When to get in touch with your provider

While less common, some serious postpartum complications can occur¹. Here's a look at what they are and when to seek help².

Perinatal mood and anxiety disorders (PMADs)

If you’re experiencing the baby blues, but your symptoms feel severe or last longer than a few weeks after childbirth, it’s possible that you’re experiencing a perinatal mood or anxiety disorder (PMAD). The medical community uses this term to encompass the entire spectrum of emotions women may feel during and after pregnancy, including depression, anxiety, psychosis, and rage.

“Postpartum depression and anxiety is the leading complication of childbirth," says Dr. Lincoln, a lactation consultant and medical writer. "We focus on physical risks, but mental-health complications are most prevalent—and partners are susceptible too.”

Like diabetes or heart disease, a PMAD is a serious illness that should be diagnosed, and treated, by a health care professional. Hormonal shifts, identity shifts, sleep deprivation, and labor are just a few of the stressors that can trigger unpredictable responses in the body. The symptoms for PMADs can vary widely, from feelings of confusion to sleep disturbances, so pay attention to your body, and prioritize your health during these busy postpartum weeks and months.

"It's important to remember that mood and anxiety disorders can happen to anyone,” says Chris Raines, a perinatal psychiatric nurse practitioner who has been treating families for 20 years. “It’s completely possible for someone with no previous mental-health conditions to find [themselves] struggling for the first time after having a child.”

If you find yourself struggling at any point in your postpartum period, reach out to your health care provider, or call the 24/7 Postpartum Support International Info helpline at 800-944-4773.

Postpartum preeclampsia

Preeclampsia is typically associated with pregnancy, as it impacts 5 percent to 7 percent of all pregnancies³. However, the condition may also develop in the postpartum period. It occurs when there is a blood pressure reading of 140/90mm Hg or higher, along with changes seen in your liver and kidney function, and it is often difficult to detect on your own. Associated symptoms include severe headaches, changes in vision, abdominal pain, shortness of breath, and vomiting.

Among the most serious reasons for hospital readmission, postpartum preeclampsia is most likely to occur within the first six months after delivery, but can occur up to two years postpartum⁴.

The causes of postpartum preeclampsia aren't yet well understood, though some research suggests that risk factors include hypertension, obesity, diabetes, preeclampsia during pregnancy, and having multiples⁵.

If you’re experiencing any of the above symptoms after giving birth, reach out to your health care provider immediately. Left untreated, postpartum preeclampsia can cause life-threatening complications, including seizures, strokes, and pulmonary edema.

Deep vein thrombosis and pulmonary embolism

Though rare, deep vein thrombosis and pulmonary embolism are leading causes of postpartum maternal death⁶. The risk is highest in the first few weeks following delivery, and nearly twice as high for women who have delivered by C-section.

These two conditions can occur together or independently. Deep vein thrombosis (DVT) is a blood clot that forms in a deep vein, typically in a leg or the pelvis, while a pulmonary embolism (PE) is a blood clot that travels to the lungs, blocking blood flow.

Symptoms of DVT include swelling of an affected limb, along with pain, tenderness, and warm or discolored skin in that area. If you experience any of these symptoms, contact your health care provider as soon as possible.

Symptoms of a PE include difficulty breathing, coughing up blood, chest pain that worsens with a deep breath, and a fast or irregular heartbeat. If you experience any of those symptoms, seek immediate medical attention.

Risk factors for either of these conditions include previous venous thromboembolism (VTE), hypertension, obesity, pregnancy with multiples, C-section, and a postpartum hemorrhage⁷. Let your provider know if you or anyone else in your family has ever had a blood clot so that you can be monitored regularly during and after pregnancy, and possibly prescribed a medicine called low-molecular weight heparin to prevent or treat blood clots during and following pregnancy.

For more information, the National Blood Clot Alliance has partnered with the Centers for Disease Control and Prevention to launch a digital public-health education campaign called Stop the Clot, Spread the Word⁸.

Postpartum hemorrhage

If you lose a large amount of blood following the birth of your baby, you could be among the roughly 3 percent to 5 percent of women who experience a postpartum hemorrhage⁹. It's a serious complication; postpartum hemorrhage is the world's leading cause of maternal mortality, accounting for about 35 percent of all maternal deaths¹⁰.

Most often occurring after the placenta is delivered, hemorrhage is defined as excessive bleeding beyond the half a quart that typically follows the vaginal delivery of a single baby or the full quart that typically follows delivery by C-section.

The most common cause of postpartum hemorrhage is that, following delivery of the baby and placenta, the uterus does not contract strongly enough to compress the blood vessels where the placenta detached from the uterine wall. When these vessels bleed freely, rapid blood loss can result in shock and a severe drop in the mother's blood pressure. Quick detection and treatment often lead to a full recovery.

Risk factors include placental abruption, placenta previa, overdistended uterus, preeclampsia, and the presence of more than one placenta in a multiple pregnancy.

Symptoms can be obvious, like heavy bleeding and decreased blood pressure, but they can also resemble other postpartum complications, from an elevated heart rate to vaginal or perineal swelling.