Postpartum Infection and Sepsis - Warning Signs Every Mother Should Know
Content reviewed against published ACOG, CDC, NIH guidelines
Last reviewed:
Your health matters just as much as your baby's. If you are dealing with postpartum infection and sepsis - warning signs every mother should know, here is what you need to know.
The short answer
Infections and sepsis are the second leading cause of pregnancy-related deaths. Over 43% of pregnancy-related deaths occur in the 6 weeks after delivery, yet many mothers receive only a single checkup during this period. Warning signs of postpartum infection include fever over 100.4F, foul-smelling vaginal discharge, increasing abdominal pain, redness or drainage from a C-section incision, painful urination, and flu-like symptoms that worsen rather than improve. Trust your instincts - if you feel something is wrong, seek care immediately.
Key takeaways
- Infections and sepsis are the second leading cause of pregnancy-related deaths. Over 43% of pregnancy-related deaths occur in the 6 weeks after delivery, yet many mothers receive only a single checkup during this period. Warning signs of postpartum infection include fever over 100.4F, foul-smelling vaginal discharge, increasing abdominal pain, redness or drainage from a C-section incision, painful urination, and flu-like symptoms that worsen rather than improve. Trust your instincts - if you feel something is wrong, seek care immediately.
- Usually normal when: Mild cramping and lochia (postpartum bleeding) that gradually decreases over 2-6 weeks.
- Call your doctor if: Fever of 100.4F (38C) or higher at any point after the first 24 hours postpartum.
- Varies by age — see the age-by-age breakdown below
“About 1 in 8 women experience symptoms of postpartum depression. If you have symptoms of depression that last longer than 2 weeks, tell your health care provider.”
Parents everywhere have the same worry. You are doing the right thing by looking into it.
By Age
What to expect by age
First 48 hours postpartum
A mild temperature elevation right after delivery can be normal, especially after a long labor. However, a fever of 100.4F (38C) or higher that persists beyond the first 24 hours or develops after initial discharge requires evaluation. The most common early postpartum infections are endometritis (uterine lining infection), wound infection from a C-section or episiotomy, and urinary tract infection from catheterization. If you had a C-section, watch the incision closely for redness spreading beyond the edges, warmth, swelling, or drainage.
First 1-2 weeks postpartum
This is the highest-risk window for postpartum infection. Endometritis symptoms include fever, lower abdominal pain, and foul-smelling lochia (postpartum bleeding). C-section wound infections typically appear 4-7 days after surgery. Mastitis (breast infection) can also develop, causing breast pain, redness, warmth, and fever. Sepsis can develop rapidly from any of these infections. Warning signs of sepsis include: fever or abnormally low temperature, rapid heart rate, rapid breathing, confusion or disorientation, extreme pain, and feeling like you might die. If you experience these, call 911.
2-6 weeks postpartum
Late-onset infections can still occur weeks after delivery. If you develop a new fever, worsening pain (especially abdominal or pelvic), foul-smelling discharge, or feel progressively sicker rather than better, do not wait for your 6-week checkup. Contact your OB or midwife or go to the emergency room. Delayed treatment of postpartum infection is one of the most preventable causes of maternal mortality. You know your body - if something feels wrong, it likely is.
What Should You Do?
When to take action
- Mild cramping and lochia (postpartum bleeding) that gradually decreases over 2-6 weeks.
- Brief low-grade temperature elevation in the first 24 hours after delivery that resolves.
- Breast tenderness during milk "coming in" around days 3-5 without fever or redness.
- Gradual improvement in energy and pain levels day by day after delivery.
- Your lochia has a strong odor or changes from pink/brown to bright red after initially decreasing.
- You notice mild redness around your C-section incision that is not spreading.
- You have painful or burning urination after delivery, even without fever.
- You are feeling progressively more tired instead of gradually better after the first week.
- Fever of 100.4F (38C) or higher at any point after the first 24 hours postpartum.
- Foul-smelling vaginal discharge combined with fever, chills, or abdominal pain.
- C-section incision that is increasingly red, warm, draining pus, or opening up.
- Signs of sepsis: rapid heart rate, rapid breathing, confusion, extreme pain, feeling like something is very wrong.
