What it is
You have a fever after birth, or your discharge smells foul, or your incision looks angry, and you want to know if this is an infection. Birth leaves several open doors: the place where the placenta was, a tear or incision, the bladder after a catheter, and the breasts.
Endometritis is infection of the lining of the uterus. It happens after about one to three of every hundred vaginal births, and more often after a cesarean or a long labor. Wound infections of the perineum or the cesarean incision are next. Any of these can tip into sepsis, which is the body's own reaction running out of control. Sepsis is a leading cause of maternal death, and it is treatable when caught early.
What's typical
Most infections show up between day two and day ten. Endometritis brings fever, a tender lower belly, chills, and discharge that smells bad. A wound infection brings redness that spreads, heat, swelling, pus, pain that gets worse instead of better, and sometimes the edges pulling apart. A bladder infection burns; a kidney infection adds back pain and fever.
Most are handled with antibiotics, sometimes in the hospital for a day or two. Breastfeeding usually continues.
What's known
ACOG and the WHO use 100.4 degrees Fahrenheit, or 38 Celsius, as the line for postpartum fever. The CDC's Hear Her campaign lists fever among the urgent maternal warning signs. Providers want to hear about a fever the day it starts, not after a weekend.
What helps
- Take your temperature whenever you feel chilled, achy, or off. Write it down with the time.
- Look at your incision or perineum once a day with a mirror or a phone photo. You will notice change.
- Peri bottle, clean pads changed often, and hands washed before and after.
- Keep the after-hours number handy. Infection is the reason that number exists.
When to call someone
- Now (911 or go in): fever with a racing heart, fast breathing, confusion, feeling faint, very little urine, severe belly pain, or a feeling that something is badly wrong.
- Todaya temperature of 100.4 or more, discharge that smells foul, or chills.
- Todayan incision or tear that is red and spreading, hot, leaking pus, or opening; pain that gets worse after day three.
- Todayburning with urination plus back pain, or a red, hot patch on a breast.
- At your next visita wound that is slow to close, or low-grade warmth and redness that comes and goes.
Who helps
Tools: Postpartum Prep Checklist · My Birth Team
Related
- Cesarean recovery, week by weekPostpartum: Your Body
- Healing a tear or stitchesPostpartum: Your Body
- Clogged ducts and mastitisPostpartum: Your Body
- Postpartum bleeding (lochia): what's normal, what's notPostpartum: Your Body
- Postpartum warning signs: the one-page listPostpartum: Your Body
- Peeing after birth and leakingPostpartum: Your Body
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Sources
- American College of Obstetricians and Gynecologists — Patient FAQ on your body after birth
- World Health Organization — Statement on maternal sepsis
- Centers for Disease Control and Prevention — Hear Her campaign: urgent maternal warning signs
- Association of Women's Health, Obstetric and Neonatal Nurses — POST-BIRTH Warning Signs patient handout
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