Problems After Delivery of Your Baby
Problems After Delivery of Your BabySkip to the navigationTopic Overview During the days and weeks after the
delivery of your baby (postpartum period), you can expect that your body will
change as it returns to its nonpregnant condition. The
postpartum period lasts for 3 months after delivery. As with pregnancy changes,
postpartum changes are different for every woman. For example, if you had
heartburn while you were pregnant, it may go away
after delivery. But other symptoms, such as
hemorrhoids, could continue to cause problems after
your baby is born. Many minor postpartum problems can be managed
at home. For example, home treatment measures are usually all that is needed to
relieve mild discomfort from hemorrhoids or constipation. If you develop a
problem and your doctor has given you specific instructions to follow, be sure
to follow those instructions. Most women need some time after
delivery to return to their normal activities. It is important to focus on your
healing and taking care of your baby for the first 6 weeks. Start other
activities slowly as you feel stronger. Your doctor will tell you when you can
have sex again, but for most women, 6 to 8 weeks after delivery is the average
time. If you had any problems during your pregnancy or during labor or
delivery, your doctor may give you more specific instructions about activities.
Although most women don't have serious health problems during the
postpartum period, you should see your doctor if you develop
heavy vaginal bleeding,
calf pain, pain with breathing (pulmonary embolism), or
postpartum depression. Check your
symptoms to decide if and when you should see a doctor. Check Your SymptomsHave you had a baby in the past 3 months? Yes Had baby in the past 3 months No Had baby in the past 3 months How old are you? Less than 12 years Less than 12 years 12 years or older 12 years or older Do you have epilepsy or a history of seizures? Yes Epilepsy or history of seizures No Epilepsy or history of seizures Was this a typical seizure for you? Are you having trouble breathing (more than a stuffy nose)? Yes Difficulty breathing more than a stuffy nose No Difficulty breathing more than a stuffy nose Would you describe the problem as severe, moderate, or mild? Severe Severe difficulty breathing Moderate Moderate difficulty breathing Mild Mild difficulty breathing Does it hurt when you breathe? This can be a warning sign of a blood clot in the lung, called a pulmonary embolism. Yes Symptoms of pulmonary embolism No Symptoms of pulmonary embolism Yes At risk for pulmonary embolism No At risk for pulmonary embolism Do you have a new headache that is different than the types of headaches you are used to? Yes New or different headache No New or different headache Do you have a severe headache that started suddenly and is the worst headache of your life? This probably would not be like any headache you have had before. Yes Sudden, severe headache No Sudden, severe headache How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine? 8 to 10: Severe pain Severe pain 5 to 7: Moderate pain Moderate pain 1 to 4: Mild pain Mild pain Are you having any vaginal bleeding? Moderate Moderate bleeding Are the clots large or small? Large means more than 1.5 in. (4 cm) across, or bigger than a golf ball. Large (bigger than a golf ball) Large clots Have you passed more than 3 clots? Yes Passed more than 3 clots No Passed more than 3 clots Do you have any bleeding after intercourse or douching? Yes Vaginal bleeding after intercourse or douching No Vaginal bleeding after intercourse or douching Do you have pain in your belly, pelvic area, or back? Yes Belly, pelvic, or back pain No Belly, pelvic, or back pain How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine? 8 to 10: Severe pain Severe pain 5 to 7: Moderate pain Moderate pain 1 to 4: Mild pain Mild pain Do you have pain or swelling in one calf? Pain and swelling in the lower leg can be symptoms of a blood clot. Yes Pain or swelling in one calf No Pain or swelling in one calf Do you have problems with urination? Yes Problems with urination No Problems with urination Are you able to urinate at all? Yes Symptoms of kidney infection No Symptoms of kidney infection Yes Symptoms of bladder infection No Symptoms of bladder infection Yes Symptoms of postpartum depression No Symptoms of postpartum depression Are you afraid