Postpartum Warning Signs: When to Call After Giving Birth
Call 911 right away if you have chest pain, trouble breathing, a seizure, pain, swelling, and tenderness in your leg, severe pain in your lower belly, or thoughts of hurting yourself or your baby after giving birth. Call your midwife or provider right away for heavy bleeding, a fever of 100.4°F or higher, or a headache that doesn't get better with medicine or comes with vision changes, and talk to your provider about anything that seems unusual or is worrying you.
Some postpartum warning signs can appear days or weeks after birth, and postpartum depression can occur anytime during the first year after birth. This guide groups the signs by what to do, explains when each problem tends to happen, and shows how to tell what's usually expected from what needs a call. The guidance comes from the American College of Obstetricians and Gynecologists (ACOG), the CDC, and other U.S. health sources. If you're ever unsure, call.
Quick Answer
Call 911 for chest pain, coughing or gasping for air, a seizure, thoughts of hurting yourself or your baby, severe pain in your lower belly, or pain, swelling, and tenderness in your leg. Call your midwife or provider right away for bleeding that soaks through one or more pads in an hour, clots bigger than an egg, a fever of 100.4°F or higher, a headache that won't go away or comes with vision changes, extreme swelling of your hands or face, red streaks or a painful new lump in your breast, a tear or incision that isn't healing, discharge that smells bad, or feelings of hopelessness that last more than 10 days after delivery. If you can't reach your provider, go to the nearest emergency room. If something seems unusual or is worrying you, don't ignore it.
When Postpartum Warning Signs Can Appear
Different problems tend to show up at different times. Knowing the usual timing helps you stay alert in the weeks that matter most, without assuming every symptom is a risk for a full year.
Physical warning signs
| Condition | When it can happen |
|---|---|
| Heavy bleeding | Bleeding should get less over the weeks after birth as your uterus heals. Heavy bleeding, or bleeding that comes back after it had stopped for more than a few days, needs a prompt call. |
| Postpartum preeclampsia | Most often within 48 hours of birth, but it can develop up to 6 weeks after delivery, even if you didn't have preeclampsia during pregnancy. |
| Blood clots | The risk is higher during pregnancy, childbirth, and the 3 months after delivery. |
| Infection | No single timeframe applies, so watch for signs of infection throughout your recovery. Breast infections usually happen in people who are breastfeeding. |
| Peripartum cardiomyopathy (a weakened heart muscle) | In the last month of pregnancy or within 5 months after birth. |
The CDC asks you to know its urgent maternal warning signs during pregnancy and in the year after delivery, and to tell any provider you see that you were pregnant within the last year. That's a reason to keep these signs in mind, not a sign that every complication is equally likely all year.
Mental health warning signs
The baby blues usually start 2 to 3 days after birth and get better within a few days or 1 to 2 weeks. Postpartum depression can occur anytime during the first year after birth, though it commonly begins in the first few weeks. Postpartum psychosis is a psychiatric emergency.
Have questions about your recovery?
Our team can talk you through what to watch for after a birth at our Hewlett center. For an emergency, always call 911.
Call 911 Right Away If You Have…
These signs come from ACOG's list of reasons to call 911 or seek emergency help right away after birth, and from AWHONN's POST-BIRTH warning signs:
- Chest pain
- Coughing or gasping for air, or shortness of breath
- A seizure
- Thoughts of hurting yourself or your baby
- Severe pain in your lower belly
- Pain, swelling, and tenderness in your leg
ACOG lists pain, swelling, and tenderness in your leg together as a reason to call 911 or seek emergency help right away. The CDC notes that these can be signs of a blood clot in the leg, and the skin may also look red or feel warm. The CDC says a clot that travels to the lungs can cause trouble breathing, chest pain that gets worse with a deep breath or cough, coughing up blood, or a fast or irregular heartbeat, and it needs immediate medical attention.
Also call 911 or go to the nearest emergency room if you notice signs of postpartum psychosis, such as seeing or hearing things that aren't there, beliefs that aren't true, paranoia, or confusion. The National Institute of Mental Health (NIMH) calls postpartum psychosis a psychiatric emergency.
The CDC also lists dizziness or fainting, and heavy vaginal bleeding after pregnancy, among its urgent maternal warning signs, and says to get medical care immediately if you have any of them. If you can't reach your provider, go to the nearest emergency room. In a life-threatening situation, call 911.
Call Your Midwife or Provider Right Away For…
For signs like these, the ACOG Foundation's Urgent Maternal Warning Signs guidance says to contact your provider right away, and to go to the nearest emergency room if you can't reach your provider.
