Labor, Birth & Postpartum
Postpartum Warning Signs: When to Call Your Doctor or 911 After Birth
Some symptoms after birth are emergencies. Call 911 for chest pain, trouble breathing, seizures, or thoughts of hurting yourself or your baby. Call your provider right away for bleeding that soaks a pad in an hour or less, a fever of 100.4°F or higher, a severe headache or vision changes, a red or swollen leg, or an incision that isn't healing. Serious complications can happen up to a year after birth, and CDC data show most pregnancy-related deaths are preventable.
The hard part is that the weeks after birth are already full of strange new sensations: bleeding, sweating, soreness, exhaustion. It's easy to tell yourself a warning sign is just part of recovery. This guide is meant to make the line clearer. Screenshot the table below and send it to whoever's helping you at home.
The POST-BIRTH warning signs
AWHONN, a nurses' organization, created an easy way to remember the most urgent signs:
| Letter | Warning sign | What to do |
|---|---|---|
| P | Pain in chest | Call 911 |
| O | Obstructed breathing or shortness of breath | Call 911 |
| S | Seizures | Call 911 |
| T | Thoughts of hurting yourself or your baby | Call 911 or 988 |
| B | Bleeding: soaking through a pad in an hour or less, or clots the size of an egg or bigger | Call your provider now; call 911 if heavy and you feel faint |
| I | Incision that's red, swollen, leaking or opening (C-section or perineal) | Call your provider |
| R | Red or swollen leg, painful or warm to the touch | Call your provider |
| T | Temperature of 100.4°F (38°C) or higher | Call your provider |
| H | Headache that doesn't get better with medicine, or comes with vision changes | Call your provider now |
If you can't reach your provider, go to the nearest emergency room. Always say "I gave birth recently" and the date, so you're checked for pregnancy-related problems. ER staff can't see that you just had a baby, and that one sentence changes how they evaluate a headache or shortness of breath.
Normal vs. not normal
| Usually normal | Call your provider |
|---|---|
| Bleeding like a heavy period that slowly gets lighter over weeks | Soaking a pad in an hour or less, or bleeding that gets heavier after it slowed |
| Small clots in the first days | Clots the size of an egg or bigger |
| Night sweats in the first couple of weeks | A temperature of 100.4°F or higher |
| Soreness that improves day by day | Pain that gets worse instead of better |
| Tired from newborn care | Exhaustion with shortness of breath, a racing heart or leg swelling |
| Weepy, up-and-down days in the first two weeks | Sadness, worry or irritability lasting more than two weeks |
What these symptoms can mean
Postpartum hemorrhage (heavy bleeding)
Heavy bleeding can happen in the first day, or days to weeks later. Watch for:
- Soaking a pad in an hour or less
- Clots the size of an egg or bigger
- Bleeding that gets heavier instead of lighter
- Dizziness, a racing heart, feeling faint, or pale, clammy skin
Postpartum preeclampsia and high blood pressure
Preeclampsia can start after birth, even if your blood pressure was normal in pregnancy. It most often appears in the first several days but can happen up to about 6 weeks postpartum. Signs include:
- A severe headache that doesn't go away with medicine
- Blurry vision, seeing spots or sensitivity to light
- Pain in the upper right belly or under the ribs
- Nausea or vomiting
- Sudden swelling of the face or hands
- Shortness of breath
Untreated, it can lead to stroke or seizures. If you had high blood pressure in pregnancy, ACOG recommends a blood pressure check within 3 to 10 days after birth. If you went home with a cuff, use it as instructed and write down the numbers.
Blood clots
Pregnancy and the weeks after birth raise your risk of blood clots, especially after a cesarean.
- In the leg (DVT): pain, swelling, warmth or redness, usually in one leg
- In the lung (pulmonary embolism): sudden shortness of breath, chest pain, a racing heart or coughing up blood. Call 911.