that you might hurt your baby or yourself? Yes Concerned about hurting self or baby No Concerned about hurting self or baby Do you think you may have a fever? Did you take your temperature? How high is the fever? The answer may depend on how you took the temperature. High: 104°F (40°C) or higher, oral High fever: 104°F (40°C) or higher, oral Moderate: 100.4°F (38°C) to 103.9°F (39.9°C), oral Moderate fever: 100.4°F (38°C) to 103.9°F (39.9°C), oral Mild: 100.3°F (37.9°C) or lower, oral Mild fever: 100.3°F (37.9°C) or lower, oral How high do you think the fever is? Moderate Feels fever is moderate Mild or low Feels fever is mild How long have you had a fever? Less than 2 days (48 hours) Fever for less than 2 days At least 2 days but less than 1 week Fever for at least 2 days but less than 1 week 1 week or more Fever for 1 week or more Do you have a health problem or take medicine that weakens your immune system? Yes Disease or medicine that causes immune system problems No Disease or medicine that causes immune system problems Do you have shaking chills or very heavy sweating? Shaking chills are a severe, intense form of shivering. Heavy sweating means that sweat is pouring off you or soaking through your clothes. Yes Shaking chills or heavy sweating No Shaking chills or heavy sweating Yes Symptoms of a vaginal infection No Symptoms of a vaginal infection Have you noticed a change in your bowel habits? Yes Change in bowel habits Have you had: At least 1 stool that is mostly black or bloody? At least 1 stool mostly black or bloody At least 1 stool that is partly black or bloody? At least 1 stool partly black or bloody Streaks of blood in your stool? Streaks of blood in stool Are you constipated? Constipation means your stools are hard and you have trouble passing them. If your stools are soft and pass easily, you are not constipated. Have you tried home treatment for constipation for more than 1 week? Home treatment includes things like drinking plenty of water; eating more fruits, vegetables, and whole grains; and getting some exercise every day. Yes Tried home treatment for constipation for more than 1 week No Tried home treatment for constipation for more than 1 week Are you having a problem with your C-section incision, such as it not healing like your doctor said it should? Yes Problem with C-section incision No Problem with C-section incision Do you have pus draining from your C-section incision? Yes C-section incision pus draining No C-section incision pus draining Are your breasts red and painful, or are your nipples cracked and bleeding? Yes Red, painful breasts or cracked, bleeding nipples No Red, painful breasts or cracked, bleeding nipples Yes Breastfeeding problems Are you having a problem with an episiotomy or tear repair (such as the wound not healing like your doctor said it should)? Yes Problem with episiotomy or tear repair No Problem with episiotomy or tear repair Are you having any new or unexpected symptoms? Yes New or unexpected symptoms No New or unexpected symptoms Would you describe these symptoms as serious or minor? Serious Serious new or unexpected symptoms Minor Minor new or unexpected symptoms Do you feel anything bulging into your vagina or feel pelvic pressure when you move? Yes Bulging into vagina or increased pelvic pressure with movement No Bulging into vagina or increased pelvic pressure with movement Many things can affect how your body responds to a symptom and what kind
of care you may need. These include: - Your age. Babies and older
adults tend to get sicker quicker.
- Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.
- Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.
- Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.
- Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
able to take care of this problem at home. - Try home treatment to relieve the
symptoms.
- Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.
If you're not sure if a fever is high, moderate, or mild,
think about these issues: With a high fever: - You feel very hot.
- It is likely one of
the highest fevers you've ever had. High fevers are not that common, especially
in adults.
With a moderate fever: - You feel warm or hot.
- You know you have
a fever.
With a mild fever: - You may feel a little warm.
- You think
you might have a fever, but you're not sure.
Temperature varies a little depending on how you measure it.
