After childbirth, you're likely focused on caring for your baby. But health problems, some life-threatening, can happen in the weeks and months afterward and many aren't aware of the warning signs. Here's what you need to know about postpartum complications.
A growing problem
A pregnancy-related death is the death of a woman while pregnant or within one year of the end of a pregnancy. More than half the pregnancy-related deaths happen after childbirth.
According to the Centers for Disease Control and Prevention (CDC), the number of reported pregnancy-related deaths in the United States in 2014 was 18 deaths per 100,000 live births. That's up from 7.2 deaths per 100,000 live births in 1987. Research also shows racial disparities. From 2011 to 2014, the pregnancy-related mortality ratios for black women were more than three times higher than for white women.
Lack of awareness
After childbirth, it's common to experience fatigue and discomfort, such as perineal pain and uterine contractions. You might not know the difference between a normal recovery and the symptoms of a complication — or when to seek medical care. If you give birth in a hospital, your health care team might not identify risk factors for serious postpartum complications before you are discharged.
Mothers also often don't see a health care provider until four to six weeks after childbirth, and as many as 40 percent don't attend a postpartum visit, likely due to limited resources. As a result, most receive little guidance on their postpartum recovery.
Common postpartum complications
According to the CDC, from 2011 to 2014 the most common causes of pregnancy-related deaths were:
- Cardiovascular diseases
- Other medical conditions often reflecting pre-existing illnesses
- Infection or sepsis
- Excessive bleeding after giving birth (hemorrhage)
- A disease of the heart muscle that makes it harder for your heart to pump blood to the rest of your body (cardiomyopathy)
- A blockage in one of the pulmonary arteries in the lungs often caused by blood clots that travel to the lungs from the legs (thrombotic pulmonary embolism)
- High blood pressure (hypertensive) disorders of pregnancy
- A rare but serious condition that occurs when amniotic fluid or fetal material, such as fetal cells, enters the mother's bloodstream (amniotic fluid embolism)
- Anesthesia complications
Sometimes the cause of a pregnancy-related death is unknown.
Risk factors for postpartum complications
The overall risk of dying of a pregnancy-related complication is low. But women with chronic conditions such as cardiac disease, obesity or high blood pressure are at greater risk of dying or nearly dying from pregnancy-related complications. If you have these risk factors, monitoring your postpartum health is particularly important.
Warning signs and symptoms
Many postpartum complications can be successfully treated if they're identified early.
Seek emergency help if you have:
- Chest pain
- Obstructed breathing or shortness of breath
- Thoughts of hurting yourself or your baby
Call your health care provider if you have:
- Bleeding and soaking through more than one pad an hour or blood clots the size of an egg or bigger
- An incision that isn't healing
- A red or swollen leg that's painful or warm to the touch
- A temperature of 100.4 F (38 C) or higher
- A headache that doesn't get better, even after taking medication, or a bad headache with vision changes
Prioritize your postpartum health. Start thinking about your postpartum care plan before you give birth. After childbirth, talk to your health care provider about your risk of a pregnancy-related complication and any special follow-up care you might need. Know the signs and symptoms of a problem.
The American College of Obstetricians and Gynecologists also now recommends that postpartum care be an ongoing process rather than just a single visit after your delivery. Have contact with your health care provider within the first three weeks after delivery. Within 12 weeks after delivery, see your health care provider for a comprehensive postpartum evaluation. If you're having trouble making time for an appointment, talk to your provider. Reach out to family and friends for help with child care.
During this appointment your health care provider will check your mood and emotional well-being, discuss contraception and birth spacing, review information about infant care and feeding, talk about your sleep habits and issues related to fatigue, and do a physical exam. This might include a check of your abdomen, vagina, cervix and uterus to make sure you're healing well. This is a great time to talk about any concerns you might have, including resuming sexual activity and how you're adjusting to life with a new baby.
Also, any time you see a health care provider in the year after childbirth, be sure to share the date that you gave birth. This can help your provider know that your symptoms might be related to your recent pregnancy.