Varicose veins are bluish, twisted, dilated, prominent veins which usually develop on the back of the calf or the inside margin of the leg. They are particularly likely to develop in, first because the hormone progesterone causes the smooth muscle of the vein walls to relax, and second because the increasing size of the uterus tends to constrict veins in the abdomen and make it difficult for blood to return easily to the heart from the legs. Varicose veins are, however, comparatively rare during a first . Because varicose veins tend to improve after pregnancy, surgical treatment is not usually necessary. Support stockings or tights or elastic bandages, which a doctor will show the woman how to apply, bring some relief from the symptoms of pain and swelling and help to reduce the damage to the vein wall. She should wear them all day and preferably put them on before getting up in the morning. She should also try to avoid standing or sitting still for long periods, and when she does sit down, put her feet up.
Vulval varicosities, that is varicose veins of the vulva,* may also develop, causing pain and irritation. The support provided by tights or close-fitting stretch pants will help alleviate these symptoms. Haemorrhoids, often called piles, are essentially varicose veins of the rectum. Some of the factors
which cause a woman to developduring pregnancy are the same as those which makes her susceptible to varicose veins of the legs. In addition, straining because of constipation often plays an important part so she should try to adjust her diet to avoid this. The doctor may prescribe a soothing cream. Minor normally regress after pregnancy, but if a woman has suffered badly her doctor may advise her to have the haemorrhoids surgically treated before another pregnancy.