For adults and children age 12 and older, these are the ranges for high,
moderate, and mild, according to how you took the temperature. Oral (by mouth) temperature - High:
104°F (40°C) and
higher
- Moderate:
100.4°F (38°C) to
103.9°F (39.9°C)
- Mild:
100.3°F (37.9°C) and
lower
A forehead (temporal) scanner is usually 0.5°F (0.3°C) to 1°F (0.6°C) lower than an oral temperature. Ear or rectal temperature - High:
105°F (40.6°C) and
higher
- Moderate:
101.4°F (38.6°C) to
104.9°F (40.5°C)
- Mild:
101.3°F (38.5°C) and
lower
Armpit (axillary) temperature - High: 103°F (39.5°C) and higher
- Moderate:
99.4°F (37.4°C) to
102.9°F (39.4°C)
- Mild: 99.3°F (37.3°C) and lower
Blood in the stool can come from
anywhere in the digestive tract, such as the stomach or intestines. Depending
on where the blood is coming from and how fast it is moving, it may be bright
red, reddish brown, or black like tar. A little bit of bright red
blood on the stool or on the toilet paper is often caused by mild irritation of
the rectum. For example, this can happen if you have to strain hard to pass a
stool or if you have a hemorrhoid. Certain medicines and foods can affect the color of stool. Diarrhea
medicines (such as Pepto-Bismol) and iron tablets can make the stool black.
Eating lots of beets may turn the stool red. Eating foods with black or dark
blue food coloring can turn the stool black. If you take aspirin or some other medicine (called a blood thinner) that prevents blood clots, it can cause some blood in your stools. If you take a blood thinner and have ongoing blood in your stools, call your doctor to discuss your symptoms. Symptoms of a vaginal infection may
include: - Vaginal itching.
- Vaginal discharge
that is not normal for you.
- Red, irritated skin in the vaginal
area.
- Pain when you urinate.
- Pain or bleeding when you
have sex.
Shock is a life-threatening condition that may quickly occur
after a sudden illness or injury. Symptoms of shock (most of which will be present) include: - Passing out (losing consciousness).
- Feeling very dizzy or
lightheaded, like you may pass out.
- Feeling very weak or having
trouble standing.
- Not feeling alert or able to think clearly. You
may be confused, restless, fearful, or unable to respond to questions.
Pain in adults and older children - Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.
- Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
there.
- Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.
Symptoms of difficulty breathing can range from mild to severe. For example: - You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).
- It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).
Severe trouble breathing means:
- You cannot talk at all.
- You have to
work very hard to breathe.
- You feel like you can't get enough
air.
- You do not feel alert or cannot think clearly.
Moderate trouble breathing means: - It's hard to talk in full
sentences.
- It's hard to breathe with activity.
Mild trouble breathing means: - You feel a little out of breath but can still talk.
- It's becoming hard to breathe with activity.
Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in adults are: - Diseases such as diabetes, cancer, heart disease,
and HIV/AIDS.
- Long-term alcohol and drug
problems.
- Steroid medicines, which may be used to treat a variety
of conditions.
- Chemotherapy and radiation therapy for
cancer.
- Other medicines used to treat autoimmune
disease.
- Medicines taken after organ transplant.
- Not
having a spleen.
Symptoms of a bladder infection may
include: - Pain or burning when you urinate.
- A
frequent urge to urinate without being able to pass much urine.
- Blood in the urine.
Symptoms of a kidney infection may
include: - Pain in the flank, which is felt just below the rib cage and above the waist on one or both sides of the back.
- Fever or chills.
- Pain
or burning when you urinate.
- A frequent urge to urinate without
being able to pass much urine.
- Belly pain.
Symptoms of a pulmonary embolism may
include: - Sudden shortness of breath.
- Sudden,
sharp chest pain that may get worse when you breathe deeply or
cough.
- Coughing up blood or pink, foamy mucus.
- Fast
heart rate.
- Severe anxiety.
- Fainting.
