The days and weeks after having a baby are a whirlwind of new emotions, routines, and huge changes. The postpartum period, or the fourth trimester, is when your body begins the incredible process of returning to its pre-pregnancy state. Just as your body changed to support and nurture your baby during pregnancy—your hormones shifted, your uterus expanded, and your core muscles adapted—now it’s starting the recovery process, which can take months or even years.
There are many common and harmless symptoms during this adjustment period, but it’s also important to recognize certain warning signs. Learn what symptoms warrant a call to your healthcare provider.
Why postpartum care is important
Every new mom needs postpartum care—even if you feel fine. The immediate days and weeks following labor and birth can be critical for health and complications, so staying on top of your health and taking time to rest and adjust is important.
Here are three simple ways to take charge of your postpartum health:
- Make sure to attend all your postpartum checkups.
- Pay attention to any warning signs or unusual symptoms.
- Call your doctor immediately or head to the emergency room if something feels wrong.
Taking these steps can help keep you safe and healthy as you recover.
Postpartum Symptoms to Watch Out For
Postpartum symptoms look different for everyone. However, there are some things to look out for–pay attention to the signs below, which can indicate something is wrong. The most important thing is to contact your healthcare provider if you feel like something is off. You know your body better than anyone else.
Very heavy bleeding
It’s normal to experience light bleeding or spotting for about four weeks after delivery as your body sheds the extra blood and tissue that supported your baby. This is the case for both vaginal and C-section births, though C-sections tend to experience less bleeding. The bleeding may be heavier in the first few days, similar to a menstrual period, but it should gradually decrease. The blood usually starts dark red, possibly with clots, and then lightens in color over time. Some blood is 100% normal.
Read more here about what to expect from postpartum bleeding from Midwife Hayley Oakes.
However, if you experience any of the below, seek medical attention or speak with your healthcare provider:
- If the bleeding doesn’t lessen after the first few days, or if you’re soaking a pad every hour, seek medical attention immediately. This could be a sign of postpartum hemorrhage
- If the bleeding increases again after initially slowing down
- If you notice signs of infection, such as a foul-smelling discharge
Breast pain/burning
After giving birth, you’ll likely experience some tenderness, soreness, or discomfort as your milk supply comes in and regulates. You may notice engorged breasts or increased leaking in the first days or weeks after leaving the hospital. If you’re breastfeeding (chestfeeding), you’ll start to understand what feels “normal” for you in terms of fullness and any lumps and bumps between feedings.
However, if you’re experiencing burning or pain, if your breasts feel warm to the touch, or if you see visible red streaks or welts, it could be a sign of a condition called mastitis. Mastitis is an infection that can occur if your milk ducts become clogged. It requires prompt attention from your healthcare provider, as antibiotics are needed. If left untreated, mastitis can lead to a breast abscess.
Strong cramping/abdominal pain
Unfortunately, cramping doesn’t stop after labor and delivery. During the postpartum period, your uterus, which expanded to support your baby, needs time to shrink to its normal size. This process can cause cramping, which is totally normal but can be pretty intense—some people say it feels almost like contractions. Intermittent cramping that doesn’t last longer than about five minutes is usually normal, but if you’re dealing with persistent pain, that could be a problem. It could be a sign of postpartum endometritis, a bacterial infection in the lining of your uterus, which might also cause symptoms like fever, chills, or just feeling unwell. Seek medical attention if you’re experiencing this type of pain.
To learn more about cramps postpartum and beyond what they might mean read: Cramps But No Period? Here Are 11 Possible Causes
Severe headaches
A routine headache here and there is standard for most people. Severe, painful headaches, however, can indicate an underlying condition. During pregnancy, your healthcare provider may have mentioned preeclampsia, a serious condition where you develop high blood pressure. Most people don’t know that you can develop the condition even after giving birth, regardless of whether or not you have a history of high blood pressure. One warning sign people notice is a severe headache. You may also experience blurred vision, sensitivity to light, or swelling in the face, hands, feet or limbs.
Postpartum preeclampsia is rare but can be serious. You are most at risk in the first few days following birth, but it can happen anytime during the first six weeks postpartum. Contact your healthcare provider if you are experiencing any of the above signs.
Tears/incisions complications
Around nine in ten first-time mothers will experience a laceration, graze or episiotomy during childbirth. For those that require stitches, your healthcare provider will counsel you on how to take care of your stitches, and the majority heal without issue. In rare cases, your wound can develop an infection. If your scar isn’t healing, the pain worsens over time, or you notice an odor or discharge, immediately seek medical attention.
