Common Postpartum Complications

The postpartum period, often referred to as the “fourth trimester”, is a critical time for new parents. It involves adjusting and recovering after childbirth and can bring both joy and challenges. Many new parents focus on caring for their baby. Yet, these new parents may face health problems in the weeks and months after birth. These are known as postpartum complications. Understanding common postpartum complications and knowing how to identify them can play a crucial role in ensuring a healthy transition into parenthood.

Common Complications

Postpartum Hemorrhage

Postpartum hemorrhage is excessive bleeding after childbirth. It is one of the leading causes of maternal deaths in Canada. It is often caused by the uterus not contracting properly after delivery. After giving birth, it is normal to experience bleeding similar to a heavy period, which may last for up to 2 to 4 weeks. This bleeding decreases over the first few days and changes from bright red to pink or brownish. However, heavy bleeding or discharge that soaks a pad in one hour, two times in a row, or blood clots that are larger than an egg may indicate a more serious issue.

It is important to seek medical attention if experiencing:

heavy bleeding that soaks one pad in an hour, two times in a row
blood clots are larger than an egg or plum
persistent stomach pain or discomfort
fever (38.0 °C or higher by ear, or 37.6 °C or higher by mouth or under the armpit)
feeling faint, dizzy, or light-headed
rapid heartbeat or significant increase in heart rate

Sometimes bleeding can happen later, up to 6 weeks after birth. It is important for new parents to know the symptoms so they can get help quickly.

Postpartum Depression (PPD)

After giving birth, many people experience mood swings or feel emotional or anxious, which is often called the “baby blues”. This is normal and usually goes away within a few weeks. However, if these feelings last longer and interfere with daily life or the ability to care for the baby, it may indicate postpartum depression. Postpartum depression is a serious condition that can develop in the weeks or months after childbirth. Unlike the temporary baby blues, postpartum depression involves more severe symptoms that require treatment. It is important to understand that postpartum depression is a medical condition and seeking help is both necessary and normal.

It is important to seek medical attention if experiencing:

persistent sadness or feelings of hopelessness
extreme fatigue or exhaustion
difficulty concentrating or making decisions
severe anxiety or panic attacks
uncontrollable crying or severe mood swings
feelings of guilt, worthlessness, or low self-esteem
sleep disturbances, including insomnia or oversleeping
feelings of isolation or withdrawal from others
intense fear of harming oneself or the baby

Call 911 if having thoughts of hurting oneself, the baby, or others.

The exact cause of postpartum depression is not fully understood, but several factors may contribute, including:

hormonal changes during and after pregnancy
significant stress and major life changes
sleep deprivation
personal or family history of mental health conditions
relationship issues
lack of support
adjusting to new parenting responsibilities

Postpartum depression is treatable, and early intervention can lead to better outcomes. If there are concerns about symptoms or well-being, consulting a healthcare provider is important. For more information about postpartum depression and other postpartum mental health concerns, including information about available supports, please visit: www.skprevention.ca/mental-health/maternal-mental-health/.

Breast Pain and Engorgement

Breast engorgement happens when the breasts become overly full with milk. Engorged breasts may feel swollen, warm, hard, lumpy, and uncomfortable. It usually happens when milk first comes in, about 2 to 5 days after birth. Milk can also build up if there are delayed or infrequent feedings.

To relieve engorgement:

breastfeed or pump frequently to help empty the breast
apply cold compresses between feedings to reduce swelling
take a warm bath or apply warm compresses just before feeding to improve milk flow

Mastitis

Mastitis is an infection of the breast tissue, usually caused by a blocked milk duct or bacteria entering the breast. Severe breast engorgement can lead to mastitis and may cause pus in the milk ducts. Mastitis can also occur if the baby is not latching properly. A person with mastitis may experience flu-like symptoms such as fever and chills, redness, swelling, and pain in the breast.

It is important to seek medical attention immediately if having these symptoms, as mastitis is a serious condition that can be treated effectively with antibiotics.

