After having a baby, your body is recovering by naturally cleaning itself and going through the healing process. For a mother, this amounts to a whole lot of discomfort from cramping and bleeding to body swelling to tender breasts to hair loss to pain sitting down to even having difficulties using the toilet.
Although these things are all normal and nothing to worry about, there is a risk of having more serious postpartum complications. They’re not super common, but pregnancy-related deaths have been increasing.
Postpartum complications on the rise
When the Pregnancy Mortality Surveillance System was instituted in 1987, there were around 7.2 pregnancy-related deaths per 100,000 live births in the U.S. As of 2018, that number had risen to 17.4 deaths per 100,000 live births, which equates to about 660 maternal deaths. Out of those numbers, postpartum deaths among black women were more than three times higher than that of white women.
The biggest cause for these rising numbers seems to be a lack of knowledge and awareness.
Most mothers don’t have their first postpartum doctor visit until four to six weeks after giving birth, but a whopping 40 percent don’t have any kind of postpartum checkup at all. Due to lack of resources and rising healthcare costs, a large percentage of women completely forego postpartum care.
This means that a lot of postpartum complications go undetected until it’s too late.
Three out of five birth-related complications could be treated and prevented if women knew the warning signs and when to seek medical help. That’s why we’ve put together a resource to help you be more aware of what’s normal, what’s not, and when you should call your doctor.
Common postpartum complications
Things that women normally experience after giving birth can sometimes turn into serious issues. Following are some of the most common postpartum complications.
Some postpartum bleeding is normal in the first few weeks after delivery, but the bleeding should lessen and go from a bright red color to more of a brown color as each day passes. If heavy bleeding continues or increases, it could indicate a retained placenta, infection, or other issues.
Infection or sepsis
This happens when incisions don’t heal properly, parts of the placenta remain inside the body, breasts become engorged and plug the ducts (mastitis), or other wounds or tears occur that go untreated. Antibiotics can usually clear it up, but if it’s not taken care of, it can lead to shock and even death.
Deep vein thrombosis (DVT)
There is a five times more likelihood of pregnant women developing blood clots than non-pregnant women. This is mostly due to reduced flow of blood to lower extremities as the baby grows, reduced movement, especially if on bed rest, and your body’s natural increase of blood clotting to reduce blood loss during childbirth.
Thrombotic pulmonary embolism
Related to deep vein thrombosis, this is where a blood clot, usually from the legs, travels to the lungs and clogs the pulmonary artery.
Cardiovascular disease or cardiomyopathy
Some women may be at greater risk for heart disease if they smoke, are obese, are over the age of 40, or have other issues like hypertension. Cardiomyopathy is a rare condition where the heart muscles weaken and struggle to pump blood through the body. Women tend to be at great risk for these conditions postpartum, and either one can lead to heart attack or heart failure.
High blood pressure during pregnancy is the greatest risk factor for causing a stroke in women postpartum. The period from delivery up to two weeks afterward is the highest window of risk, but it can happen even as long as six weeks after delivery. Nearly 50% of strokes happen postpartum.
Amniotic fluid embolism
Although this is a very rare condition, it’s extremely serious so worth mentioning. This postpartum complication occurs when amniotic fluid, fetal cells, or other fetal materials enter the mother’s bloodstream and cause a reaction. This can trigger sudden respiratory failure, followed by cardiac arrest, and then hemorrhaging, usually at the site of placental attachment.
One of the most common postpartum complications is Perinatal Mood and Anxiety Disorder (PMAD), which affects around one in five women. It can happen during pregnancy as well as after childbirth, but it usually subsides within the first couple of weeks postpartum. If it lasts longer than that or interferes with your ability to care for your baby or yourself, talking to your doctor will allow you to get the help you need for this very treatable condition.
Warning signs and symptoms
There are some common symptoms and warning signs that should prompt you to get medical help as soon as possible.
If you experience any of the following, call your doctor as soon as possible:
- Fever of 100.4F (38C) or higher
- Other fever-like symptoms such as chills, shaking, clammy skin, and excessive sweating
- Any incisions that aren’t healing, are red, swollen, and tender, or that have pus
- A leg that has become red or swollen and is painful or warm to the touch
- A severe headache that doesn’t improve after taking medicine or that affects your vision
- Pain or burning when urinating (other than the pain from an episiotomy or a perineal tear), pain in your lower back
- while urinating, or needing to pee more than usual
- Severe pain in one or both sides of your abdomen or in your lower belly
- Racing heart or heart palpitations
- Lumps or red streaks in your breasts, extreme tenderness, and unusual redness, swelling, and pain
- Foul-smelling vaginal discharge
For the following symptoms, seek medical attention immediately by going to the hospital or calling an ambulance:
- Excessive bleeding (soaking one or more hospital or maxi pads in an hour or less) and/or passing clots larger than prune size
- Shortness of breath, trouble breathing, or feeling like you might pass out
- Chest pain or a squeezing pain that keeps getting worse
- Thoughts of hurting yourself or your baby
When to see a doctor
If you have any of the warning signs that indicate postpartum complications, you should call your doctor as soon as possible. Even if they turn out to not be life-threatening, they could be signs of an infection that, when caught in time, can be treated before becoming more serious.
Heavy blood loss, inability to breathe, the possibility of passing out or losing consciousness, and chest pain or tightness are some of the most critical signs of an urgent medical situation.
In these cases, you should get to a hospital immediately or call an ambulance.
The important thing is to not hesitate or second guess. If something doesn’t feel right, or you suspect that you might be having some kind of postpartum complication, it’s better to have it checked out and be sure. Things can go from bad to worse quickly if left untreated, and it’s not worth risking your life over.
Can you prevent postpartum complications?
The best way to prevent postpartum complications is through planning and awareness. Even before you give birth, discuss with your doctor if you have any pre-existing health issues that might put you at risk, such as diabetes or gestational diabetes, high blood pressure or preeclampsia, a history of smoking or cardiotoxic drug use, obesity, being over age 40, or having a family history of conditions like heart disease.
In addition, make postpartum care a priority.
Ideally, try to see your doctor for your first postpartum checkup by the third or fourth week after delivery.
If you can’t make a physical appointment, at least have a phone or video call to discuss how you’re doing and if there’s anything you’re concerned about or want to ask about.
No matter what, make sure to have at least one postpartum visit within 12 weeks of delivery.
This way, your doctor can physically check you to see how you’re healing, how you’re feeling physically and emotionally, and if there is anything you should be concerned about.
Postpartum complications can occur even months after pregnancy, so for the first year after delivery, note anything that seems out of the ordinary, and when you see a doctor, always mention the date when you gave birth. This can help him/her correlate if an issue might be pregnancy-related.
Your body goes through a lot during pregnancy and after giving birth. While it’s painful, tiring, and even overwhelming, most of it is normal and natural. Every woman is different, so the amount of time it takes you to heal and recover could be vastly different from what others have reported. That’s nothing to worry about.
However, it’s best to be aware of when things aren’t so normal. No one knows your body like you do, so if something doesn’t feel right, it’s better to err on the side of getting it checked. The warning signs and symptoms for postpartum complications can be a useful guide but always trust your intuition, too. Through education and awareness, hopefully, we can bring those statistics down and have more happy, healthy mothers enjoying long lives with their children.
Tell us in the comments about any postpartum complications you’ve experienced or ask any questions you have about the topic. By sharing, we can all help each other prevent potentially life-threatening conditions.