Although it’s perfectly normal to experience a degree of bleeding, discomfort and tiredness after giving birth, there are several postnatal symptoms that need immediate medical intervention.
Signs that there may be a medical problem
- Bleeding or worsening pain
- Sudden heavy, bright red bleeding or clots
- Severe cramps or pain in the area of the stitches
- Smelly vaginal discharge or vaginal itchiness
- Discharge or bleeding from a C-section wound
- Discomfort or stinging sensation when passing urine
- Pain or bleeding during bowel movements
- Firm, painful and red lumps on breasts
- Feeling ill with fever.
Sudden or heavy blood loss
Lochia (postpartum bleeding) is completely normal and every woman who delivers a baby, either vaginally or through a C-section will experience this type of bleeding. It’s similar to menstruation, although it’s heavier and may last up to six weeks.
Postpartum haemorrhaging is a more severe type of postpartum bleeding and could be potentially life-threating.
- Losing massive amounts of bright red blood
- Passing large clots
Causes of postpartum haemorrhaging
- Tears to the vagina, perineum or cervix
- A blood clotting disorder or a retained placenta
- 90% of postpartum haemorrhages are due to the uterus not contracting properly after birth.
Who’s at risk?
Although every woman is at risk of developing a postpartum haemorrhage, certain factors could increase your risk:
- Multiple birth
- Placenta praevia
- Induced labour
- Birthing a large baby
Severe or persistent headaches
A severe and/or persistent headache can be a side effect of epidural or spinal anaesthesia. However, a bad headache in the first 72 hours after delivery can also be a sign of pre-eclampsia (high blood pressure associated with pregnancy), which can happen before birth too.
Pre-eclampsia can develop into full-blown eclampsia, which causes seizures and convulsions.
Pre-eclampsia symptoms include:
- Severe and persistent headaches accompanied by blurred or spotted vision
- Swelling of hands, feet and face
- Raised blood pressure
You’re at risk of developing eclampsia for up to four weeks after your baby is born, especially if you were diagnosed with pre-eclampsia during your pregnancy.
Occasionally, pre-eclampsia develops very quickly. Don’t hesitate to consult your doctor immediately if you experience severe headaches combined with very high blood pressure, blurred vision and vomiting.
Pain in chest, thigh or calf
Your body is bound to feel battered for the first few days after having a baby. But certain aches and pains are causes for concern.
Sharp pains in your chest and/or shortness of breath or localised pain and tenderness and warmth in your thigh or calf (whether you flex your foot or not), may indicate a blood clot. If the pain is in your chest, contact your emergency medical service. If the pain is in your legs, get off your feet, keep them elevated and call your doctor.
Inability to pass urine within six hours of delivery
The inability to pass urine within this time may indicate that you have urine retention (the inability to urinate). This means that the bladder fills up and you may feel the need to urinate, but simply can’t.
Several risk factors for urine retention have been identified and include:
- Regional anaesthesia
- Instrumental delivery
- An episiotomy
- Multiple pregnancies
Let your doctor know if you’re having trouble passing urine.
Swollen or severe piles
Although piles are common, they can sometimes be enormously swollen and painful after birth. Piles are varicose veins just inside the anus, but they can pass outside. This is called prolapsed piles, which may also be accompanied by bleeding. Over-the-counter ointments and sprays, as well as a diet rich in fibre and fluids, may help to reduce the swelling of piles.
A warm bath, followed by a cold compress can also offer some relief. However, don’t use laxatives, suppositories or enemas without consulting your doctor, especially if you’ve had an episiotomy or have stitches in the perineal area.
Severe perineal pain
For women who delivered vaginally, pain in the perineal area (between the rectum and vagina) is quite common. The tender tissues may have stretched or been torn during delivery, causing them to feel swollen, bruised and sore.
The discomfort may also be aggravated by an episiotomy. It’s crucial that your caregiver checks to see if your perineum is healing properly. Alert your doctor if you experience severe and persistent pain in your perineum, as this could indicate an infection in your episiotomy stitches or a urine infection.