Nope Not Normal! An Ob/Gyn’s Guide to the Red Flags of Postpartum Recovery

postpartum Mar 24, 2019

*This article is not intended to be medical advice and is for general education purposes only

This article could save your life or the life of someone you love.

You may have heard that the maternal mortality rate is increasing in the United States and has been since the 1980s. This is an unacceptable trend. Though there are many smart, dedicated, rockstar humans working tirelessly on this issue, there are steps all of us can take in our own lives to make an impact.

What most people don’t know is that many of these deaths occur in the postpartum period.

We estimate that a large percentage of these maternal deaths are preventable. When we look at preventable deaths postpartum we typically identify a delay in the decision to seek care or a delay in receiving adequate care once at a medical facility.

Today I am going to run through some of the symptoms in the postpartum period that should not be ignored. If you would like a list of items to help your postpartum recovery check out my Ultimate Postpartum Kit Checklist


1. Heavy bleeding

Before leaving the hospital ask how much bleeding is too much. While it is common to have a slight increase in bleeding with activity, the increase should be slight. We often say to return to the hospital if you are bleeding enough to saturate 2 pads in an hour. Make sure you find out from your doctor how much bleeding is too much as depending on your unique characteristics your doctor may want you to be more cautions

2. Shortness of breath

In pregnancy, mild shortness of breath with activity and in certain positions is common. After delivery, this should resolve. Shortness of breath is not a normal symptom in the postpartum period and could signal a blood clot in your lungs or a problem with your heart. Even more concerning is shortness of breath that gets worse when you lie down or is accompanied by chest pain, palpitations, or a cough. These symptoms warrant immediate medical evaluation.

3. Fever (T >100.4 F or 38 C)

There are numerous reasons you may have a fever in the postpartum period, some of them are no big deal and others are very serious. It is not up to you to determine the seriousness of your fever— that is the job of a trained medical professional. All fevers in the postpartum period warrant a phone call to your provider or a trip to the hospital


4. Headache not relieved by over-the-counter medications such as Tylenol or Motrin

This could be the sign of some seriously high blood pressures and warrants medical evaluation. Preeclampsia is a pregnancy related condition that often involves high blood pressure. It can progress and is considered life-threatening. The good news is that under appropriate medical care we can drastically reduce complications and risks from this condition.

5. Change in vision, seeing stars or spots

Another potential symptom of preeclampsia or elevated blood pressure. These symptoms are not normal or expected and need medical evaluation

6. New pain in the upper portion of your abdomen

This is yet another possible sign of a blood pressure issue or preeclampsia and warrants medical evaluation.


7. Pain and swelling in your leg

This could be a sign of a blood clot. These frequently occur in just one leg making one leg more painful and large than the other. Blood clots can be life-threatening, particularly if they travel to your lungs. You may have heard that Serena Williams suffered this complication, called a pulmonary embolism, postpartum. These symptoms warrant immediate medical evaluation.

8. Depression, Anxiety, Psychosis

Postpartum depression and anxiety are common. Sometimes, through no fault of the individual, these medical conditions (and they are very much medical conditions) progress to suicidal or homicidal thoughts. If you find yourself having these thoughts it is extremely important that you tell someone immediately. If you are planning the hows and whats of a suicide this is considered an absolute emergency and you should call 911 immediately. Inability to sleep (even when given the opportunity) is a major risk factor for suicide in the postpartum period and if this happens to you or someone you love it is time to seek medical attention.

A condition that gets little attention is something called Postpartum Psychosis. This can occur in women with no prior history of mental illness. Women will have obsessive thoughts of harm coming to themselves or their children. They will often hear voices or grow concerned that a spirit or a person is coming to harm their children. Unfortunately, some of these women end up killing their children thinking they are protecting them. If you or someone you know is experiencing these symptoms this is an emergency. Call 911 or proceed to the emergency room.

National Suicide Prevention Lifeline: 1-800-273-8255


This is not a comprehensive list. If you have a symptom not discussed here talk to you doctor! Your Ob/Gyn did at least 12 years of higher education so that she can answer your questions.

I hope that you never experience any of these complications. Please share this article with any expecting or postpartum women you know so that we can spread the word about these life-threatening conditions. You could save your friend’s life!

On a lighter note, if you are wondering what you will need to bring with you to the hospital make sure to check out my Ultimate Hospital Bag Checklist.

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