Postpartum red flags and the reasons why you should not ignore pain and other symptoms

Post In: Afterbirth Perineum Care
Postpartum red flags and the reasons why you should not ignore pain and other symptoms

About 60 percent of deaths caused by pregnancy-related complications in the US are preventable, according to the Centers for Disease Control and Prevention (CDC). While this number remains low – an estimated 420 out of 700 annually – it is still an alarming fact.

Several factors lead to this worrying situation, including a woman inadvertently ignoring the warning signs and the lack of knowledge about pregnancy and postpartum complications.

If you know someone who has just given birth – or if you’re a new mom yourself – read on as we round up the most common post-delivery symptoms, including those that can turn fatal.

Common postpartum symptoms

Postpartum symptoms may vary from one woman to another. Some may only experience slight discomfort while some may have more serious after-birth problems.

The following symptoms are considered normal and almost all women experience them.

  • Perineal tearing – To accommodate an infant’s head, a mother’s vagina has to stretch, sometimes requiring episiotomy or incisions, to make vaginal childbirth possible. As a result, a woman’s perineum, or the area between her vagina and anus, gets torn.
  • Vaginal pain and swelling – Perineal tears most often require stitching, resulting in vaginal tissue swelling and pain. However, even without episiotomy, vaginal childbirth almost always causes discomfort to the perineal area.

Postpartum vaginal swelling and pain will last from as short as one week to as long as three weeks, depending on the depth of the tear or incision.

Besides pain and swollen genitals, you’ll likely experience the following:

  • Vaginal itching
  • Vaginal dryness
  • Burning sensation
  • Uterine cramping
  • Pain or discomfort during sex

    • Vaginal discharge – A woman will secrete postpartum vaginal discharge called lochia. A mix of blood, uterine tissue and mucus, this discharge may emit an odd-smelling odor.
    • Overall pain and soreness – A woman who has recently given birth will experience abdominal and pelvic pains as the uterus shrinks back to its normal or pre-pregnancy size.

    As the hormonal changes resulting from pregnancy take a while to get fixed, a new mom may experience overall body pains aggravated by sleep deprivation.

    • Hemorrhoids and constipation The downward pressure from the uterus with a growing fetus inside and other internal organs trigger constipation and hemorrhoids in pregnant women. The bad news is, it can last even after childbirth.

    This postpartum perineal kit is heaven sent for new moms suffering from perineal pain. Whether set off by episiotomy, hemorrhoids or vaginal tissue swelling, this kit relieves pain and discomfort and leaves you feeling refreshed all day.

    15 postpartum red flags that you should never ignore

    Postpartum pain and discomfort will linger long after childbirth, and some postpartum symptoms may last for a few weeks. Unfortunately, complications and other medical problems may also arise, so you need to watch out for these postpartum red flags.

    Signs and symptoms of an infection

    Women who have just delivered a baby are at a higher risk of having kidney, uterine, wound and other types of infections. These signs may indicate there’s something wrong:

    1. Severe abdominal pain Whether you had a vaginal or C-section delivery, abdominal cramps or contractions are expected as your uterus and other reproductive organs attempt to get back to their pre-pregnancy status. However, a debilitating abdominal pain may be a sign of endometritis, an inflammation of the lining of the uterus.

    2. Lumpy and extremely painful breasts, with red streaks These symptoms may indicate mastitis, an inflammation of the breast tissues due to an infection. While it peaks anytime within 6–12 weeks post-delivery, it can also happen sooner or later than the said period. It is possible for breastfeeding mothers to continue nursing their infant, but this has to be discussed with the doctor as antibiotics are often prescribed.

    Besides pain and swelling, mastitis can also cause skin redness and fever.

    3. Lower leg pain – Due to increased weight-bearing pressure, it is common for pregnant women, especially those in the third trimester, to experience leg pain and cramps. If a woman experiences postpartum leg pain, it can be caused by a blood clot, says Dr. Washington Hill, a veteran Maternal and Fetal Medicine specialist.

    4. High-grade fever A high body temperature is a telltale sign of an infection. It signals that the body’s immune system is working to ward off disease-causing bacteria or viruses. Post-delivery, new moms who record over 100.4 degrees Fahrenheit (38 Celsius) in body temperature and a racing pulse higher than 110 beats per minute should be seen by a medical practitioner.

    5. A foul-smelling vaginal discharge It is normal for lochia, or the postpartum vaginal discharge, to smell a little weird. A foul-smelling discharge post-delivery could mean that you have either endometritis or bacterial vaginosi, among other issues.

