Some discomfort is expected after birth. But “postpartum is uncomfortable” should never become a reason to ignore concerning symptoms.
Learn urgent warning signs during pregnancy, and make sure your partner or support person knows them too. Serious complications can develop after delivery, even when pregnancy and birth seemed uncomplicated.
Heavy bleeding
Some bleeding is expected. Seek immediate medical care if you are soaking through a pad in an hour, passing very large clots or tissue, feel faint or weak, or bleeding suddenly becomes much heavier.
A severe or persistent headache
A headache that will not go away, becomes progressively worse, is suddenly extremely severe or occurs with vision changes, dizziness or upper abdominal pain deserves prompt evaluation. Do not assume every postpartum headache is only sleep deprivation.
High or low blood pressure
Blood pressure deserves attention after delivery—even if it was normal throughout pregnancy.
High blood pressure can occur with postpartum hypertension or postpartum preeclampsia. It may accompany severe headache, vision changes, shortness of breath, swelling or upper abdominal pain, although an elevated reading may be the first clue.
Low blood pressure can also be concerning, particularly with heavy bleeding, dizziness, fainting, unusual weakness, confusion, a racing heart or the feeling that something is not right.
If your provider asks you to monitor at home, know your numbers and your plan: What range do they expect? At what number should you call? When should you seek immediate care? Which symptoms require care regardless of the number?
Vision changes
Blurred vision, flashing lights, bright spots, double vision or temporary loss of vision should be taken seriously.
Trouble breathing or chest pain
Shortness of breath, difficulty breathing, chest tightness or pressure, chest pain, or a racing or irregular heartbeat can indicate a serious complication. Seek immediate evaluation.
Fever or possible infection
A temperature of 100.4°F (38°C) or higher may indicate infection or another complication. Also report worsening incision redness or drainage, foul-smelling discharge, increasing breast redness or pain, or feeling acutely unwell.
Severe abdominal pain
Some uterine cramping is expected. Severe pain that does not go away, begins suddenly or becomes progressively worse is different and warrants evaluation.
One-sided leg or arm pain and swelling
Severe swelling, redness, warmth, tenderness or pain—particularly on one side—can be concerning for a blood clot. Seek medical attention immediately.
Concerning emotional or mental changes
Thoughts of harming yourself or your baby require immediate help. Severe anxiety, hopelessness, rage, persistent sadness, frightening intrusive thoughts, confusion, hallucinations or feeling unable to care for yourself or your baby also deserve urgent attention.
Give your support person a job
The person recovering may be exhausted, overwhelmed, medicated or focused entirely on the baby. A support person can notice changes, help track symptoms, communicate with the care team and insist on evaluation when something is worsening.
The Dr. Doula takeaway
You are not overreacting by asking questions. You are not inconveniencing anyone by seeking care. If something feels wrong, say so clearly: “I recently gave birth, and I am concerned about these symptoms.”
This article is for educational purposes and is not a substitute for individualized medical care. Contact your healthcare professional with questions about your pregnancy or postpartum recovery, and seek urgent care for emergency symptoms.