Infection
- Uterine infection: fever, belly tenderness, foul-smelling discharge
- Wound infection: redness, warmth, pus or opening at the incision or stitches
- Breast infection (mastitis): a painful, red, warm area on the breast with fever or flu-like aches
- Urinary tract infection: burning, urgency, or back pain with fever
Heart problems
Conditions like postpartum cardiomyopathy can appear in late pregnancy or the months after birth. Warning signs include shortness of breath (especially lying flat), a racing or pounding heartbeat, leg swelling and extreme tiredness. These are easy to mistake for normal new-parent exhaustion, so say something if you can't catch your breath lying down.
Mental health emergencies
Thoughts of harming yourself or your baby, seeing or hearing things that aren't there, or extreme confusion are emergencies. Milder symptoms that last more than two weeks, like persistent sadness or constant worry, still need care. Read more about postpartum depression.
Other CDC urgent warning signs
The CDC's Hear Her campaign also lists:
- Dizziness or fainting
- Severe nausea and throwing up
- Severe belly pain that doesn't go away
- Overwhelming tiredness
- Fast or pounding heartbeat
Trust your gut, and say it plainly
People often delay care because they think it's normal recovery, or they worry about being dismissed. If something feels wrong, speak up and keep asking. Use this sentence:
"I had a baby on [date]. I'm worried this could be [preeclampsia, a blood clot, an infection]. Can you check?"
A partner, family member or doula can help you advocate, especially if you're too exhausted to push.
Make a postpartum safety plan
Before you leave the hospital:
- Save key numbers in your phone: your OB/GYN's or midwife's after-hours line, your baby's pediatrician, and the hospital's labor and delivery unit.
- Know where you'd go for emergency care, and how you'd get there at 3 a.m. In much of New York City that may be a car service or 911, not a car.
- Share this list with your partner or a family member, since you may not notice changes in yourself.
- Keep your discharge papers handy. They list your birth date, type of birth and any complications.
- Use any home equipment you were given, like a blood pressure cuff, and log the readings.
- Book your early follow-up visits before discharge, especially a blood pressure check if you had high blood pressure.
When to call your provider
Beyond the urgent signs above, call during office hours for:
- Pain that's getting worse instead of better
- Trouble peeing, or leaking stool
- Breast pain, cracked nipples or feeding concerns
- Sadness, anxiety or irritability lasting more than two weeks
- Questions about medicines
ACOG recommends contact with your care team within 3 weeks after birth and a full postpartum checkup by 12 weeks. See what's normal in our postpartum recovery timeline.
Coverage and care in New York
If you have NY Medicaid or Child Health Plus because of pregnancy, coverage continues for 12 months after your pregnancy ends, so you can get follow-up care for blood pressure, mental health and other complications. If you need a new provider after birth, or a maternal-fetal medicine specialist for complications, search the directory or browse providers who take Medicaid.
Frequently asked questions
How much bleeding after birth is too much?
Soaking through a pad in an hour or less, or passing clots the size of an egg or larger, is too much and needs urgent care. Bleeding that suddenly gets heavier after it had slowed also needs a call.
Can you get preeclampsia after giving birth?
Yes. Postpartum preeclampsia can develop even if your blood pressure was normal in pregnancy, most often within the first week but up to about 6 weeks after birth. Signs include a severe headache, vision changes, swelling and shortness of breath.
How long after birth do I need to watch for warning signs?
Serious complications can happen up to a year after birth. Many happen in the first few weeks, so be especially watchful during that time, and tell any provider you see that you were recently pregnant.
What temperature is a fever after birth?
A temperature of 100.4°F (38°C) or higher is a fever and should be reported to your provider, since it can be a sign of infection.
Sources
- AWHONN — POST-BIRTH Warning Signs
- CDC — Hear Her: Urgent Maternal Warning Signs
- ACOG — Gestational Hypertension and Preeclampsia (Practice Bulletin 222)
- ACOG — Optimizing Postpartum Care (Committee Opinion 736)
- CDC — Pregnancy-Related Deaths: Data From Maternal Mortality Review Committees
This article is for general education and is not medical advice. It does not replace an evaluation by a licensed clinician who knows your history. If you think you have a medical emergency, call 911.