Postpartum can be a stressful, exhausting, and confusing time. While there are plenty of normal changes happening, there are some critical postpartum red flags to never ignore.
You made it through nine whole months of pregnancy and the birth marathon. Your baby is now in your arms.
The oxytocin bliss bubble and adrenaline high are starting to fade, and you’re looking in the mirror or searching endlessly on Google asking, “why did no one tell me?” or “is what I’m feeling normal?” or “do I need professional help?”.
Disclaimer: This article is for informational purposes only and does not substitute medical advice. Please reach out to your doctor or care team with any medical concerns or questions.
Postpartum reality hits: one mom’s story
The bleeding. The cramping. The night sweats. The emotional roller coaster of tearful outbursts. The emptiness you feel in your womb.
These typical – yet very challenging – aspects of your recovery period, although rarely discussed, can be challenging to cope with at the time.
As a Doctor of Physical therapy, I was trained and knowledgeable about the physical aspect of recovery. I knew to look for pelvic floor and abdominal muscle weakness. I knew the results of tearing during labor could affect the coordination of my pelvic floor muscles and could result in leaking.
I was not prepared for the lesser discussed red flags, though. The insomnia, the intrusive thoughts, the rage I felt towards my partner sleeping peacefully next to me, or the emptiness when I couldn’t soothe the baby I held in my womb.
I was not prepared for breastfeeding/chestfeeding to be excruciating or for my son not to know how to remove milk from my breasts easily. Naively, I had thought, “I have bottle-like nipples and have seen few friends breastfeed and I know it’ll be natural, like breathing.”
I was so wrong.
Nothing could prepare me to navigate the weekly tongue tie therapy and release appointments in those first few weeks. They often left me feeling even more depleted.
I wish I knew what “normal” was and what was not throughout these changes. I wish I knew what red flags to look for during my postpartum recovery so I could reach out and get the support I deserved.
Postpartum red flags to look for after birth
The word “postpartum” means the period of life after birth. During this time, physical and mental changes occur, and these changes are red flags to be aware of and get support around.
Physical red flags during postpartum
Vaginal changes
If you are experiencing:
- An increase in vaginal bleeding
- Belly pain
- Foul-smelling lochia
You need to see your provider as soon as possible as you may have an infection.
Breast changes
If you are breastfeeding/chestfeeding and you are experiencing:
- Painful breasts with flu-like symptoms
You may have mastitis, and you need to see your provider as soon as possible.
Physiological changes
If you are experiencing:
- Elevated blood pressure
- Pressure in your chest
- Headaches
You need to see your provider.
Pelvic floor changes
If you are experiencing any of the following:
- Pelvic pain*
- Urinary or fecal or gas leaking
- Heaviness in your pelvis (do you feel a bulging pressure in your vagina?)
- Coning in your abdomen when you sit up or lift your head off the floor
- Joint pain of any kind including back, neck, shoulder, and wrist
*Pelvic soreness after the first few days with vaginal delivery is normal, but when you are having trouble sitting or with penetration, it’s time to seek help.
Note: The above pelvic floor changes can be treated with the help of a trained pelvic health physical therapist. You can find a pelvic health physical therapist with a Google search or APTA.org.
Mental health red flags
The most commonly discussed mental health challenge during postpartum is postpartum depression (PPD). While PPD can affect many new parents, there are other mental health red flags to look out for – in addition to PPD – such as the signs outlined below.
- Insomnia (you can’t sleep even when baby is sleeping)
- Thoughts of harming yourself or your baby
- Intrusive thoughts
- Not finding pleasure or joy in anything
- Not connecting or feeling a sense of bonding with your baby*
- Feeling rage or anger towards your partner
- Uncontrollable crying (tears are normal the first few weeks as your hormones regulate)
- You feel fear to leave the house (granted, we are mothering in a pandemic)
- You often wonder “should I have had a child?“ on thought loop
*Developing a bond can take time to learn. Your bond with your child should grow with time, so don’t stress if you don’t feel immediately connected to your newborn.
Note: if you have any concerning thoughts of harming yourself or your baby, please call 911 immediately. If you have a non-life-threatening concern and would like support, please text or call the Postpartum Support International Hotline.
Final thoughts on postpartum recovery
If you find yourself experiencing any of the above red flags, I want you to know that you are not alone or to blame for any of these things, and you can find support.
You will not feel like this forever. You will feel like yourself with more energy, creativity, and zest for life again.
If you are in a state of overwhelm where you cannot possibly imagine finding help or don’t even know where to start, reach out to your care provider, your partner, a trusted friend, or call the Postpartum Support International Hotline.
You are a “good enough” mother, and you will feel joy again.
