Urgent Maternal Warning Signs After Birth: What to Watch For

Why the weeks after birth need their own watch list

You are home, the baby is the center of everything, and your own body has dropped to the bottom of the list. You are sore and tired, and it is hard to know which aches are part of healing and which ones are not. That is exactly why the CDC created its Hear Her campaign: some serious problems show up after you leave the hospital.

The CDC asks you to know the urgent maternal warning signs during pregnancy and in the year after delivery. ACOG, the national group for OB-GYNs, also treats postpartum care as an ongoing process rather than a single visit. It recommends contact with your OB-GYN or other obstetric care provider within the first 3 weeks after birth and a full postpartum visit no later than 12 weeks after birth. A warning sign does not wait for that appointment, and neither should you.

For what ordinary recovery can feel like, our post on the fourth trimester covers the emotional and practical side of the early weeks. This guide is the other half: the signs that mean call now.

The CDC warning signs, in the CDC's words

The CDC says to seek medical care immediately if you have any of these. The details in parentheses come from the CDC page.

• Headache that won't go away or gets worse over time (it may feel like the worst headache of your life).
• Dizziness or fainting.
• Changes in your vision (you see flashes of light or bright spots).
• Fever of 100.4°F (38°C) or higher.
• Extreme swelling of your hands or face (swelling in your hands makes it hard to bend your fingers or wear rings).
• Thoughts about harming yourself or your baby.
• Trouble breathing (you feel short of breath, suddenly or over time).
• Chest pain or fast-beating heart.
• Severe nausea and throwing up.
• Severe belly pain that doesn't go away.
• Vaginal bleeding or discharge after pregnancy (heavy bleeding, soaking through one or more pads in an hour).
• Severe swelling, redness or pain of your leg or arm (the CDC flags this anytime during pregnancy or up to 6 weeks after birth).
• Overwhelming tiredness (you are suddenly very tired and weak, not like chronic fatigue).

What to say when you call

The CDC asks you to tell any health care provider if you are pregnant or were pregnant within the last year. That one sentence changes how a nurse or emergency doctor thinks about a headache, a fever or shortness of breath. Say it every time, including at an urgent care or an emergency room, and say the date: "I gave birth on [date]."

Then be specific. Give the temperature reading, how many pads you soaked in the last hour, when the headache started and whether it is getting worse. If it feels life-threatening, such as chest pain or trouble breathing, call 911. That works the same way in Westchester, Fairfield County and all five boroughs.

ACOG suggests building a postpartum care team before your baby is born and keeping a list of everyone's names and phone numbers nearby once you get home. Your OB-GYN or obstetric care provider is the person to call first with questions about your own health after delivery. Your baby's pediatrician is the person to call about the baby.

What partners, family and helpers can do

You may not be the first to notice. The CDC asks partners, friends and family to listen to your concerns and encourage you to seek medical help, to offer to go with you to a provider and help you ask questions, to make sure you say that you were pregnant within the last year, and to support you through follow-up care.

• Learn the list before the birth, so a worried "I just don't feel right" gets taken seriously.
• Handle the baby, the older children and the car so you can go right away.
• Write down what you said and what time it started, so you do not have to repeat it from memory.
• Do not talk you out of a call. If you are unsure, call and ask.

Where a postpartum doula fits

A postpartum doula is one more set of eyes in the house, not a medical provider. She does not take blood pressure, examine you or decide whether a symptom is normal. She can notice that you look pale or sound different, ask you how you are feeling, encourage you to call your provider, and keep the household running while you get care.

With Northeast Doulas, postpartum support can begin as soon as you get home with your new baby, and the doula provides non-medical support in the days and weeks after delivery. If your concern is about mood rather than your body, our guide to postpartum depression and anxiety help lists the lines that are open around the clock.

Put the list where you will see it

Print the CDC list and tape it inside a kitchen cabinet, or save it as a note on your phone and your partner's phone. Keep a working thermometer where you change the baby. Decide in advance who drives and who watches the baby if you need to leave quickly.

Add these steps to your written plan; our guide on how to make a postpartum plan shows where they fit. Some families in New York and Connecticut also qualify for a free nurse or health worker home visit after birth, covered in our guide to newborn home visiting programs. Neither a plan nor a visit replaces a call when a warning sign appears.