Problems After Delivery of Your Baby
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.
Health Tools help you make wise health decisions or take action to improve your health.
|Actionsets are designed to help people take an active role in managing a health condition.|
|Depression: Managing Postpartum Depression|
|Stress Management: Doing Guided Imagery to Relax|
Check Your Symptoms
Try Home Treatment
You 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.
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.
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.
- 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.
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).
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.
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.
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.
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.
Severe vaginal bleeding means you are passing clots of blood and soaking through your usual pads or tampons each hour for 2 or more hours. 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.
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.
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
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
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.
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 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.
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 a medicine that affects the blood's ability to clot, such as aspirin, warfarin (Coumadin), enoxaparin (Lovenox), or clopidogrel (Plavix), 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.
Seek Care Now
Based 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
- 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.
Seek Care Today
Based 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.
Some of the problems with breast-feeding 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.
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.
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.
Call 911 Now
Based on your answers, you need emergency care.
Call 911 or other emergency services now.
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.
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 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 breast-feeding. 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 discomfort
Most 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.
If you are breast-feeding, it is safe to use acetaminophen, such as Tylenol, to help with mild discomfort.
- 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 mastitis
If you are breast-feeding, 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 breast-feeding. This inflammation can be related to tissue injury, infection, or both. Mastitis while breast-feeding 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 breast-feeding, but it most commonly occurs during the first 2 months after delivery, before your baby's feeding patterns become regular.
If you are not breast-feeding, 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.
Many 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.
Constipation and hemorrhoids
Constipation 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 and fruit juices.
- 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.
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.
Just 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 breast-feeding, it is important to get the right amount of calories and nutrients for your baby.
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home treatment:
- Abnormal or increased vaginal bleeding
- Pain in your lower belly
- Urinary problems
- Symptoms that become more severe or occur more often
It 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 breast-feeding.
- 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 breast-feeding, 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 breast-feeding
- Smoking or using tobacco products
- Illegal drugs
- Misusing medicines
- Fish that contain high levels of mercury. This includes shark, swordfish, king mackerel, tilefish, more than 6 oz (170 g) of white albacore tuna a week, or 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 breast-feeding. This may help prevent any problems.
Preparing For Your Appointment
To 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 Help
|Postpartum Support International|
|927 North Kellogg Avenue|
|Santa Barbara, CA 93111|
Postpartum Support International offers information and support not only to women who are coping with postpartum depression and anxiety after childbirth but also to their families. The Web site also includes the Mills Depression and Anxiety Symptom-Feeling Checklist for evaluating your symptoms.
- Abnormal Vaginal Bleeding
- Breast Problems
- Constipation, Age 12 and Older
- Feeling Depressed
- Female Genital Problems
- Fever, Age 12 and Older
- Leg Problems, Noninjury
- Nausea and Vomiting, Age 12 and Older
- Rectal Problems
- Sleep Problems, Age 12 and Older
- Urinary Problems and Injuries, Age 12 and Older
|Primary Medical Reviewer||William H. Blahd, Jr., MD, FACEP - Emergency Medicine|
|Specialist Medical Reviewer||H. Michael O'Connor, MD - Emergency Medicine|
|Last Revised||November 16, 2012|
|By:||Healthwise Staff||Last Revised: November 16, 2012|
|Medical Review:||William H. Blahd, Jr., MD, FACEP - Emergency Medicine|
H. Michael O'Connor, MD - Emergency Medicine
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