Who is at risk for postpartum complications?

Although childbirth gives rise to new life, unfortunately about 700 women die from pregnancy-related complications each year in the U.S. 

Not all postpartum complications turn serious, but chronic conditions such as heart disease, obesity, or high blood pressure can increase the risk of pregnancy-related death.

Most postpartum complications occur within 15 days after childbirth. It’s important to monitor your health after giving birth to look for any warning signs.

What are signs of postpartum complications?

After childbirth, you may be more focused on caring for your baby than yourself. This may result in neglecting your own health and missing some signs of complications that may occur within a few days, weeks, or even months after the delivery of your child.

Call your doctor right away if you experience any of these signs or symptoms:

Wound infection

• Fever higher than 100.4 degrees F
• Discharge, pain, or redness around the C-section wound
• Vaginal wound that does not heal or worsens

Heavy bleeding 

Bleeding that is heavier than your normal period or that keeps increasing is a sign of postpartum hemorrhage (PPH), or uncontrolled bleeding that occurs after delivery. This is a serious condition that requires immediate medical attention.

Breast redness and pain

Redness, pain, tenderness, or swelling in the breast may indicate an infection called mastitis.

Painful lumps in the breast

Hard, painful lumps in the breast may also be a sign of mastitis. Lumps are more likely to form because of breast engorgement, which occurs when you don’t release milk regularly or forget to clean your nipples after each feed.

Severe pain in your lower abdomen

You may have a urinary tract infection (UTI) or endometritis, which is inflammation in the lining (endometrium) of the uterus.

Foul-smelling vaginal discharge

This may be a sign of either endometritis or bacterial vaginosis. Bacterial vaginosis occurs when good bacteria decreases in your vagina, leading to an overgrowth of harmful bacteria.

Pain or burning sensation while peeing

You may have a UTI and experience additional symptoms such as pain in the lower abdomen.

Pain, swelling, redness, or warmth in your legs

You may have deep vein thrombosis (DVT), which is the formation of blood clots in the deep veins of the leg. Being overweight or being on prolonged bed rest can increase the risk of developing this condition.

Sudden shortness of breath

This may be a sign of pulmonary embolism. This occurs when blood clots due to DVT get lodged in the big (pulmonary) vein that carries blood to your lungs.

Changes in vision, dizziness, severe headache

You may have postpartum preeclampsia, characterized by high blood pressure and increased protein in your urine. Although rare, this is a serious condition that can lead to kidney and liver problems.

New-onset chest pain

This may be a sign of heart disease. Other signs of heart disease include breathlessness, chest pain radiating to the arms or back, and nausea.

Depression

Postpartum depression (PPD) can fill you with feelings of anxiety and hopelessness caused by the sudden change in your life brought about by the birth of your baby. You may be unable to take care of yourself and your baby. In severe cases, PPD can lead to suicidal thoughts.

Medically Reviewed on 6/10/2021

References

Pregnancy-related deaths. https://www.cdc.gov/vitalsigns/maternal-deaths/index.html Warning signs of health problems after birth. https://www.marchofdimes.org/pregnancy/warning-signs-of-health-problems-after-birth.aspx

Labor and delivery, postpartum care: Postpartum complications: What you need to know. https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/postpartum-complications/art-20446702

• Some discomforts after giving birth are normal. But new moms may be at risk of serious health conditions that need medical care.

• Learning signs and symptoms of health complications may help save your life. Getting treatment quickly may help prevent certain life-threatening conditions. 

• Life-threatening conditions that can happen after giving birth include infections, blood clots, postpartum depression and postpartum hemorrhage.

• Warning signs to watch out for include chest pain, trouble breathing, heavy bleeding, severe headache and extreme pain.

• If you think your life is in danger, call emergency services (911) or go to a hospital emergency room.

Your body goes through lots of changes after giving birth, and it needs time to heal. It’s normal to feel some discomforts in the weeks after you give birth, like being sore and really tired. But some women have complications after having a baby that can cause serious, life-threatening health problems. If you’re worried about how you feel or you have pain or discomforts that don’t feel right, call your health care provider. If you think your life is in danger, call emergency services (911) or go to a hospital emergency room.  