- Heavy vaginal bleeding that soaks more than one pad per hour for two consecutive hours.
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Postpartum Infection and Sepsis - Warning Signs Every Mother Should Know.
Things to mention
- Your lochia has a strong odor or changes from pink/brown to bright red after initially decreasing.
- You notice mild redness around your C-section incision that is not spreading.
- You have painful or burning urination after delivery, even without fever.
- You are feeling progressively more tired instead of gradually better after the first week.
Observations to share
- Your lochia has a strong odor or changes from pink/brown to bright red after initially decreasing.
- You notice mild redness around your C-section incision that is not spreading.
- You have painful or burning urination after delivery, even without fever.
Urgent signs to report immediately
- Fever of 100.4F (38C) or higher at any point after the first 24 hours postpartum.
- Foul-smelling vaginal discharge combined with fever, chills, or abdominal pain.
- C-section incision that is increasingly red, warm, draining pus, or opening up.
My notes
From ismybabyalright.com — free, evidence-based baby health guides
Related Conditions
Related Resources
Fever Decision Tree
Step-by-step guidance for evaluating your baby's fever by age and temperature.
Postpartum Recovery Guide
Week-by-week postpartum recovery timeline and warning signs.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is postpartum infection and sepsis - warning signs every mother should know normal?
When should I call the doctor about postpartum infection and sepsis - warning signs every mother should know?
When is postpartum infection and sepsis - warning signs every mother should know normal?
What causes postpartum infection and sepsis - warning signs every mother should know?
What should I mention to my pediatrician about postpartum infection and sepsis - warning signs every mother should know?
Is postpartum infection and sepsis - warning signs every mother should know normal at First 48 hours postpartum?
Is postpartum infection and sepsis - warning signs every mother should know normal at First 1-2 weeks postpartum?
Should I go to the ER for postpartum infection and sepsis - warning signs every mother should know?
Does postpartum infection and sepsis - warning signs every mother should know go away on its own?
References
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources
Related Resources
Bottom line
Most cases of postpartum infection and sepsis - warning signs every mother should know are normal. Talk to your pediatrician if fever of 100.4f (38c) or higher at any point after the first 24 hours postpartum.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
Was this page helpful?
Related Maternal Concerns
Dealing with Abnormal Prenatal Screening Results
An abnormal prenatal screening result can be terrifying, but it is important to understand that screening tests are designed to cast a wide net and have significant false-positive rates. Most people with abnormal screening results go on to have healthy babies after further testing confirms the baby is fine. An abnormal screening is a reason for more information, not a diagnosis.
Pregnancy Over 35 (Advanced Maternal Age)
While pregnancy after 35 carries some increased risks (including chromosomal abnormalities, gestational diabetes, and hypertension), the vast majority of people over 35 have healthy pregnancies and healthy babies. The term "geriatric pregnancy" is outdated and does not reflect reality. With appropriate prenatal care and monitoring, outcomes are excellent.
Amniocentesis Questions and Fears
Amniocentesis is a diagnostic test performed between 15-20 weeks that analyzes amniotic fluid to detect chromosomal conditions and genetic disorders with over 99% accuracy. The risk of pregnancy loss from the procedure is approximately 1 in 500-1,000 when performed by an experienced provider. Understanding the actual risks can help you make an informed decision.
20-Week Anatomy Scan Unexpected Findings
The 20-week anatomy scan checks your baby's major organs, structures, and growth. Most scans are completely normal. When unexpected findings are identified, they range from minor variants that resolve on their own to conditions that need further evaluation. Many findings require nothing more than a follow-up ultrasound to confirm the baby is developing well.
Less Movement with Anterior Placenta
An anterior placenta (attached to the front wall of the uterus) acts as a cushion between the baby and your belly wall, which can make movements feel muffled or less intense. You may feel movement later (22-24 weeks instead of 18-20) and primarily on the sides and lower belly. This is normal, but you should still feel regular movement once it is established.
Placenta Position Concerns
The placenta can attach anywhere on the uterine wall - anterior (front), posterior (back), fundal (top), or lateral (sides). All positions are normal. An anterior placenta may cushion the baby's movements, making kicks feel less intense or take longer to notice. The only concern is when the placenta is low-lying or covering the cervix (placenta previa).