Warning Signs During the Postpartum Period

by Robin Elise Weiss, Ph.D. Health Professional

After you give birth, you are suddenly confronted with major life changes, not the least of which is caring for your new baby. There can be many things to learn, including diapering, bathing, and feeding. While the baby is usually the center of attention, this may mean that you overlook your own needs as a postpartum mother. Others caring for your baby may overlook your needs as well. But the postpartum period is critical for your healing and well-being.

The process of healing after giving birth

It is important to remember that even if you are feeling relatively well, you are still going a through a healing process after having a baby. Your body has been through a major shift in so many of its functions. Your hormone levels rapidly change, you’re bleeding from the healing placental site, and it may seem like every orifice is leaking. These changes occur whether you have had a vaginal birth or a cesarean section.

As you go through this healing process, your body will continue to undergo many changes, from profuse sweating and weight loss to increased hunger and sleep issues. Even with the most careful research, you may still find yourself surprised by some of these symptoms. Many postpartum women who ask about these changes are often told: “Oh, that’s just normal postpartum!”

This dismissive attitude can lead you to stop asking questions or reporting symptoms, which can be problematic. A study showed that most nurses don’t provide adequate education before discharge about the warning signs of postpartum complications. This means you may have left the hospital or birth center with little information on what is a problematic symptom and what isn’t. But knowing these symptoms and how to report them could literally save your life.

Warning signs in the postpartum period

It is imperative that women and their families know the warning signs after having a baby. The Association of Women’s Health, Obstetric, and Neonatal Nurses (AWHONN) suggests watching for the following signs and symptoms for a year after the birth of your baby:

  • Pain in your chest

  • Obstructed breathing or shortness of breath

  • Seizures

  • Thoughts of hurting yourself or your baby

  • Bleeding that is soaking through one pad per hour, or blood clots the size of an egg or bigger

  • Incision that is not healing

  • Red or swollen leg that is painful or warm to touch

  • Temperature of 100.4° F or higher

  • Headache that does not improve, even after taking medicine, or bad headache with vision changes

You may have noticed that this list spells out the acronym POSTBIRTH. There is also a sheet you can print out to help you remember this after you’ve had a baby. If you experience any of the first four signs on this list, you should call 911. The rest of the signs only require contacting a doctor or midwife. If none are available, you should go to the emergency room or call 911.

You will also hopefully hear about these warning signs in your childbirth class, during your discharge education at your place of birth, and from anyone caring for you and your baby after birth. The physical symptoms are easy to identify once you know what you’re looking for. Issues with mental health, on the other hand, are not always so cut and dry.

Perinatal mood disorders

Perinatal mood disorders are also a part of the picture for women, both during and after pregnancy. Most people know about the “baby blues,” but many women experience depression that is much more severe.

Often overlooked, and more common than depression, are women who suffer from postpartum anxiety disorders, as well as obsessive compulsive disorder (OCD). This may include intrusive thoughts of the baby being harmed, which are different from thoughts of you hurting the baby. For example, you may worry about the baby falling down the steps to the point that you have trouble on the stairs. There is help available for all of these symptoms, though many well-meaning people may not understand the differences. Postpartum Support International (PSI) offers a variety of tools and advice for families and practitioners.

When to call your practitioner

If you have any signs or symptoms that are worrisome, you should call your practitioner. Some things can wait for your regular checkup, but most women only have one checkup, usually six weeks after you have the baby. Be sure to mention that you have had a baby recently when talking to anyone about your signs and symptoms, even if you feel like you have completely healed.

While most families won’t need this information, when you do need it, it is crucial to know where to go, and what to say. Be prepared and learn the POSTBIRTH warning signs.

Robin Elise Weiss, Ph.D.
Meet Our Writer
Robin Elise Weiss, Ph.D.

Robin Elise Weiss, Ph.D., LCCE, CLC, AdvCD(DONA) is a childbirth educator, doula, founder of Childbirth.org, and the award-winning pregnancy and parenting author of “The Complete Illustrated Guide to Pregnancy” and more than 10 other books. Between her nine children, teaching childbirth classes, and attending births for more than two decades, she has built up an impressive and practical knowledge base. You can follow Robin on Twitter @RobinPregnancy, Instagram @Robineliseweiss, and Facebook @childbirthtrainings.