All women need postpartum care after giving birth. Postpartum care is medical care for women who just had a baby. Go to all of your postpartum checkups, even if you’re feeling fine. These are medical checkups you get to make sure you’re recovering well from labor and birth. They help your health care provider spot and treat health conditions you may have. Postpartum care is important because new moms are at risk of serious and sometimes, life-threatening health complications in the days and weeks after giving birth. Too many new moms die from problems that could have been prevented. 

What are warning signs to look for after giving birth?

In general, warning signs of serious health conditions include chest pain, trouble breathing, heavy bleeding and extreme pain. If you have any of these signs or symptoms, call your provider right away. If you think your life is in danger, call emergency services (911) or go to the emergency room. 

Signs of a condition are things someone else can see or know about you, like you have a rash or you’re coughing. Symptoms are things you feel yourself that others can’t see, like having a sore throat or feeling dizzy.

Call your provider if you have any of these signs or symptoms:

Signs and symptoms of infection

• Fever higher than 100.4 F. You get a fever when your body is trying to kill the virus or bacteria that caused an infection.
• Discharge, pain or redness that doesn’t go away or gets worse around a c-section incision (cut), episiotomy or perineal tear. A c-section (also called cesarean birth) is a surgery in which your baby is born through a cut that your doctor makes in your belly and uterus (womb). An episiotomy is a cut made at the opening of the vagina to help let the baby out during birth. A perineal tear is a tear in the perineum, which is the area between the vagina and the rectum. Your perineum may tear naturally during vaginal birth.
• Pain or burning when you urinate (pee), pain in your lower back or side or needing to pee often. You may have a urinary tract infection (also called UTI), like a bladder infection called cystitis or a kidney infection called pyelonephritis.
• Red streaks on your breasts or lumps in your breast that are new and hurt. You may have a breast infection called mastitis. This can happen when you have a plugged duct, you miss or delay breastfeeding or your breasts become engorged (swollen and full of milk).
• Severe pain in your lower belly. You may have endometritis. This is inflammation (redness or swelling) in the lining of the uterus.
• Vaginal discharge that smells bad. You may have endometritis or an infection called bacterial vaginosis (also called BV). BV happens when there’s too much of a certain bacteria in the vagina.

Sometimes the body has an extreme response to infection called sepsis. Sepsis can be life-threatening. Call 911 or go to the emergency room if you have any of these signs or symptoms of sepsis after giving birth:

• Chills or feeling very cold
• Clammy or sweaty skin
• Fast breathing
• Fast heart rate
• Feeling confused
• Fever
• Having extreme pain or discomfort

Signs and symptoms of other health conditions

• Bleeding that’s heavier than your normal period or bleeding that gets worse over time. You may have postpartum hemorrhage (also called PPH). PPH is when a woman has heavy bleeding after giving birth. It’s a serious, but rare condition that can happen up to 12 weeks after having a baby.
• Pain, swelling, redness, warmth or tenderness in your legs, especially in your calves. You may have deep vein thrombosis (also called DVT). This happens when a blood clot forms deep in the body, usually in the lower leg or thigh.
• Changes in vision, dizziness, severe headache, pain in the upper right belly or in the shoulder, trouble breathing, sudden weight gain or swelling in the legs, hands or face. You may have postpartum preeclampsia. This is a serious condition that happens when a woman has high blood pressure and signs that some of her organs, like her kidneys and liver, may not be working normally after giving birth.
• Chest pain, coughing or gasping for air. You may have a pulmonary embolism (also called PE). An embolism is a blood clot that moves from where it formed to another place in the body. When the clot moves to a lung, it’s PE. PE is an emergency.
• Feeling sad or hopeless for more than 10 days after giving birth. You may have postpartum depression (also called PPD), a kind of depression some women get after having a baby. PPD is strong feelings of sadness, anxiety (worry) and tiredness that last for a long time after giving birth. These feelings can make it hard for you to take care of yourself and your baby. PPD is a medical condition that needs treatment to get better.
• Feeling sick to your stomach or throwing up. You may have PPH or cardiovascular disease (also called heart disease). Heart disease includes conditions that affect the heart and blood vessels. They often affect the heart muscle or involve narrowed or blocked blood vessels that can lead to a heart attack or stroke.

Last reviewed: July, 2018

See also: Your body after baby: The first 6 weeks, Your postpartum checkups, Pregnancy-related death, maternal death and maternal mortality