Postpartum Symptoms to Watch For: What’s Normal and What’s Not

What’s Normal in the First Few Weeks After Birth?

Whether you had a vaginal delivery or a caesarean, your body is in recovery mode. It’s normal to experience:

1. Postpartum Bleeding (Lochia)
   You’ll bleed after birth, even with a C-section. This is called lochia and includes blood, mucus and uterine lining.
   What’s normal:
   • Bright red bleeding that gradually lightens
   • Flow lasting up to 6 weeks
   • Small clots (smaller than a 50p coin)
   • Slight blood-like smell
2. Afterpains
   You may experience cramp-like pains as your uterus contracts back to its original size, especially during breastfeeding. These typically last a few days.
3. Perineal Soreness
   If you had a vaginal birth with stitches or tears, expect some discomfort. Using warm water while weeing, witch hazel pads, or cooling maternity pads can help ease the sting.
4. Breast Changes
   Even if you're not breastfeeding, you may experience:
   • Fullness or engorgement
   • Leaking milk
   • Tenderness as milk "comes in" around day 3–5
5. Emotional Ups and Downs
   The “baby blues” are common around days 3–5, often triggered by hormone shifts and exhaustion. You may feel weepy, irritable, or overwhelmed. These feelings usually pass within a week.

Postpartum Symptoms That May Need Medical Attention

Some symptoms are not normal and may indicate infection, complications, or other health issues. Don’t wait - call your GP, midwife, or NHS 111 if you experience:

1. Heavy Bleeding or Large Clots
   • Soaking more than one pad an hour
   • Passing clots larger than a 50p coin
   • Sudden increase in bleeding after it had slowed down

   This may signal postpartum haemorrhage or retained placenta tissue and both need urgent attention.

2. Foul-Smelling Discharge
   Lochia should smell like a light period. A strong, unpleasant or fishy odour may signal infection of the uterus (endometritis).
   Watch for:
   • Fever
   • Lower abdominal pain
   • Feeling unwell or weak
3. Pain or Swelling Around the C-Section Scar or Perineum
   • Increasing redness, heat or swelling
   • Pus or weeping from the scar
   • Unusual pain that worsens instead of improving

   These may be signs of wound infection or abscess.

4. High Temperature (Over 38°C)
   A fever in the days or weeks after giving birth can be a sign of:
   • Uterine or wound infection
   • Urinary tract infection (UTI)
   • Mastitis (breast tissue infection)
5. Burning or Pain When You Wee
   Mild stinging is common, especially after a tear or catheter. But if it's accompanied by:
   • Cloudy or smelly urine
   • Lower back pain
   • A strong urge to wee often

   …it could be a urinary tract infection, which needs treatment.

6. Swollen, Painful Legs or Calves
   Pain, redness, or swelling in one leg may indicate a deep vein thrombosis (DVT), which can be dangerous if left untreated.
   Get urgent help if:
   • One leg is red, hot or painful
   • You feel chest pain or shortness of breath
   • You notice a rapid heartbeat
7. Headaches
   Postpartum headaches can be common after childbirth, often linked to hormonal fluctuations, sleep deprivation, and the physical and emotional demands of caring for a newborn.
   Please contact a health professional if the headache is:
   • Severe, sudden, or accompanied by other symptoms like fever, vision changes, or stiff neck
   • Worsening over 24 hours
   • Not responding to over-the-counter pain relievers
   • Accompanied by confusion, seizures, or difficulty speaking
8. Intense Emotional Distress
   It’s okay to cry but persistent sadness, panic, anger, or feeling disconnected from your baby may be signs of postnatal depression or anxiety.
   Seek support if:
   • You feel hopeless or numb
   • You can’t sleep even when baby sleeps
   • You’re having intrusive thoughts
   • You feel like you can’t cope

Listen to Your Body: You Know Best

You’ve just been through something extraordinary and it’s okay to feel uncertain. But you deserve to feel safe, seen, and cared for during your recovery.

If something doesn’t feel right, even if it’s not on this list, trust your instincts and speak to your GP or midwife. It’s always better to check.

Midwife’s Top Tips

• Monitor your bleeding - a sudden change is a red flag
• If your scar becomes more painful or hot, seek medical attention
• Don’t ignore mental health - your emotions matter too
• Take your temperature if you feel flu-like or off
• You’re never wasting anyone’s time - call if you’re worried

The postpartum period is full of change. While many symptoms are expected, some aren’t and learning to spot the difference can make all the difference to your health and peace of mind.

There’s no shame in asking for help. You’ve done something powerful and now it’s time to heal with the support, clarity and care you deserve.