Guide

Postpartum warning signs: when to get help now

Last updated: September 2026

Written by Cynthia Obinatu, community and editorial lead · Checked against published guidance from BMJ Open, via PubMed Central, National Health Service and World Health Organization. Not yet reviewed by a clinician, so read it with our medical policy.

Most of what happens after birth is uncomfortable and normal. A few things are not normal, and it helps to know which before you need them. This page gives you numbers you can count, because a word like "excessive" is what makes a woman wait.

If you are reading this at 3am and worried. Go. Do not finish the page first. Nobody at a clinic will mind that you came and it turned out to be nothing, and a great deal of what follows is treatable when it is caught early. This guide helps you recognise a sign. It is not a diagnosis, and it has not been reviewed by a clinician.

How do you know your bleeding after birth is too much?

Severe bleeding after childbirth is the single largest cause of maternal death worldwide. The World Health Organization puts severe bleeding, infection, high blood pressure, delivery complications and unsafe abortion together at around 75 per cent of all maternal deaths. It says most of them are preventable, because the treatments are well known. What stands between a woman and that treatment is usually time.

Researchers in Yola asked women how they knew their own bleeding had gone too far. The answers describe a threshold that arrives far too late.

The moment you get up, you'll faint. That way, they'll know that you've lost too much blood.

Maimuna, in a focus group in Yola, North-East Nigeria, quoted in BMJ Open, 2021

Fainting comes after the blood is already lost. Count pads instead, because a pad can be counted and a feeling cannot.

For you: get help today if you have

Bleeding that soaks a maternity pad in an hour, or that is getting heavier rather than lighter, or clots bigger than a 50 naira coin. The National Health Service says to tell your midwife if you are losing blood in large clots.
A fever, shivering, or feeling generally unwell. Infection after childbirth is one of the big causes of maternal death and one of the most treatable when caught early.
Pain that is getting worse rather than better, particularly in your abdomen, or pain around stitches with redness, heat or discharge.
A bad headache, blurred or flashing vision, or sudden swelling in your face and hands. Blood pressure problems do not end at delivery and can start after it.
Chest pain, breathlessness, or a hot, painful, swollen area in one calf. These are clot signs. They are an emergency, so do not wait and see.
Vaginal discharge that smells foul. Lochia has a smell. It should not be offensive.
A red, hot, painful wedge on one breast with flu-like aching. That is mastitis, and it needs treatment. Do not push through it.
Being unable to pass urine, or leaking that is not improving.

One more, because it is the one women most often talk themselves out of. If something feels badly wrong and you cannot name it, that is a reason to go. You have carried this body for longer than any clinician has known it.

When to see a doctor

If you have thoughts of harming yourself or your baby, or you feel you cannot cope, tell someone you trust today and contact a health professional. Postnatal depression is common and treatable. The National Health Service describes it as an illness, and it is nothing you failed at. The baby blues lift within about two weeks. Depression does not lift, and it responds to help.

For your baby: get help today if they

Are feeding much less than usual, or are hard to wake for feeds. A newborn who will not wake to eat is a newborn to take in.
Have a fever, or feel unusually cold. In a small baby, too cold matters as much as too hot.
Have far fewer wet or dirty diapers than normal. Wet and dirty diapers are the most reliable count you have.
Are breathing fast, grunting with each breath, or pulling in under the ribs.
Are becoming more yellow in the skin or the whites of the eyes, especially in the first week, or look very pale or mottled.
Are floppy, unusually still, or crying in a way that is not like them.
Have a rash that does not fade when you press a glass against it.

Several of those overlap with sepsis. Sepsis moves quickly in babies. The National Health Service keeps a plain list of sepsis symptoms worth reading once while nothing is wrong.

Can something still go wrong after the six-week check?

Yes. The six-week check is a milestone, and the risks do not end there. Blood pressure problems, clots, infection and postnatal depression can all begin after it. A woman who has been discharged often assumes she has been signed off. You have not been. If a new sign appears in month two or month four, it counts exactly as much as one in week one.

How to be taken seriously when you go

Bring numbers. Say how many pads in how many hours. "A lot" is hard to act on. Say what your temperature was if you took it. Say when it started and whether it is worsening. A clinician can act on a number immediately and has to work to get there from "I do not feel right".

Take someone with you if you can, especially if you are exhausted. If you are sent home and it gets worse, go back. Going back is not a complaint about the first visit. It is new information.

Common questions

How much bleeding after birth is too much?

Soaking a maternity pad within an hour, bleeding that gets heavier instead of lighter, or clots larger than a 50 naira coin all mean get help now. Count pads and do not judge by feel. The feeling-based thresholds women use, such as feeling faint on standing, arrive far too late.

How long does bleeding after birth last?

A few weeks. It is heaviest in the first days, then lightens and changes colour from red to brown to a pale discharge. Bleeding that becomes heavier again after lightening needs a call.

What are the warning signs of infection after birth?

A fever or shivering, pain that worsens instead of easing, foul-smelling discharge, or redness, heat and discharge around stitches. Infection after childbirth is a major cause of maternal death and is very treatable when caught early.

Is it normal to feel low after having a baby?

A short dip is. The baby blues affect many women and lift within about two weeks. A low mood that deepens, or lasts beyond that, or brings thoughts of harming yourself or your baby, is postnatal depression. It is common and treatable. It is an illness, and nothing you failed at.

When should I take my newborn to hospital?

If they are feeding much less or are hard to wake, have a fever or feel unusually cold, have far fewer wet diapers, are breathing fast or grunting, are becoming more yellow or look very pale, are floppy or unusually still, or have a rash that does not fade under a pressed glass.

Can something go wrong after the six-week check?

Yes. Blood pressure problems, clots, infection and postnatal depression can all begin after six weeks. Being discharged is not being signed off. A new sign in month two counts as much as one in week one.

What if I go and it turns out to be nothing?

Then it was nothing, and you found out. No clinic minds. The cost of a wasted trip is an afternoon. The cost of waiting when it was serious is much higher.

Sources

Your body after the birth, including what bleeding is normal and when to tell your midwife, National Health Service
Maternal mortality: the major complications and how far they are preventable, World Health Organization
Women's perceptions and self-reports of excessive bleeding during and after delivery, Yola, North-East Nigeria, BMJ Open, via PubMed Central, 2021
Postnatal depression: symptoms, and why it is an illness rather than a failing, National Health Service
Sepsis: symptoms in adults and in children, National Health Service

Go further

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