Postpartum Complications
Infections, Blood Clots And Excessive Bleeding

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postnatal problems

Postpartum Problems

Contents

What Is Normal In The First 6 Weeks Postpartum?
What Is Not Normal?
List Of Postpartum Complications
Personal Stories



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Postpartum Period
The Female Body
What Is Normal In The First 6 Weeks Postpartum?

The first 6 weeks after childbirth are considered the recovery period. Even if you experienced an easy pregnancy and sailed through labor your body has still been through the wars and needs a chance to heal. Depending on the type of delivery procedure you had, you may experience any or just some of the following:



Postpartum bleeding: Also called lochia, heavy bleeding which starts off bright red, then turns pink, brown and finally creamy yellow. It gradually subsides but can last up to 6 to 8 weeks.
Pain: Continued pain and discomfort in the perineum (region between the vagina and anus), especially if you had stitches or labored before a c-section.
Exhaustion: your baby will want to feed every hour or two.
Minor issues ease: Gradual easing of constipation and hemorrhoids.
Baby fat: Gradual weight loss (see, losing weight after childbirth).
Body shape returns: Tummy starts to flatten as the uterus recedes back into the pelvis.
C-section incision heals and pain gradually recedes (see, cesarean section recovery).
When milk starts to flow: Engorged breasts.
Sore nipples and other breastfeeding problems if you are nursing.
Joint pain as a result of the joints loosening in preparation for childbirth.
Backache due to weakened abdominal muscles after 9 months of carrying your baby.
Hair loss: See, hair loss after pregnancy.
Mood swings: Baby blues, swinging from elation to moodiness and tears.
Sexual relations: Little or no interests in sex (see, postpartum sex).

What Is Not Normal?

The following are symptoms which are not normal in the postpartum period. If they occur, contact your doctor immediately:

• Temperature of 100.4 F (38 C) or more.
• Chills.
• Nausea or vomiting.
• Increasing pain, swelling, redness or drainage from the C-section or episiotomy incision.
• Vaginal bleeding that soaks a maxi pad every hour or produces clots the size of a golf ball.
• Foul smelling vaginal discharge.
• Abdominal or back pain that is more than just an ache.
• Chest pain or cough.
• Painful breasts which are red and warm to touch (mastitis).
• Increasing tenderness in the lower abdomen.
• Burning sensation when urinating or blood in the urine.
• Severe headache accompanied by extreme pain when standing or sitting.
• Severe depression that lasts more than a week.
• Extreme paleness, weakness or rapid pulse rate.