Heavy bleeding or large clots
- Bleeding that soaks through one or more pads in an hour
- Blood clots bigger than an egg, or passing tissue
- Bleeding that comes back after it had stopped for more than a few days
The CDC lists heavy vaginal bleeding after pregnancy as an urgent maternal warning sign that needs medical care immediately. If you can't reach your provider, go to the nearest emergency room.
Fever or signs of infection
- A temperature of 100.4°F or higher
- Vaginal discharge that smells bad
- Redness or discharge from a tear, an episiotomy, or an incision
- Pain from a tear, an episiotomy, or an incision that doesn't go away or gets worse
- Pain or burning when you urinate that is severe or continues more than a few days after birth
A headache, vision changes, or swelling
These can be signs of postpartum preeclampsia, a serious high blood pressure disorder. It most often appears within 48 hours of birth but can develop up to 6 weeks after delivery, even if you didn't have preeclampsia during pregnancy. Call right away if you have:
- A headache that doesn't get better after taking medicine, or that gets worse over time
- Changes in your vision, such as blurry vision, flashing lights or spots, or sensitivity to light
- Extreme swelling of your hands or face
- Pain in your upper belly or shoulder
- A sudden weight gain over 1 or 2 days, or a gain of more than 2 pounds in a week
Don't ignore these symptoms if they appear later. The CDC lists a headache that won't go away or gets worse over time, changes in your vision, and extreme swelling of your hands or face as urgent maternal warning signs that need medical care immediately, during pregnancy and in the year after delivery.
A sore, red, or hard area on your breast
Call if you notice red streaks on your breast, a painful new lump, or a tender, red, or warm area. Breast infections usually happen in people who are breastfeeding.
Nausea, vomiting, or belly pain that won't stop
Call for nausea and vomiting that keeps going, or belly pain that is severe and doesn't go away. If the pain is severe and in your lower belly, call 911.
Overwhelming tiredness
You may feel tired after having a baby, particularly in the first few weeks. The CDC lists overwhelming tiredness as an urgent maternal warning sign. The ACOG Foundation's Urgent Maternal Warning Signs guidance describes it as suddenly feeling very tired and weak, not having enough energy to go about your day, or feeling so tired that you don't get up to take care of your baby.
Low mood, hopelessness, or anxiety that isn't getting better
According to NIMH, mood changes and feelings of anxiety or unhappiness that are severe or last longer than 2 weeks after birth may be signs of postpartum depression. MedlinePlus advises contacting your provider if you feel sad, depressed, or withdrawn, or unable to care for yourself or your baby. ACOG lists feelings of hopelessness that last more than 10 days after delivery as a reason to call right away, and advises not waiting until your postpartum checkup if you think you may have postpartum depression. If you have thoughts of hurting yourself or your baby, call 911.
What's Usually Expected After Birth, and When to Call
Some changes can be expected after birth, but recovery looks different for everyone. The CDC notes that you may feel tired and have some pain, particularly in the first few weeks after having a baby, but some symptoms could be signs of more serious problems. This table shows changes that can be expected and the signs that mean it's time to call. It isn't a complete list. If something feels wrong, or you aren't sure, contact your provider.
| Symptom | What's usually expected | Call your provider if… |
|---|---|---|
| Bleeding | Bleeding and cramping can be expected while your uterus heals over the 6 weeks after birth. In the first 2 to 3 days, bleeding may be like a period or a heavy period. Over the following weeks it should get less every day, changing to a brownish, pinkish, then whitish discharge. | You soak through one or more pads in an hour, or bleeding comes back after it had stopped for more than a few days. |
| Clots | In the first 1 to 2 days, you may pass a few small clots (no bigger than an egg), especially after you stand up. | Clots are bigger than an egg, or you pass tissue. |
| Cramping | Your uterus contracts as it shrinks back to its normal size. These cramps, called afterpains, can feel like period cramps and are more common in the first days of breastfeeding and after a previous birth. | Belly pain is severe or doesn't go away. Severe lower belly pain means calling 911. |
| Perineal pain and swelling | A few weeks of swelling and soreness between the vagina and anus after a vaginal birth. It can be more painful and take longer to heal after a tear or episiotomy. | Pain doesn't go away or gets worse, or you notice redness or discharge. |
| Breasts | Your breasts may feel very full, hard, and tender as your milk comes in. Some nipple pain while breastfeeding can be expected and can improve with help on breastfeeding technique. | You see red streaks, feel a painful new lump, or have a tender, red, or warm area. |
| Mood | Some people feel sad, anxious, or upset starting about 2 to 3 days after birth (the baby blues). These feelings usually get better within 1 to 2 weeks. | Feelings are severe or last longer than 2 weeks, hopelessness lasts more than 10 days, or you feel unable to care for yourself or your baby. Thoughts of harming yourself or your baby mean calling 911. |