Severe vaginal bleeding means that you are soaking 1 or 2 pads or tampons in 1 or 2 hours, unless that is normal for you. For most women, passing clots of blood from the vagina and soaking through
their usual pads or tampons every hour for 2 or more hours is not normal and is
considered severe. If you are pregnant: You may have
a gush of blood or pass a clot, but if the bleeding stops, it is not considered
severe. Moderate bleeding means that you
are soaking more than 1 pad or tampon in 3 hours. Mild bleeding means that you are soaking less than 1 pad or
tampon in more than 3 hours. Minimal vaginal bleeding means "spotting" or a few drops of blood. Some of the problems with breastfeeding that you might have include: - Sore, red nipples.
- Stabbing or burning
breast pain.
- A hard lump in your breast.
- Your baby
having trouble latching onto your breast.
If you have pain when you are breathing, you may be at
immediate risk for a pulmonary embolism if you also
have: - Pain deep in one leg for no clear reason. This can
be a sign of a blood clot in the leg (deep vein thrombosis) that could travel
to the lungs.
- A history of problems with blood clots, such as deep
vein thrombosis or a previous pulmonary embolism.
Symptoms of postpartum depression may
include: - Trouble sleeping.
- Feeling sad or
hopeless.
- Crying often, or feeling like you are going to cry.
- Feeling anxious or edgy.
- Not being able to
concentrate.
Seek Care TodayBased on your answers, you may need care soon. The
problem probably will not get better without medical care. - Call your doctor today to discuss the symptoms
and arrange for care.
- If you cannot reach your doctor or you don't
have one, seek care today.
- If it is evening, watch the symptoms and
seek care in the morning.
- If the symptoms get worse, seek care
sooner.
Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care. - Call your doctor now to discuss the symptoms and
arrange for care.
- If you cannot reach your doctor or you don't have
one, seek care in the next hour.
- You do not need to call an
ambulance unless:
- You cannot travel safely either by driving
yourself or by having someone else drive you.
- You are in an area
where heavy traffic or other problems may slow you down.
Make an Appointment Based on your answers, the problem may not improve without medical
care. - Make an appointment to see your doctor in the
next 1 to 2 weeks.
- If appropriate, try home treatment while you
are waiting for the appointment.
- If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.
Call 911 NowBased on your answers, you need
emergency care. Call911or other emergency services now. Home Treatment If you develop problems and your
doctor has given you specific instructions to follow, be sure to follow those
instructions. Feeling tired (fatigue)Most women feel tired after
labor and delivery. Caring for a new baby, loss of sleep, and the normal
physical changes you experience as your body returns to its nonpregnant
condition can add to your fatigue. It is important to focus on your healing and
taking care of your baby for the first 6 weeks. Start other activities slowly
as you feel stronger. To help with fatigue in the first few weeks
and months after delivery: - Eat regularly. Do not skip meals or go for long
periods without eating. Choose healthy foods.
- Exercise regularly.
Get outside, take walks, or keep your blood moving with your favorite workout.
If you do not have your usual energy, do not overdo it. If you had any problems
during your pregnancy or during labor or delivery, your doctor may give you
more specific instructions about activities.
- Try to take rest
breaks often during the day.
- Do only as much as you need to, and do
not take on extra activities or responsibilities.
- Spend time with
family and friends and let them help you care for your baby.
Sleep problemsSleep problems are common when you
are caring for a new baby. These tips may help you get a good night's
sleep. - Sleep when your baby is sleeping or
napping.
- Keep your naps as short as possible.
- Use your
bed only for sleep.
- Try to have a regular feeding pattern if you
are breastfeeding. If you are bottle-feeding, have others feed the baby
sometimes so you can rest.
- Limit your caffeine, such as coffee,
tea, cola drinks, and chocolate.
- Try relaxation methods such as meditation or guided imagery. For more
information, see the topic
Stress Management.
Nonprescription medicine to help relieve discomfortMost women have some mild discomfort after delivery. You may have some
cramping as your uterus returns to its nonpregnant size. If you had an
episiotomy, you may have pain in your genital area.