To aid recovery:

get plenty of rest
breastfeed or express milk frequently
take antibiotics and pain relief medications as directed by a healthcare provider

Urinary Incontinence

Urinary incontinence is the involuntary leakage of urine that can occur after childbirth. After giving birth, it is normal to experience some degree of urinary leakage. It results from weakened pelvic floor muscles due to pregnancy and delivery. Stress urinary incontinence is the most common type of urinary leakage after childbirth. It happens when physical activities like coughing, sneezing, or lifting put pressure on the bladder, causing urine to leak. While urinary incontinence can be embarrassing, it is a normal part of postpartum recovery.

Tips for management:

perform Kegel exercises regularly to strengthen the pelvic floor
go to the bathroom regularly, extending the intervals between bathroom breaks over time
eat a diet high in fruits, vegetables, and whole grains to avoid constipation and reduce bladder pressure
stay hydrated

It is important to seek medical attention if experiencing:

persistent and severe leakage that interferes with daily activities
a sudden, intense urge to urinate frequently or uncontrollably
pain or discomfort
blood in the urine

Perineal Tears or Episiotomy

After childbirth, many birthing parents experience discomfort in the perineum (the area between the vagina and anus). This can happen because of tears that occurred during delivery or if an episiotomy (a surgical cut) was done to ease delivery. The perineal area may be sore, swollen, and tender for weeks following childbirth. If there is a tear or episiotomy, stitches may be used to repair it. There is no need to go back to the hospital to have them taken out because the stitches will dissolve on their own.

To ease discomfort:

change pads at least every 4 hours
rinse the perineum with warm water using a squeeze bottle
take sitz baths or warm soaks
apply ice packs wrapped in a towel for 15 to 20 minutes at a time to reduce swelling
use pain medications recommended by a healthcare provider
drink plenty of water to prevent constipation
practice Kegel exercises to strengthen pelvic floor muscles
rest when you can and avoid strenuous activities until healed

It is important to seek medical attention if experiencing:

heavy bleeding or discharge that is more than usual
new or severe pain
unusual or foul smell
wounds that refuse to heal
fever

Constipation

Constipation is common after childbirth and can make bowel movements painful and challenging. It usually starts within 2 to 3 days after a vaginal delivery or 3 to 5 days after a caesarean section. Contributing factors include hormonal changes, pain medications, dehydration, reduced physical activity, and new sleep schedules.

To ease discomfort:

drink plenty of water
eat more fibre like fruits, vegetables, and whole grains
increase physical activity slowly

Talk to a healthcare provider about stool softeners and other medications if there is no relief.

Hemorrhoids

Hemorrhoids are swollen veins in the rectal or anal area. They often result from the pressure of pregnancy and childbirth, as well as from constipation.

Symptoms include:

pain or discomfort in the anal area
itching or irritation around the anus
bleeding during bowel movements

To aid recovery:

increase water intake to prevent constipation
eat fibre-rich meals like whole grains, fruits, and vegetables
move around regularly; avoid prolonged periods of sitting or standing
use gentle wipes like baby wipes or hemorrhoid pads instead of toilet paper to reduce irritation
apply a cold pack or ice for 10 to 20 minutes several times a day to relieve swelling and discomfort

For severe or persistent hemorrhoids, consult a healthcare provider.

Resources and Support

The postpartum period is an important time that can bring both happiness and challenges for new parents. It is essential to recognize and understand potential complications to ensure a smooth recovery. If any of the symptoms mentioned above occur, seeking timely medical advice is important. It is important to remember that support is available – whether through healthcare professionals, support groups, or discussions with loved ones. Prioritizing physical and mental well-being during this time is crucial, as compassion for oneself can help ensure a healthier transition into parenthood.

For immediate health advice and information in Saskatchewan, dial 811 or call 1-877-800-0002 to access HealthLine services, including support for postpartum care and mental health concerns. This service is available 24 hours a day, 7 days a week. Dial 911 in case of an emergency.

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Common Postpartum Complications

Common Complications

Postpartum Hemorrhage

Postpartum Depression (PPD)

Breast Pain and Engorgement

Mastitis

Other Postpartum Infections

Urinary Incontinence

Perineal Tears or Episiotomy

Constipation

Hemorrhoids

Resources and Support

Related Saskatchewan Prevention Institute Resources:

Canadian Resources:

Saskatchewan Resources: