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Potential Postpartum Complications To Be Aware of

The new love of your life is here, commanding much (all?) of your energy and focus. But your body is still adjusting to your baby's big entrance, so you need to take care of yourself, too. The postpartum period is a time of recovery, healing, and a wide variety of physical and emotional changes. It’s especially important to give yourself time to rest during this period because your body is vulnerable, and pushing yourself even a little bit could go a long way–and not in the direction you want.

1. Postpartum infection

After birth, some women may have postpartum infections affecting the urinary tract, uterus (called a puerperal infection), cesarean section wound, perineum tear, the upper respiratory tract, or the breasts. There are additional potential contributing factors for women who have had the following conditions and/or procedures:

Potential contributing factors of postpartum infection:

Cesarean delivery
Diabetes
Prolonged labor
Anemia
Internal fetal monitoring
Preexisting pelvic infection
Multiple vaginal exams during labor
Obesity

Indicators of infection after birth include:

Fever
Foul-smelling vaginal discharge
Lower abdominal pain
Chest pain

See your doctor right away if you think you may have an infection. Infections should be promptly identified and managed to help reduce the likelihood of more serious ailments such as sepsis, pulmonary embolism, septic shock, or other complications.

2. Hemorrhaging

Postpartum hemorrhaging (PPH) is a rare complication that can happen up to 12 weeks after giving birth. It causes excessive bleeding, and its most common cause is the uterus not contracting strongly enough after the placenta is delivered.

Potential contributing factors:¹

Uterine overdistension
Prolonged or rapid labor
Infection
Placenta problems
Preeclampsia
Obesity
Anemia

Indicators:

Heavy vaginal bleeding that doesn’t stop
Nausea or vomiting
Pale skin
Swelling and pain around the vagina or perineum

3. Stroke and intracerebral hemorrhage (bleeding in the brain)

Having a stroke during pregnancy could happen to anyone, and while it is relatively uncommon to have a stroke during pregnancy, elevated levels of stress, blood pressure, and gestational diabetes may all increase the likelihood of experiencing a stroke during pregnancy.

Potential contributing factors:

High blood pressure
Gestational diabetes
Blood clots

Indicators:

Sudden numbness
Sudden loss of vision
Sudden confusion
Severe headache for no obvious reason

It’s worth noting that these indicators of a stroke are sudden and appear to come from nowhere.² If you believe you or someone else is experiencing a stroke, be sure to seek medical attention immediately.

4. Pulmonary embolism (internal blood clot in the lungs)

A blood clot is when platelets, proteins, and cells in the blood stick together, usually to stop external bleeding, but sometimes they can form internally. Some blood clots after birth—such as those passed through the vagina—are normal, but when a blood clot forms in a vein in the leg and travels to the lungs, it can cause pulmonary embolism, a serious, life-threatening postpartum complication. If you know of a family history of blood clots or pulmonary embolism, be sure to let your doctor know.

Potential contributing factors:⁴

C-section delivery
Previous blood clot, a blood clotting disorder, or family history of blood clots
Obesity
Hypertension
Pregnancy over age 35

Indicators:

Shortness of breath
Fever
Chills
Clammy skin
Pain, redness, swelling, or warmth in one leg

5. Postpartum preeclampsia (high blood pressure)

Preeclampsia is a type of high blood pressure that can be developed during or shortly after pregnancy. It is relatively rare in the United States, but unaddressed postpartum preeclampsia can lead to serious complications and should be addressed as soon as possible.

Potential contributing factors:

Obesity
Family history of postpartum preeclampsia
High blood pressure during pregnancy

Indicators of postpartum preeclampsia:

Headaches
Nausea
Abdominal pain

6. Postpartum depression

If you’re feeling down, overwhelmed, or just not yourself–it’s not always the baby blues. Mood swings that don’t go away or feelings of extreme sadness, guilt, or hopelessness can all be indicators of postpartum depression, which is a type of depression that affects moms after pregnancy.

Potential contributing factors:⁵

Hormonal changes
Personal or family history of depression, anxiety, or mental illness
Emotional stressors
Lack of support

Indicators:

Baby blues that don’t go away
Debilitating sadness
Overwhelming feelings of hopelessness or guilt
Severe anger
Not bonding with the baby
Trouble concentrating and making decisions
Changes in appetite
Feelings of harming baby or self

7. Peripartum cardiomyopathy (weakness of the heart muscle)

Peripartum cardiomyopathy is a relatively rare condition where the heart is weak and enlarged. It usually occurs shortly after delivery. Many women experience mild indicators such as swelling in the feet or legs, and in more severe cases may be very short of breath. Many women recover quickly regardless of the severity.

Potential contributing factors:

A weak or injured heart
Obesity
Personal history of cardiac disorders such as myocarditis
Use of certain medicines
Smoking/alcoholism
Poor nourishment

Indicators:

Shortness of breath
Heart palpitations
Swelling in the legs

8. Mastitis (swollen breasts)

Mastitis is inflammation of breast tissue that may be caused by infection. Mastitis usually affects nursing moms, but anyone, including women who are not pregnant and men, could have mastitis.

Potential contributing factors:⁷

Nursing moms during the first six to 12 weeks of breastfeeding
Previous mastitis
Sore or cracked nipples

Indicators of Mastitis:

Swelling, redness, and pain in one or both breasts

About potential contributing factors:

Keep in mind that the above are just some of the potential contributing factors associated with each condition. Having a potential contributing factor doesn’t mean you will definitely develop a complication. Not having any potential contributing factors won’t rule out the chance that you could. Don’t hesitate to talk to your doctor about your any uncertainties or concerns and what you could do to possibly reduce your chance of developing complications.

Indicators you should NOT Ignore

While you’re busy doting on your bundle of joy, it’s important not to ignore anything that could indicate a possible postpartum complication.

See your doctor if you have...

Bleeding that soaks a pad every hour for two hours
Foul-smelling discharge
Severe abdominal pain
Pain at your cesarean incision site
A fever of 100.4°F or higher
Urinary problems including difficulty urinating, dark urine, or burning
Swelling, discharge, redness, or bleeding from your cesarean incision or episiotomy site
A hot, painful, and swollen area of the breast

Call 911 if you experience…

Weakness or numbness in the face, arm, or leg, especially on one side of the body
Sudden vision problems
Severe headache
Confusion or difficulty speaking
Chest pain
Red or swollen leg that’s painful or feels warm to the touch
Seizures
Thoughts of hurting yourself or your baby

Postpartum complication avoidance tips

Be proactive

Speak with your doctor about postpartum care before you deliver. Discuss your potential contributing factors for potential postpartum complications and determine if you may require extra postpartum care or specialized attention.

Know what to look out for

Understand what you can expect after childbirth and what could be a red flag that something isn’t right. Identifying an early indicator of a complication can help you manage it better than catching it late.

Keep communication open

You will typically have a comprehensive postpartum checkup within 3-6 weeks after giving birth. However, you shouldn’t hesitate to reach out to your doctor earlier if you have any concerns.