It's normal to have some
bleeding, discomfort and
tiredness for a little while after baby is born. A bit of self-help may well be all that's needed to help you cope. (Take a look at our article about
you after the birth). Sometimes, though, medical emergencies do happen in the days and weeks following birth. Getting help quickly can help prevent severe illness and improve your recovery.
After you've had your baby, ask your midwife or doctor how and when you can get hold of emergency medical help should you need it. Make sure these details are written in a safe place and that your loved ones also know where they are. It's a good idea to tell them where you keep your birth notes or medical records. In the event of an emergency these will help you to get the right treatment straight away.
We’ve written some lists to help you decide whether you need to get medical help right away. If you have any doubts, contact your midwife or doctor without delay.
Postpartum conditions that need urgent treatment
Call 911 if you experience any of the following:
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- Fainting
- Sudden or heavy blood loss (perhaps accompanied by signs of shock, such as racing heartbeat, dizziness, sweating, or feeling faint)
A constant large loss of fresh blood from your vagina (if you are leaking from a maternity pad in less than an hour) is likely to be a postpartum hemorrhage. This is heavy bleeding following the birth of your baby, and you must call for help immediately. If it causes you to lose consciousness, call 911 as soon as you come around (HealthLink BC 2022).
- Severe or persistent headache
This may be a side-effect of an epidural or spinal anesthesia and you should speak to a doctor as soon as possible. In the first 72 hours after delivery a bad headache can also be a sign of pre-eclampsia, which can occur in the weeks after the birth, as well as before.
- Raised blood pressure
Your blood pressure will be taken a few times within the first six hours after you have given birth. If the bottom figure (diastolic) is greater than 90 it could mean you have pre-eclampsia and are at risk of full-blown eclampsia. You should be seen by a doctor or midwife as urgent and, if necessary, admitted to hospital. It is more worrying if you also have other signs of pre-eclampsia, such as a headache, blurred vision, feeling or being sick (SOGC 2014).
- Shortness of breath
Being short of breath is usual if you’re doing something active, such as walking up a hill. But if you become very breathless following the birth and it does not go away when you rest, it may be a sign of peripartum cardiomyopathy (Heart&Stroke nd 2022) or a pulmonary embolism (when a clot becomes stuck in one of the blood vessels of the lung). Both of these issues are an emergency, so call a doctor or midwife right away. (Thrombosis Canada 2019).
- Chest pain
If you have a pain in your chest it could be a chest infection or strained muscles from exertion in labour. In some cases, it could also be a sign of a pulmonary embolism. So, it should never be ignored. If you have pain, are short of breath or cough up blood, call an ambulance immediately.
- Calf pain
Pain in your calf can be a deep vein thrombosis (DVT). This is a blood clot in the deep veins of the muscle and it can be life threatening. Sometimes, you may also have redness, swelling, or a slightly raised temperature (Thrombosis Canada 2019).
- Suicidal thoughts
If you find yourself having morbid thoughts about hurting yourself or your baby, or thinking about ending your life, contact your doctor or midwife or talk to a loved one so that they can get support for you (HealthLink BC 2022). No one will judge you. Postpartum depression is a very real illness. With help you can start to feel better.
- Manic behaviour, including insomnia and severe agitation
After having a baby, some moms have drastic changes in their emotional and mental health. Thought disorders, severe agitation, confusion and delusions can be the beginning of a rare condition called postpartum psychosis. It is important that you get treatment and the help that you need (CAMH nd). It’s worth making sure loved ones are aware of the signs of mental health conditions before you give birth, so that they know what to look for in terms of your mood and behaviour once they baby has arrived. Often, these things are harder to detect in ourselves.
- Very high fever of 38 degrees C (100 degrees F) or over
High fever can be accompanied by shivering and is a sign of infection. After having your baby you can become very ill, very quickly, if you have an infection that is not treated. The common places for infection, other than mastitis, are your stitches or your womb (Moldenhauer 2022).
- Unable to pee within six hours of delivery
If you have not passed a good amount of urine within this time, you may have urine retention. If you've had your baby in a hospital, your postpartum nurses or your healthcare provider will be keeping an eye on how much pee you pass. If you are at home, you should contact your midwife or doctor for urgent help.
Conditions that are urgent, but can wait till the morning
Speak to your midwife or doctor if you have any of these symptoms:
- Strong smelling vaginal discharge
Some smells should not be ignored. Unusually smelly vaginal discharge is one of those, as it can mean your womb or vagina is infected (Moldenhauer 2022). - Very tender tummy
This can also be a sign of an infection (Moldenhauer 2022). This may be on the outside of your tummy, around your stitches, if you've had a caesarean. It may also be inside, as the place where the placenta comes away is a wound that needs to heal. If an infection in the womb is left untreated, it can increase your risk of postpartum hemorrhage (see above). If your symptoms also include a fever or feeling faint, get seen by a medical professional, urgently. - Severe, swollen prolapsed hemorrhoids
Although hemorrhoids are pretty common, they can sometimes become very swollen and painful after your baby's birth. Hemorrhoids are varicose veins just inside the anus, but they can pass outside. This is called prolapsed hemorrhoids. You may also have some bleeding. - Baby blues that don't go away after 10 days
If, towards the end of two weeks after the birth of your baby, you still feel very tearful, moody, irritable, and you’re just not enjoying being a parent, you could have postpartum depression (HealthLink BC 2022). It is quite common, and help is available. You just need to speak to your healthcare provider.
- Severe perineal pain, possibly with stinging and/or smelly pee
This could be an infection in your stitches or a urinary infection. Your midwife or a doctor needs to check that your perineum is healing as it should be. It could also be a hematoma, which is a large bruise inside your vagina.
- Leaking from your bottom
Needing to rush for a pee is common in the days and weeks after having a baby. But leaking from your bottom before you get to the toilet could be fecal incontinence (when you cannot control your bowel movements). It should clear up on its own a few weeks after the birth. If it doesn’t improve then talk to your doctor or midwife, who will discuss referring you, to help you regain your quality of life (RCN 2021).
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