Women who have had a
cesarean section (C-section) will have some pain at
the incision site. Most women can take acetaminophen (such as Tylenol) and ibuprofen (such as Advil) while breastfeeding to help relieve discomfort from some of these problems. But talk to your doctor before taking any medicine (prescription or nonprescription). - Acetaminophen dosage:
The usual dose is 650 mg; recommended doses may range from 500 mg to 1,000 mg.
You can take 650 mg every 4 hours or 1,000 mg every 6 hours in a 24-hour
period. Do not take more than the maximum adult dose of 4,000 mg in a 24-hour
period.
- Be sure to follow these nonprescription medicine precautions.
- Use, but do not take more than the maximum
recommended doses.
- Carefully read and follow all labels on the
medicine bottle and box.
Breast engorgement or mastitisIf you are
breastfeeding, your breasts may be sore as they fill with milk. Place ice
packs on your breasts for the pain and swelling. Be sure to put a cloth between
your skin and the ice pack. Some women find a hot shower or warm towels on the
breasts help the pain. You can also use acetaminophen, such as Tylenol. Mastitis is an inflammation of the breast that is most
commonly related to breastfeeding. This inflammation can be related to tissue
injury, infection, or both. Mastitis while breastfeeding usually affects only
one breast and starts as a painful area that is red or warm. Fever, chills, and
flu-like symptoms or body aches can also develop. You can develop mastitis at
any time while breastfeeding, but it most commonly occurs during the first 2
months after delivery, before your baby's feeding patterns become
regular. If you are not breastfeeding, do not stimulate your
nipples or warm your breasts. Instead, apply
cold packs, use medicine for pain and inflammation,
and wear a supportive bra that fits well. Postpartum depressionMany new mothers may feel
"blue" after the birth of their baby. This may be caused by a change in
hormones, not getting enough sleep, feeling too busy, or just worried about
taking care of the baby. Postpartum depression is a medical
condition, not a sign of weakness. Be honest with yourself and those who care
about you. Tell them about your struggle. You, your doctor, and your friends
and family can team up to treat your symptoms. - Plan activities and visit with friends and
family, and ask them to call you regularly.
- Eat a nutritious diet.
Eat small snacks throughout the day to keep up your energy.
- Get
daily exercise, such as outdoor stroller walks. Exercise helps improve
mood.
- Get as much sunlight as possible-keep your shades and
curtains open, and get outside as much as you can.
- Ask for help
with food preparation and other daily tasks. Family and friends are often happy
to help a mother with newborn demands.
- Don't overdo it. Get as much
rest and sleep as possible. Fatigue can increase depression.
- Do not
use alcohol or caffeine.
- Join a support group of new mothers. No
one can better understand and support the challenges of caring for a new baby
than other postpartum women.
- Depression: Managing Postpartum Depression
Constipation and hemorrhoidsConstipation and
hemorrhoids may bother you after delivery. To prevent
or ease these symptoms: - Eat a high-fiber diet with lots of fruits,
vegetables, and whole grains.
- Drink plenty of fluids, especially
water.
- Try a stool softener, such as Colace.
- Do not strain (push hard) during a bowel movement.
- Get
more exercise every day.
If you had a tear in your genital area during delivery
(episiotomy), talk to your doctor before using any nonprescription
suppositories for constipation. To treat the itching or pain of
hemorrhoids: - Keep the anus clean by wiping carefully after
each bowel movement. Gently wipe from the front to the back. Baby wipes or
hemorrhoid pads are usually more gentle than toilet paper. If you use toilet
paper, use only soft, undyed, unscented toilet paper.
- Take warm
soaks in a tub or a
sitz bath. Warm water can help soothe
hemorrhoids. Add baking soda to the water to relieve itching.
- Use
cold packs.
- Do not sit for long periods, especially on hard
chairs.
