Postpartum complications: What you need to know

After you give birth, you’re likely focused on the care that your baby needs. But health problems can happen to you in the weeks and months after childbirth. They are called postpartum complications.

Some of these problems can be life-threatening. A pregnancy-related death is the death of a person while pregnant or within one year of the end of a pregnancy. More than half of pregnancy-related deaths happen after a baby is born.

In recent decades in the U.S., there has been a large rise in pregnancy-related deaths. Black, American Indian and Alaska Native people are 2 to 3 times more likely to die of pregnancy-related causes than are white people. More than 60% of pregnancy-related deaths are thought to be preventable.

After childbirth, it’s common to feel tired and have some pain. It also is common to deal with lack of sleep, changing hormones and breastfeeding concerns.

You might not know what’s typical for recovery after childbirth or what symptoms may signal a problem. And you may not know when to seek medical care.

If you give birth in a hospital, your healthcare team might not find risk factors for postpartum complications before you leave the hospital.

People often don’t see a healthcare professional until 4 to 6 weeks after childbirth. As many as 40% of people don’t have an appointment with their healthcare team at all for a checkup after giving birth. Not being able to visit a healthcare professional and not having insurance to cover the cost are two reasons why that visit might not happen. As a result, many people get little or no guidance on recovery after giving birth.

According to the Centers for Disease Control and Prevention (CDC), common causes of pregnancy-related deaths are:

• Diseases that affect the heart and blood vessels, called cardiovascular diseases.
• Other medical conditions often present before childbirth.
• A serious infection such as sepsis.
• Heavy bleeding after giving birth, called hemorrhage.
• A disease of the heart muscle called cardiomyopathy. This condition makes it hard for the heart to pump blood to the rest of the body.
• A blockage in one of the blood vessels in the lungs that carry blood from the heart to the lungs. Blood clots that travel to the lungs from the legs, called thrombotic pulmonary embolism, often are the cause of the blockage.
• Stroke.
• High blood pressure, called hypertension, or high blood pressure linked with protein spilled into the urine during pregnancy, called preeclampsia.
• A rare condition that happens when the fluid that surrounds the baby during pregnancy, called amniotic fluid, or fetal material such as fetal cells enters a pregnant person’s bloodstream. This is called amniotic fluid embolism.
• Problems with the medicines used to prevent pain during delivery or surgery, called anesthetic.

Sometimes the cause of a pregnancy-related death is not known.

The overall risk of dying of a pregnancy-related complication is low. But people with chronic conditions such as heart disease, obesity or high blood pressure are at greater risk of dying of pregnancy-related complications. If you have these risk factors, take extra care of your health after giving birth.

Many postpartum complications can be treated if found early.

Seek emergency medical care if you have:

• Chest pain.
• Trouble breathing or shortness of breath.
• Extreme tiredness that doesn’t get better with rest.
• Seizures.
• Thoughts of hurting yourself or your baby.

Call your healthcare professional if you have:

• Bleeding that soaks through more than one pad an hour or passing blood clots the size of an egg or bigger.
• A cut from surgery, also called an incision, that isn’t healing.
• A leg that has changed color or swells and is painful or warm to the touch.
• A temperature of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher.
• A headache that doesn’t get better even after taking medicine, or a bad headache with vision changes.
• More than one blood pressure reading of 150/100 or greater if you’re measuring your blood pressure at home after giving birth.

Your health should be one of your main concerns after childbirth. Start thinking about your postpartum care plan before you give birth. Talk with your healthcare professional about that plan.

After childbirth, talk to your healthcare professional about your risk of a pregnancy-related complication. Your risk might be higher if you had a problem during pregnancy such as gestational diabetes or high blood pressure. Your risk also may be higher if you had a cesarean birth. Ask about special care you may need. Learn the symptoms of problems that you could have.

The American College of Obstetricians and Gynecologists says to make postpartum care an ongoing process rather than a single visit after you give birth. Have contact with your healthcare professional by phone or in person within three weeks of delivery. Within 12 weeks of delivery, see your healthcare professional for a complete checkup.

If you have trouble making time for an appointment, contact your care team and ask about your options. If possible, ask a family member or friend for help with child care while you go to your appointment.

During the appointment, your healthcare professional checks your mood and emotional well-being. You can talk about birth control and how long to wait before getting pregnant again. You can review information about your baby’s care and feeding. Tell your healthcare professional about your sleep habits and talk about any concerns you may have about being too tired.

The physical exam might include a check of your breasts, belly, vagina, cervix and uterus to make sure you’re healing well. This is a good time to talk about any concerns you have. That may include when you can start having sex again and getting used to life with a new baby.

Also, when you see anyone on your healthcare team in the year after childbirth, tell them when you gave birth. This can help your care team know whether any symptoms you have might be linked to pregnancy.