (That has changed) But it is so painful. Lying on the bed crying because it hurts so bad. I did order a groin compression belt so I am hoping that will help.

  7. I wish I had read this sooner. I don’t seem to have as much pain as you but my varacies are more wide spread (pelvis to ancles) and my spirt is so deflated. It has really been a painful process.
    Also thank you for posting pictures. I’ve only gained 10lbs (27 weeks) and it’s hard to understand when you don’t have excess weight gain how so much “damage” can occur.

  8. All these years later and this post is still so helpful – thank you for putting this out there! I’ve never heard of anyone with this condition and it’s such a relief to hear it goes away.

  9. Thank you so much for posting this. I’m pregnant with my third and last pregnancy got awful varicose veins in left leg (gnarled like a bicycle chain, hideous veins) – and my vaginal area. The swelling and pain and distended feeling is already bad and I’m only 15 weeks…you give me hope’

  10. Thank You SOOO MUCH!!!! I am 18 weeks pregnant. It’s my 3rd pregnancy. I have never seen or heard anything like this before! I didn’t know what was happening to me! I had TIA (mini stroke) when I was 12 weeks pregnant! Now, I have this!
    Last week, when I was 17 week pregnant, I felt a strong push down there. It felt like baby was ganna come out. I had to hold down there to stop the pain. It lasted about a day. The next day, when I was using the bathroom, I felt something big down there. I looked in the mirror. I was SHOCKED, SCARED, and HORRIFIED! My vulva was swollen and very tick Veins only on the right side. I started getting a lot of varicose veins on my RIGHT LEG ONLY. I didn’t know what was happening to me. I was very scared because this was just the beginning of my pregnancy and I had many more weeks to go and I have gone a lot already!
    I didn’t know what this thing was called. I read more and more vulva varicose veins and learnt more about it. I learned that it will get worst each day however it will go away, a few days or weeks after the delivery. Each person is different! Each pregnancy is different so it will take everyone different amount of time to heal. I also found out that you have to sleep on your LEFT SIDE during pregnancy. I was pregnant twice before and NOONE told me that!!! I always slept on my right until I learned it was wrong!

  11. Did you not try completion tights and the V2 support underwear? I’m sure I’d be on bed rest without them. They are saving my life right now.

  12. I am having my third and had “the Vein” with my other 2. With my last son it was, like yours, “the worst anyone had seen”. I am trying to be hopeful and bout the third time but I feel it when I cough at 12 weeks. I know its coming. I may try the brace although eventually I know it may not work. It is nice to hear of someone who has experienced the same thing.

  13. Thank you for your post, it is reassuring to hear that someone else was in as much pain as me but managed somehow to get through it. It seems very hard to talk about; everyone asks how the pregnancy is going and you cant really say, ‘well i can hardly walk because of swollen veins in my vagina!’

    Thanks for taking the time to tell your story!

  14. Thank you for your post, it is reassuring to hear that someone else was in as much pain as me but managed somehow to get through it. It seems very hard to talk about; everyone asks how the pregnancy is going and you cant really say, ‘well i can hardly walk because of swollen veins in my vagina!’

    Thanks for taking the time to tell your story!

  15. Thank you
    Thank you
    Thank you
    It’s so good to hear everything will be ok, that other women go through what I’m experiencing right now. I have 10 more weeks to go! I hope you and your kids are doing wonderfully.

  16. Thank you for sharing. It is so true that it’s hard to find resources out there that could help me be prepare for this condition during labor and how to manage it during pregnancy.

    I’m 30wks and the pain has slowly increase as the baby grows. I also have sciatica which makes it hard for me to raise my leg. What are some exercise(s) you recommend?

  17. Thank you. The most helpful thing I have read yet. When people ask me how I am “feeling” with this pregnancy (I am 44 having my 3rd), and “tired” all I can answer is “you have no idea”, or “it’s all worth it.” Kind of too personal to explain that I can hardly close my legs cause my labia are inflated like balloons and I feel like everything will fall out of my bottom. Ha!

  18. Hi, I’ve the condition for about 2 month with my first pregnancy and from 12 month onwards with my second.
    I agree it’s horribly painful and this time around my whole leg is affected as well. But a word of encouragement, as I am an extremely active person I wasn’t gonna give in; I bought compression tights as they my leg as well as keeping my vulva in place. I have been wearing them every day for three month now and they are a god sent. I have less then two weeks to my due date now and hope the veins will disappear straight after birth again.
    Good luck everyone

  19. I thought my body parts were falling out, but after two examinations (the midwife was stumped at what this blob protruding out of me was so she called in a doctor), they said it was basically a bulging varicose vein. I have zero of these anywhere on my exterior, and hadn’t realized they were even possible internally. I am just glad baby is fine and my organs seem to be in check. Thank you so much for publishing this article!! I am in constant pain and feeling like I’ve been giving birth to some stubborn corn on the cobb… I’m 30 weeks with my first and it’s been a nightmare since week 5. Sometimes misery just needs a little company. Thank you.

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