| Tiredness | You may feel tired, particularly in the first few weeks. | Tiredness feels overwhelming, for example you're too tired to get up to take care of your baby. |
Postpartum Warning Signs: Quick-Reference Table
| If You Have… | What to Do |
|---|---|
| Chest pain | Call 911 |
| Coughing or gasping for air, or shortness of breath | Call 911 |
| A seizure | Call 911 |
| Thoughts of hurting yourself or your baby | Call 911 |
| Severe pain in your lower belly | Call 911 |
| Pain, swelling, and tenderness in your leg | Call 911 or seek emergency help right away |
| Seeing or hearing things that aren't there, paranoia, or confusion | Call 911 or go to the emergency room |
| Dizziness or fainting | Get medical care immediately |
| Bleeding that soaks through one or more pads in an hour, or clots bigger than an egg | Get medical care immediately |
| A temperature of 100.4°F or higher | Call your provider right away |
| A headache that won't go away, vision changes, or extreme swelling of your hands or face | Call your provider right away |
| Discharge that smells bad, or redness, discharge, or worsening pain at a tear or incision | Call your provider right away |
| Red streaks, a painful lump, or a red, warm area on your breast | Call your provider right away |
| Nausea and vomiting that won't stop | Call your provider right away |
| Overwhelming tiredness | Call your provider right away |
| Hopelessness lasting more than 10 days, or sadness or anxiety that is severe or lasts longer than 2 weeks | Call your provider right away |
| Something seems unusual or is worrying you | Don't ignore it. Talk to your provider. |
If you can't reach your provider, go to the nearest emergency room. In a life-threatening situation, call 911.
Want to know how postpartum care works here?
See how our midwives follow you and your baby after birth, from the first check through your six-week visit. For an emergency, always call 911.
What to Say When You Call
Whoever answers, whether it's a 911 dispatcher, an emergency room nurse, or your midwife's office, start by saying that you recently had a baby. The CDC advises telling providers if you were pregnant within the last year. AWHONN, the national nursing organization behind the POST-BIRTH warning signs, suggests a simple script:
- "I had a baby on [date], and I'm having [symptom]."
It also helps to have a few details ready:
- When the symptom started, and whether it's getting worse
- Your temperature, and how you took it
- How many pads you've soaked, and over how long
- Any medicine you've taken
- Whether you had any complications during pregnancy or birth
None of this should delay a call. If you think you're having an emergency, call 911 first.
After a Birth Center Birth: Who to Call
After a birth center birth, your care team will give you instructions about when to go home and when to contact them. Before you leave, make a plan:
- For an emergency: call 911.
- For signs in the "call right away" group: call your midwife or provider. If you can't reach them, go to the nearest emergency room.
- For questions that aren't urgent: keep a list for your next visit. If you aren't sure whether something is urgent, call your provider.
Ask your care team who to call in the first days and weeks, and save those numbers in your phone and your support person's phone. For your baby, our guide to warning signs to watch for in your baby covers when to call about a newborn.
For Partners and Family: What to Watch For
Partners and family can help by learning these postpartum warning signs too.
- Keep this list somewhere you can both see it
- Know where the thermometer is, and how to reach the midwife
- Speak up if something seems off. ACOG advises calling right away if a partner or family members are concerned about postpartum depression, without waiting for the postpartum checkup.
- If you see any sign in the 911 group, call 911
Practical help at home matters too. Some families arrange postpartum doula support for the first weeks. Our sister center also has a guide to preparing for postpartum care at a birth center.
Mental Health Support, Day or Night
If you're struggling with how you feel, you don't have to wait for an appointment to talk to someone.
- National Maternal Mental Health Hotline: call or text 1-833-TLC-MAMA (1-833-852-6262). It's free, confidential, and available 24/7, in English and Spanish.
- 988 Suicide and Crisis Lifeline: call or text 988, or chat at 988lifeline.org, any time.
- Emergency: if you have thoughts of hurting yourself or your baby, or signs of postpartum psychosis, call 911 or go to the nearest emergency room.
Tell your midwife or provider how you're feeling too. Postpartum depression can be treated.
How Our Midwives Support You After Birth
At Birthing Center Long Island, your midwife checks on you and your baby in the first 24 to 48 hours after birth, with a newborn assessment, newborn screening, and lactation support. Later visits cover your physical recovery, how feeding is going, and how you're doing emotionally. Mood changes are common and worth raising early rather than waiting for the six-week visit. Our postpartum and newborn care page explains how visits work, and our midwives also offer newborn care at the center through your baby's first weeks.
Use your visits to ask about anything on this list. If something doesn't feel right between visits, reach our care team, and in an emergency, call 911.
Planning your birth and recovery on Long Island?
Talk with our midwives about postpartum care, follow-up visits, and what to expect after a birth at our Hewlett center. For an emergency, always call 911.