The Hidden Danger After Delivery
Most people associate the risks of childbirth with labor and delivery, but the postpartum period carries its own serious dangers. According to the CDC's Pregnancy Mortality Surveillance System, 53 percent of pregnancy-related deaths occur after delivery — between seven days and one year postpartum. For Black women, the risk is even more pronounced. Conditions like postpartum hemorrhage, infection, blood clots, preeclampsia that develops after delivery, and cardiomyopathy affect Black mothers at higher rates, and the symptoms can be easy to dismiss when you are exhausted from caring for a newborn.
Understanding the warning signs that require immediate medical attention is one of the most important things you can do to protect yourself during the postpartum period. Share this information with your partner, family members, and anyone who will be supporting you after birth so that multiple people are watching for signs that something is wrong.
Severe Bleeding
Some bleeding after birth is normal and expected. Lochia — the postpartum vaginal discharge — typically starts heavy and bright red, then gradually lightens in color and flow over several weeks. What is not normal is soaking through a heavy pad in an hour or less, passing blood clots larger than an egg, or experiencing a sudden increase in bleeding after it had started to slow down. These can be signs of postpartum hemorrhage or retained placental tissue, both of which require urgent evaluation. If you are soaking through pads rapidly or feeling dizzy and lightheaded along with heavy bleeding, seek emergency care immediately.
High Blood Pressure and Preeclampsia
Many people do not realize that preeclampsia can develop for the first time after delivery, sometimes days or even weeks later. Postpartum preeclampsia is a medical emergency. Watch for severe headaches that do not improve with rest or medication, vision changes such as blurriness, seeing spots or flashing lights, pain in the upper right area of your abdomen, sudden swelling in your face or hands, and nausea or vomiting that starts after delivery. If you experience any combination of these symptoms, your blood pressure needs to be checked immediately. Do not wait for your next scheduled appointment — go to an emergency room.
Black women are at significantly higher risk for hypertensive disorders of pregnancy, including postpartum preeclampsia. CDC data from 2024 shows cardiac and coronary conditions are the leading underlying cause of pregnancy-related death among Black women. If you had any blood pressure issues during pregnancy, be especially vigilant in the weeks after delivery. But even if your pregnancy was uncomplicated, stay alert. Postpartum preeclampsia can develop in people who had perfectly normal blood pressure throughout pregnancy.
Signs of Infection
Whether you had a vaginal birth or a cesarean section, infection is a risk in the postpartum period. Watch for fever above 100.4 degrees Fahrenheit, increasing pain at the site of a perineal tear, episiotomy, or cesarean incision, redness or swelling that is getting worse rather than better, foul-smelling vaginal discharge, and pain or burning with urination along with frequent urgency. Endometritis — an infection of the uterine lining — can also occur, causing lower abdominal pain, fever, and abnormal bleeding. Any of these symptoms warrant a call to your provider or a visit to urgent care.
Blood Clots
Pregnancy and the postpartum period increase the risk of blood clots, including deep vein thrombosis in the legs and pulmonary embolism in the lungs. Symptoms of a blood clot in the leg include pain, swelling, redness, or warmth in one leg, usually the calf. A pulmonary embolism is far more dangerous and symptoms include sudden shortness of breath, chest pain that worsens with deep breaths, rapid heartbeat, coughing up blood, and feeling faint. A pulmonary embolism is a life-threatening emergency that requires immediate treatment. If you experience sudden difficulty breathing or chest pain after delivery, call 911.
Mental Health Warning Signs
Postpartum mood disorders affect up to one in five new mothers, and Black women face additional barriers to recognition and treatment. Postpartum depression goes beyond the typical exhaustion and emotional adjustment of new parenthood. Warning signs include persistent sadness or emptiness that lasts more than two weeks, inability to sleep even when the baby is sleeping, loss of interest in things you usually enjoy, withdrawing from your baby or family, intrusive thoughts of harming yourself or your baby, severe anxiety or panic attacks, and feeling like you are not yourself or that something is fundamentally wrong.
Postpartum psychosis is rare but extremely serious. Symptoms include confusion, hallucinations, paranoia, and erratic behavior. It typically develops within the first two weeks after delivery and requires immediate psychiatric evaluation. Black women with postpartum mood disorders are less likely to be diagnosed and treated, often because their symptoms are attributed to being a strong woman who can handle it, or because they lack access to mental health providers who understand their experience. You deserve help, and asking for it is not weakness — it is one of the bravest and most important things you can do for yourself and your baby.
When to Call and When to Go
As a general rule: call your midwife or provider for any symptom that concerns you, even if you are not sure it is serious. They would rather hear from you and reassure you than have you wait until a manageable situation becomes an emergency. Go directly to the emergency room for heavy uncontrolled bleeding, chest pain, difficulty breathing, seizures, thoughts of harming yourself or your baby, fever above 100.4 with other symptoms, or severe headache with vision changes. Tell the triage team that you recently gave birth, as postpartum complications require specific evaluation.
If you feel that your concerns are being dismissed in any healthcare setting, you have the right to request a different provider, ask for a supervisor or patient advocate, and insist that your symptoms be evaluated and documented. Your life and health are worth every question you ask and every boundary you set.