Postpartum experiences are as unique as the pregnancies that come before them.
Because of this, it can be difficult to recognise what’s normal and what could be a complication, even if you’ve given birth before.
The postpartum period is generally defined as the first six weeks after birth.
“Postpartum begins immediately following birth, and extends through the time when your body and mind are recovering from pregnancy and delivery,” says Mayo Clinic maternal-fetal medicine specialist Dr Kylie Cooper from the United States.
Recovery isn’t the same for everyone, and for some people, the postpartum timeline can be longer.
While the spectrum of what is considered typical postpartum is wide, there are warning signs of complications you should never ignore.
Don’t ignore these
Dr Cooper says consistent improvement is the best indicator of typical recovery.
“In general, recovery should tend toward improvement.
“So, if you feel like things are getting worse, or new symptoms come up, we definitely want you to reach out for care.”
The first two weeks after delivery carry the highest risk for serious complications, though they can sometimes occur later.
“The most common complications we see in that time frame are high blood pressure, haemorrhage or bleeding complications, infection, anxiety and postpartum depression,” she says.
While many postpartum concerns are common and treatable, some rare, but serious, complications can develop during this time, which is why new or worsening symptoms should never be ignored.
“These include blood clots, like deep vein thrombosis or pulmonary embolism, as well as postpartum heart issues like cardiomyopathy,” she says.
If you experience any of the symptoms below, you should seek care as soon as possible because they can indicate serious complications:
- Worsening pelvic or incision pain, or pain that doesn’t improve.
- New, heavy or increased bleeding.
- Headaches that don’t improve with medication.
- Confusion or behaviour changes.
- Fever or flu-like symptoms.
- Mood changes, anxiety or depression.
- Extreme fatigue that doesn’t improve with rest.
- Shortness of breath, trouble breathing or chest pain.
“Symptoms related to pain, mood changes and energy levels can be dismissed as normal postpartum symptoms.
“While the postpartum time frame can be a challenging time, these symptoms shouldn’t be dismissed,” says Dr Cooper.
Mental health complications
After delivery, your body undergoes a significant hormonal shift that can affect your mood and emotions in various ways.
While this is expected, symptoms usually improve in a couple of weeks.
When these feelings linger, or cause depression or anxiety that doesn’t improve, it could indicate postpartum depression.
In rare cases, a serious and life-threatening condition called postpartum psychosis can develop.
“While ‘baby blues’ might initially cause people to feel off or be tearful, that should improve, and it should not persist,” says Dr Cooper.
She says these feelings can improve with treatment and support.
After postnatal visits
After your six-week postpartum visit, your care will transition back to your primary care team. (Editor’s note: This is usually after four weeks postpartum in Malaysia.)
But this shouldn’t mean the end of postpartum care.
“It’s becoming increasingly recognised that this is a much longer process, extending up to a year after delivery.
“I think it’s important that we acknowledge that many people are not done recovering at the six-week mark – not by a long shot,” says Dr Cooper.
If you had physical or mental health complications during the postpartum period, this transition is crucial to ensure your long-term wellness.
“This is a really important time frame to ensure we help patients establish their preventive care because pregnancy complications can impact long-term health,” she says.
As you continue to monitor your health and well-being during this period, it’s important to pay attention to symptoms that may arise or persist beyond the initial recovery phase, as these can often be treated.
“Pelvic floor symptoms are often dismissed.
“For example, there’s this misnomer that once you have children, you will have pelvic floor issues.
“And that’s an accepted part of your future, but it shouldn’t be,” she says.
“These are issues that can be treated and improved.”
Getting the support you need
Support plays an important role in recognising postpartum complications.
Partners, family members and caregivers may notice subtle changes before you do, especially during a time marked by sleep deprivation and physical recovery.
“Sometimes, partners or family members are the first to recognise that something isn’t right,” says Dr Cooper.
“If you notice changes that concern you about your loved one, it’s important to speak up and help them seek care.”
She emphasises that it takes a village to provide postpartum support.
“In our practice, we have a team approach with obstetric providers, perinatal mood specialists, lactation consultants and pelvic floor physical therapists, and we all work together to make sure that the patient has the care they need.” – Mayo Clinic News Network/Tribune News Service