Let your doctor know if you are having problems with
constipation or hemorrhoids. He or she may recommend a nonprescription or
prescription medicine to treat your hemorrhoids. Swelling
If you had mild swelling from normal fluid buildup when you were pregnant, it may last for days or weeks after you deliver. You are most likely to notice this swelling in your face, hands, or feet. As your body changes back to how it was before you were pregnant, the swelling will go away. To help with swelling in your lower legs: - Whenever you are resting, raise your legs up. Try to keep the swollen area higher than the level of your heart.
- Take breaks from standing or sitting in one position.
- Walk around to increase the blood flow in your lower legs.
- Move your feet and ankles often while you stand, or tighten and relax your leg muscles.
Problems with the veins in the legs (varicose veins) and changes in hormones can also cause swelling. If the swelling in your ankles and feet does not go away or gets worse after trying home treatment, talk to your doctor about your symptoms. Weight lossJust as you slowly gained weight during
your pregnancy, it may take some time to lose weight after your baby is born.
Eat a nutritious diet and try to exercise daily. It may take 6 to 8 weeks for
you to get back to your normal activities. As the body returns to its
nonpregnant condition, many women feel they can manage their weight with
healthy eating and exercise. If it is hard for you to lose weight from your
pregnancy, talk to your doctor about your goals. If you are breastfeeding, it
is important to get the right amount of calories and nutrients for your
baby. Symptoms to watch for during home treatmentCall your doctor if any of the following occur during home
treatment: - Abnormal or increased vaginal
bleeding
- Pain in your lower belly
- Urinary
problems
- Fever
- Symptoms that become more severe or
occur more often
PreventionIt is important to make healthy lifestyle
choices to lower your chance for problems after your delivery. - Get plenty of rest.
- Limit your use of
caffeine if you are breastfeeding.
- Eat a nutritious diet. Healthy eating will help you get the right balance of vitamins, minerals, and other nutrients. It will help you feel your best and have plenty of energy.
If you are breastfeeding, it is important to get good nutrition for you and your baby.
- Try to get 30 minutes of
exercise on most, if not all, days of the week.
- Do pelvic floor (Kegel) exercises to prevent urine control problems (incontinence)
after childbirth.
Things to avoid if you are breastfeeding- Alcohol
- Smoking or using tobacco
products
- Illegal drugs
- Misusing
medicines
- Fish that contain high levels of
mercury. This includes shark, swordfish, king
mackerel, marlin, orange roughy, bigeye tuna, or tilefish from the Gulf of Mexico. Avoid eating more than 4 oz (113 g) a week of white albacore tuna. Canned light tuna is low in mercury and a better option. And avoid eating more than 4 oz (113 g) a week of fish caught in local waters that have not tested as safe.
- Hazardous chemicals, certain cosmetic
products, or radiation
Call your doctor if you have any questions about
breastfeeding. This may help prevent any problems. Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. You can help your
doctor diagnose and treat your condition by being prepared to answer the
following questions: - What are your main symptoms?
- How long
have you had your symptoms?
- Have you had this problem before? If
so, do you know what caused the problem at that time? How was it
treated?
- What activities make your symptoms better or
worse?
- Do you think that activities related to your job or hobbies
caused your symptoms?
- Do you think that exercise or sports
activities have caused your symptoms?
- What home treatment measures
have you tried? Did they help?
- What prescription or nonprescription
medicines have you taken or used? Did they help?
- Do you have any
health risks?
Other Places To Get HelpOrganizationsAmerican Congress of Obstetricians and Gynecologists
(ACOG) www.acog.org Postpartum Support International (U.S.) www.postpartum.net CreditsByHealthwise Staff Primary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine Kathleen Romito, MD - Family Medicine Elizabeth T. Russo, MD - Internal Medicine Specialist Medical ReviewerAdam Husney, MD - Family Medicine Current as ofJune 12, 2017 Current as of:
June 12, 2017 Last modified on: 8 September 2017
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