Postpartum Infections
Infections that can occur after childbirth
Quick Facts
- Type: Infections after childbirth
- Common sites: Uterus, wounds, breasts, urinary tract
- Key symptom: Fever after delivery
- Treatment: Antibiotics and supportive care
Overview
Postpartum infections are infections that develop in the days to weeks after childbirth. They can affect several parts of the body, most commonly the lining of the uterus (endometritis), a cesarean incision or other birth-related wound, the breasts (mastitis), or the urinary tract.
These infections are an important cause of illness after birth, but most are treatable, especially when recognized early. Fever after delivery is a key warning sign and should always be evaluated. Prompt treatment with antibiotics and supportive care usually leads to full recovery, while delays can allow an infection to become more serious.
Symptoms
Symptoms depend on where the infection is, but fever is a common thread. Warning signs include:
- Fever or chills in the days or weeks after birth
- Lower abdominal or pelvic pain and tenderness
- Foul-smelling vaginal discharge or heavier-than-expected bleeding
- A red, swollen, painful, or draining wound (cesarean or perineal)
- A red, hot, painful area of the breast with fever (mastitis)
- Burning when urinating, frequent urination, or back pain (urinary infection)
High fever, severe pain, confusion, a racing heartbeat, or feeling very unwell can signal a serious, spreading infection and require emergency care.
Causes
Postpartum infections occur when bacteria enter or multiply in tissues that were stressed or opened during birth. Contributing causes include:
- Uterine infection (endometritis): Bacteria from the vagina reaching the uterine lining, more common after cesarean birth.
- Wound infection: Bacteria entering a cesarean incision or perineal tear or cut.
- Mastitis: Breast infection, often linked to blocked milk ducts during breastfeeding.
- Urinary tract infection: Sometimes related to catheter use during labor.
Retained pieces of placenta and prolonged labor can also increase the risk.
Risk Factors
- Cesarean birth
- Prolonged labor or long time after the waters break
- Multiple vaginal examinations during labor
- Perineal tears or an episiotomy
- Retained placental tissue
- Diabetes, obesity, or a weakened immune system
Diagnosis
Diagnosis is based on symptoms, examination, and tests to find the source. It may include:
- Physical examination: Checking the abdomen, uterus, wounds, breasts, and overall condition.
- Vital signs: Temperature, heart rate, and blood pressure to gauge severity.
- Blood and urine tests: To look for infection and check kidney function.
- Cultures: Of urine, wound drainage, or other samples to identify the bacteria.
- Imaging: Ultrasound or other scans if a deeper infection or retained tissue is suspected.
Treatment
Most postpartum infections are treated effectively with antibiotics and supportive care. Treatment may include:
- Antibiotics: By mouth for milder infections, or intravenously in hospital for more serious ones.
- Wound care: Cleaning, drainage, or opening of an infected incision when needed.
- Mastitis care: Continued breastfeeding or milk removal, warm compresses, and antibiotics.
- Fluids and rest: Supportive measures to aid recovery.
- Removal of retained tissue: A procedure if placental tissue is causing infection.
Severe or spreading infections need urgent hospital treatment to prevent complications such as sepsis.
Prevention
- Keep birth wounds clean and dry and follow care instructions
- Wash hands before touching incisions or pads
- Empty the breasts regularly and treat blocked ducts early when breastfeeding
- Stay hydrated and care for any urinary symptoms promptly
- Attend postnatal check-ups and report fever or worsening symptoms
When to See a Doctor
Contact your provider promptly for a fever after birth, increasing pain, foul-smelling discharge, or a wound that becomes red, swollen, or drains pus. Seek emergency care for:
- A high fever with shaking chills and feeling very unwell
- Severe abdominal or pelvic pain
- A fast heartbeat, confusion, or difficulty breathing
- Very heavy vaginal bleeding
Frequently Asked Questions
What are postpartum infections?
Postpartum infections are infections that develop after childbirth, most often affecting the uterus, a cesarean or perineal wound, the breasts, or the urinary tract. Fever after delivery is a key warning sign.
What are the warning signs?
Watch for fever or chills, lower abdominal or pelvic pain, foul-smelling discharge, a red or draining wound, a red and painful breast, or burning with urination. Feeling very unwell with a high fever needs urgent attention.
How are postpartum infections treated?
Most are treated with antibiotics, given by mouth for milder cases or in hospital for more serious ones, along with wound care, fluids, and rest. Mastitis also involves continued milk removal, and retained tissue may need to be removed.
Are postpartum infections dangerous?
Most are treatable, especially when caught early, but an untreated infection can spread and lead to sepsis, which is life-threatening. That is why any fever or worsening symptoms after birth should be evaluated promptly.
Can I keep breastfeeding with mastitis?
Yes. Continuing to breastfeed or otherwise empty the breast is an important part of treating mastitis, along with warm compresses and antibiotics if prescribed. Stopping suddenly can make the blockage and infection worse.
References
- World Health Organization (WHO). Maternal sepsis.
- Mayo Clinic. Postpartum care.
- MedlinePlus, U.S. National Library of Medicine. Postpartum care.
- Centers for Disease Control and Prevention (CDC). Maternal infections.