Postpartum Warning Signs
(please read the entire page)
The infographic provided here was created by the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) and provides valuable information on warning signs to look out for during the first year postpartum, and when to call your care provider versus when to call 911. Please print and keep in a visible location and share with your support system.
Click image to download full handout.
Used with Permission. AWHONN POST-BIRTH Warning Signs Save your Life handout, © 2023.
Important notes from the POST-BIRTH document:
You only need one symptom to be present to seek medical care, do not delay care because you are waiting for more than one symptom to appear or for the symptom to worsen.
If you can’t reach your healthcare provider, call 911.
When in doubt, check it out - trust your instincts and insist on receiving the care you deserve.
To help facilitate communication with your care provider or 911 operator, a useful guide is provided by the CDC Hear Her Campaign (click to access).
If you had preeclampsia/eclampsia or pregnancy-related hypertension (high blood pressure) at any point during your pregnancy you are still at risk of complications due to high blood pressure during the postpartum period. To learn more visit stillatrisk.org and watch this video by clicking on the image below.
In the early weeks after giving birth, it’s important to be aware of potential complications beyond high blood pressure, such as bleeding and infection. Understanding the signs and symptoms of these issues can help you stay vigilant. Always remember: if you’re unsure about anything, it’s better to reach out for medical advice. Getting checked early can give you peace of mind and ensure that any concerns are addressed promptly, rather than risking more serious complications by waiting. Your health and well-being are worth the extra step of seeking care whenever you feel something is off.
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Bleeding and soaking through more than one pad an hour.
Blood clots the size of an egg/golf ball or bigger.
New/worsening abdominal pain and/or abdominal firmness.
Increasing swelling/pain/bruising in perineal area.
Discharge that has a strong foul odor.
Bleeding that changes from rust colored or pale pink back to bright red
Bleeding that persists past 6 weeks
Light headed/dizzy
Nausea/vomiting
Racing heartbeat
Shortness of breath
Feeling faint going from laying to sitting or sitting to standing.
Blurry Vision
Decrease in blood pressure
Note: postpartum hemorrhage is most common in the first 24 hours after giving birth but can happen anytime within the first 12 weeks.
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Uterine atony: this is when your uterus does not contract, or does not contract adequately enough to close off the blood vessels at the site where your placenta was attached. This is why your nurse will "massage your fundus" after delivery - to feel for contractions and to ensure that the uterus feels strong.
Trauma to reproductive tract: Use of devices such as forceps or vacuum and/or a prolonged and difficult delivery can cause damage to your vagina, cervix, uterus or perineum (area between your genitals and anus). This damage can be immediately apparent or blood can collect under the surface of the tissue and cause bleeding days or weeks later.
Retained placental tissue: This is when pieces of your placenta remain attached to the uterine wall after delivery. You may be more at risk for this to happen if you have uterine fibroids, placenta accreta, placental abruption, or placenta previa.
Infection
Blood clotting conditions also known as a coagulation disorder can cause increased bleeding. Some medications can also interfere with your blood's ability to clot appropriately.
Eclampsia, or high blood pressure during pregnancy.
A history of postpartum hemorrhage during a previous delivery.
Note: up to 40% of postpartum hemorrhage cases occur in women without any known risk factors.
Source: Cleveland Clinic Postpartum Hemorrhage overview
Infection warning signs in the postpartum period:
Note: If you're taking pain medications like Tylenol or Advil, you might not have a fever even with an infection. Call your provider if you notice any other signs of infection, regardless of fever.
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Fever and/or chills, body aches and/or generally feeling unwell.
Pelvic pain
Vaginal bleeding or discharge (especially if it has a foul odor).
Constipation or painful bowel movements.
Swelling in your abdomen, sometimes accompanied by tenderness.
Read more: Cleveland Clinic Endometritis overview.
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A lump in your breast that is swollen, tender, warm to the touch, or red (the lump may not always be close enough to the surface to be easily felt so if you are having these symptoms but don't feel a lump you may still have mastitis).
Fever and/or chills (flu-like symptoms)
Pain (that might feel like burning) which worsens when your baby nurses.
Read More: Cleveland Clinic Mastitis overview.
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Drainage that is discolored, foul smelling or increases in volume.
Redness, warmth/heat, swelling or tenderness at the incision site.
Fever or chills
Feeling unwell (flu-like), body aches
Persistent (little to no relief from comfort measures such as medication) or increasing pain.
The incision edges begin to separate.
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Fever and/or chills
Painful urination
Peeing more often than usual, not fully emptying bladder
Sudden uncontrollable urge to pee
Urine that is cloudy, has a foul odor or is bloody
Note: you are at an increased risk for developing a UTI if a urinary catheter (Foley) was inserted during/after delivery (this is common if you've had a c-section, epidural or magnesium infusion).