    6. An incision that turns red and shows no signs of healing An incision is expected to become swollen and painful for several days to more than a week. If you notice your wounds becoming red and swollen over time, it is not normal and could be a sign of an infection.

7. An open wound oozing with discharge Vaginal and C-section wounds should close and heal in a matter of days. If this isn’t the case for you, consult with your healthcare provider. A wound that stays open can be a magnet for bacterial infection. If it oozes a foul-smelling discharge, it could mean you already have an infection.

8. Seizures, fainting or increasing abdominal pain – These are common accompanying signs of an infection or abscess.

Symptoms of other health or medical problems

9. Chest pain, coughing or shortness of breath These are symptoms of pulmonary embolism, or a blockage in any of the lung’s pulmonary arteries. It is most often caused by a blood clot that forms elsewhere in the body but travels through the bloodstream and settles in the lungs. Pulmonary embolism is a life-threatening condition that requires emergency care.

10. A swollen lower leg or calf that is painful and tender to the touch This may be a sign of deep vein thrombosis, which happens when a blood clot forms deep within the body. The danger of developing DVT occurs when the blood clot travels in the bloodstream all the way to the lungs, causing pulmonary embolism.

11. Heavy bleeding – Postnatal vaginal bleeding is normal, but if your blood-soaked maternity pad overflows in an hour or less, it could be a sign that there’s something wrong. If the bleeding intensifies rather than showing signs of decreasing or stopping over time, call your healthcare provider. It can be a symptom of a hemorrhage.

12. Large blood clots Postpartum bleeding or “menstruation” may take up to two weeks to stop. Besides heavy bleeding, check out for large blood clots in your maternity pad. Normal blood clot sizes may only be the size of a pea or as large as a golf ball. It’s time to call your doctor if you have multiple, big blood clots.

13. Bad headaches Head pain that affects your vision or does not get better with medications is cause for concern because it may be a sign of high blood pressure or stroke.

14. Postpartum depression and anxiety Stress, hormones and physical tiredness may contribute to mood swings in a new mom. It is normal for a woman to express fear and worry. Some, however, may fall into postpartum anxiety and depression that impede their ability to take care of themselves and their newborn.

Postpartum anxiety may cause restlessness, constant worrying and crying. This may then turn into postpartum depression, where a woman refuses to eat, or may have thoughts about hurting herself or her baby. This is a serious condition that warrants emergency care. If you feel that a family member is suffering from postpartum anxiety or depression, immediately contact a healthcare professional.

15. Changes in vision, dizziness, severe headaches, breathing difficulties, sudden weight gain or limb and face swelling These are signs of postpartum preeclampsia, also referred to as postpartum high blood pressure. Postpartum preeclampsia could happen after delivery or 20 weeks later. If left untreated, it could result in stroke, brain damage or death.

Common postpartum complications

The Centers for Disease Control and Prevention cites heart disease and stroke as the most common causes of pregnancy-related deaths in the US.

In the week following childbirth, severe postpartum bleeding, high blood pressure and infection top the list, while cardiomyopathy, or a weakened heart muscle, is the leading cause of death from one week to a year post-delivery.

Risk factors for postpartum complications

Your pre-pregnancy health status may be a good indicator of your susceptibility to postpartum complications. In general, women who have pre-existing health problems such as heart disease, high blood pressure or hypertension and obesity may be prone to various complications post childbirth.

Pre-existing health issues are not the only factor, though. For instance, excessive postpartum bleeding can happen even to healthy women, but those who are carrying twins or have previously given birth to several babies may be at a higher risk.

How to prevent postpartum complications

There are no fool-proof ways to prevent postpartum complications. Besides keeping yourself healthy during pregnancy and post-delivery, doing these can help ward off potential problems:

  • Take enough rest and exercise Postpartum self-care is important for a new mom’s (and her baby’s) overall well being. A nutrient-rich diet can also help her heal faster and prevent infections.
  • Communicate with your doctor It’s important to maintain in contact with your doctor for medical advice, particularly if something is bothering you. Take heed of postpartum red flags and listen to your body for some cues.
  • Show up at scheduled postpartum check-ups Show up during scheduled visits even if you feel well and don’t have worrying symptoms. A visit to your doctor may help prevent specific symptoms from aggravating and could save your life.


Some types of postpartum complications are preventable, hence, early diagnosis and treatment are keys to managing serious postpartum symptoms. This starts with a woman who knows or is sensitive about life-threatening symptoms.

Can you think of other ways to prevent postpartum complications? Share your thoughts with us in the comments section.

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