Foot Health in Pregnancy: Evidence-Based Evaluation And Podiatric Care Recommendations

Abstract

Pregnancy-related biomechanical adaptations cause morphological and functional changes in the foot and lower extremity, leading to pain, oedema, imbalance and reduced quality of life. This narrative review aims to summarise evidence on changes in foot health during pregnancy and the postpartum period and to propose a trimester-based framework for podiatric assessment and care. Studies addressing body biomechanics in pregnancy, plantar pressure distribution, gait patterns, foot morphology, low back and pelvic girdle pain, fall risk, risk factors, assessment tools and podiatric interventions were examined. The literature indicates that, particularly in the second and third trimesters, flattening of the medial longitudinal arch, increases in foot length and width, elevated midfoot plantar pressure, a rise in lower extremity oedema and gait adaptations aimed at maintaining stability are frequently observed. Factors such as obesity, multiparity, pre-existing foot deformities, diabetes, rheumatologic disease and prolonged standing increase vulnerability; however, these variables are not systematically considered in routine antenatal follow-up. The Foot Posture Index, pedobarography, circumferential measurements and simple balance tests appear feasible for monitoring foot and lower extremity loading in pregnancy, yet randomised controlled trials evaluating podiatric interventions remain limited. In light of these findings, a trimester-structured clinical decision framework may help standardise risk stratification, assessment intervals and care. In conclusion, the review highlights that foot health in pregnancy should be recognised as an integral component of antenatal and postpartum care, and that risk-based assessment, appropriate footwear and orthotic use, oedema and balance management, exercise and structured educational programmes should be planned within a multidisciplinary team.