List Of Postpartum Complications

Condition Symptoms and Signs
Hemorrhaging
Postpartum bleeding that is excessive and can result in the need for IV fluids and blood transfusion.
• Bleeding soaks a maxi pad every hour for several hours in a row.
• Bleeding remains bright red in color for more than 7 days after birth.
• Passing large clots of blood - the size of a golf ball or lemon.
• Pain or swelling in the tummy after the first few days of delivery.
• Loss of blood may cause faintness, breathlessness, dizziness or a racing pulse.
Pulmonary embolism
Potentially lethal condition, pulmonary embolism is second only to sudden cardiac arrest in the cause of sudden death. It is where a blood clot develops deep in the veins of the legs (known as DVT or deep vein thrombosis) and travels to the lungs causing a pulmonary embolism. The risk of a pulmonary embolism is 15 times higher in the postpartum period than in pregnancy itself.
• Chest or shoulder pain like you are having a heart attack.
• Cough, may be blood in any spit coughed up.
• Sudden shortness of breath.
• Leg swelling, usually only one leg.
• Rapid heartbeat, fainting and clammy bluish skin.
Deep vein thrombosis
Where a blood clot forms deep in one of the veins of the body, usually the leg. If it breaks free and travels to the lungs it can cause a pulmonary embolism.
• Half of cases experience no symptoms.
• Pain in the calf that feels like cramping and can spread to the foot and ankle.
• Skin is warm in the affected area and may turn bluefish in color.
Postpartum Infections
This includes reproductive or urinary tract system infections, puerperal infections and infections of the episiotomy or cesarean section incision. One study showed that 90 percent of infections only develop once the patient has returned home.
The presence of postpartum fever alone is nearly always a sign of some sort of infection. Postpartum fever is defined as having a temperature of more than 38 C on any 2 of the first 10 days following delivery (excluding the first 24 hours).
Symptoms depend on where the infection is, but there is nearly always pain and tenderness in the affected area.
Endometritis
Inflammation of the uterus due to bacterial infection. It is not to be confused with endometriosis, a different condition. Endometritis is most likely to occur after a long and difficult labor or c-section and is easily treated with antibiotics.
• Abnormal vaginal bleeding and/or discharge.
• Fever.
• Constipation.
• General feeling of unwellness.
• Lower pelvic, uterine pain.
• Swollen tummy (abdominal distention).
C-section post-operative complications
A cesarean section is considered a relatively safe operation. However it is still higher risk than a vaginal delivery.
The most serious complications are infection, hemorrhage, DVT, pulmonary embolism. Less serious problems include constipation and severe headaches (a temporary side effect of anesthesia).
Vulva Hematoma
This is where the vulva is bruised during childbirth. A blood vessel under the skin is damaged - but because the skin is not cut, the blood does not seep out but rather collects and forms a blood bruise. This condition is not serious but it can be painful and sore. It is usually treated by applying an ice pack and painkillers but if it is large it may need to be drained to relieve pressure on the surrounding area.
childbirth hematoma
Hematoma has formed and is swollen and full of blood.
Postpartum depression
Postpartum depression (PPD) is a form of moderate to severe depression that can occur after childbirth. It affects between 10 and 20 percent of women after delivery.
Symptoms of postpartum depression:
Initially the woman may feel quite happy after delivery, even elated and slightly ‘high’ before symptoms kick-in:
• Anger, irritability, rage.
• Feeling overwhelmed and anxious.
• Sleeping too much or too little.
• Worrying about everything, all the time.
• Problems concentrating.
• Guilty feelings.
Lacerations
Tears in the cervical and vaginal tissue can occur when the baby pushes his head through the birth canal during childbirth. These tears are known as lacerations. Tears also commonly occur in the perineum, the area between the vagina and anus. Nearly half of all women experience some lacerations in childbirth. Your surgeon will repair the tissue with stitches immediately after the birth. Depending on how deep the tears are, your recovery time will be affected.
vaginal laceration
Small laceration in the vaginal tissue.
Uterine Prolapse
With a prolapsed uterus, the muscles which support the uterus (womb) are weakened by prolonged labor or giving birth to a large baby. The uterus protrudes into the vagina or in severe cases protrudes outside the vagina.
• A heaviness or bearing down feeling in the pelvic region.
• Tissue sticking out from the vagina.
• Lower back pain.
• Urine leakages when you sneeze, cough or laugh (stress incontinence).
• A feeling like you are sitting on a small ball when you sit down.

Personal Stories

I sailed through my pregnancy and had a wonderful homebirth. About 22 days later, I ended up in emergency with what I thought was a severe shoulder pain. After doing a CT scan the doctors found a blood clot which they said was a postpartum pulmonary embolism. It was so scary, they said I could have died.

I developed a hematoma after delivery, the labor was 28 hours long and it was my first child. The pain of the hematoma was almost as bad as the labor itself. I couldn't enjoy the first few days of being a mom. The doctors decided not to drain it because they feared me losing any more blood. It was so large it became infected. Then it burst and I had to have an operation to remove the skin, drain it and pack it. This is weeks later and the soreness is only going now.

  Related Articles on Postpartum Care

For more tips, see the following:

Postpartum checkup: What to expect at your first visit.
Postpartum exercises: Tips on shaping up.
Postpartum emotions: Stress, anxiety and boredom.
Postpartum baby care: Bathing, diapers and other tips.

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