Frequent peeing or burning
It can be uncomfortable to use the bathroom in the days and weeks following childbirth–especially if you had any lacerations and have stitches. Your healthcare provider may even suggest using a special bottle (called a peri bottle) with room temperature water instead of wiping, which could irritate any wound or soreness you have. If the discomfort persists past the first week or two after giving birth or gets worse, that could be a sign of a urinary tract infection (UT), which is common after birth. If it burns, or you feel a sharp pressure or pain when you pee, tell your medical provider ASAP.
Incontinence
As many as four in ten women experience postpartum incontinence or leaking urine. It’s perfectly normal; pregnancy and birth put a significant strain on the pelvic and vaginal muscles. You can try some simple at-home exercises if you're up to it. If your problems include bowel incontinence (leaking stool) or frequent incontinence that’s impacting your quality of life, speak with your healthcare provider about pelvic floor physical therapy.
Chest pain/trouble breathing
You should NOT have trouble breathing or chest pain after pregnancy or birth. If you do, that may indicate a pulmonary embolism, when a blood clot travels to your lungs and stops the blood flow. Other signs include shortness of breath and coughing; you may even cough up bloody mucous. A pulmonary embolism is very serious; seek medical treatment ASAP.
Leg pain
During pregnancy, your blood volume increases to support the growing fetus. During postpartum recovery, you may be at an increased risk of blood clots, which can travel to your lungs or other vital organs and pose a serious problem. Signs of a blood clot in your leg, called Deep Vein Thrombosis (DVT), are redness, swelling or warmth. If you notice any of these signs, contact your healthcare provider right away.
Signs of Postpartum Depression
The physical side of postpartum recovery is essential, but so is the emotional and mental side. Many people think having a baby means you are automatically on cloud nine, but the postpartum adjustment period can be fraught with fatigue, uncertainty and many new challenges.
In fact, up to four in five new parents report having the “baby blues,” which is a feeling of general sadness after birth. If the sadness persists past the first two to three weeks or feels more intense, that could be Postpartum Depression (PPD). PPD is nothing to be ashamed of; it doesn’t make you a bad parent. If you are experiencing any of the below feelings, speak with your partner, family or friends or your healthcare provider:
- Intense or long-lasting sadness
- Symptoms worsen over time
- Thoughts of harming yourself or your baby
- Consistently feeling overwhelmed
- Unable to take care of yourself or your baby
The first few weeks after delivery can be stressful, but you don’t have to feel alone or overwhelmed. In order to take care of your baby, you have to take care of yourself, so reach out for help if you think you have PPD.
How to Take Care of Yourself After Giving Birth
Giving yourself time to rest and heal is the best thing you can do after giving birth. It’s easier said than done with a newborn, but your body has to heal, and you cannot do that without taking time for yourself. Turn to your community and ask for help when necessary–that could look like help with meals, cleaning or even limiting visitors.
Other than plenty of rest, taking care of yourself after giving birth can include:
- Nutrition: Drink lots of water and eat healthy foods like lean protein, fruit, vegetables and whole grains. Staying hydrated can also help with constipation. Nutritious meals can be difficult when you’re busy with a new baby, so consider adding a postpartum supplement to your daily routine.
- Caring for your perineal area: If you had a vaginal delivery, you may be sore for a few weeks. Be careful when using the restroom, use a peri bottle when necessary, invest in witch hazel pads to help with healing and discomfort, and follow your healthcare provider’s instructions.
- Limiting physical activity: While you may want to return to your pre-pregnancy size, don't rush to exercise to get back into shape. Your healthcare provider will let you know when it's safe to exercise. Most people can begin walking or doing gentle movements a few days after giving birth. If you had a C-section, you may need to wait longer. Once you can exercise, start slowly so you don't accidentally injure yourself.
- Mental health support: Don't be afraid to ask for help; be patient with your emotions. This is a challenging time. If you feel sad, overwhelmed, anxious or stressed, talk to a friend, partner or healthcare provider. They can help you find resources to support your mental and emotional health.
Postpartum Complications FAQs
When do most postpartum complications happen?
Most postpartum complications typically occur within the first six weeks after delivery, with the highest risk period being the first few days to two weeks. However, some complications can develop later, up to 12 weeks after giving birth, so it's important to monitor your health and stay in touch with your healthcare provider during this time.
What are the most serious postpartum complications?
Some serious complications include postpartum hemorrhaging, blood clots (DVT), high blood pressure (postpartum preeclampsia) and heart problems, including peripartum cardiomyopathy.
When should I be worried about postpartum?
The postpartum period looks different for everyone, and between midnight feedings and adjusting to a newborn, you may be worried about what’s considered “normal.” A few red flags are heavy bleeding, a bad headache, swollen legs, face or arms, fever or trouble breathing. You can also check with your healthcare provider if you feel like something is off–nobody knows you better than you, so don’t hesitate to seek care if needed.
