It’s Spooky Season- Red Flags to be-ware of postpartum

Fall, knee high boots and streaming Hocus Pocus on repeat is here (eee!!). Something far spookier than the amount of sugar in that PSL that has unofficially been branded as the start of Fall, are some red flags than warrant immediate attention. Keep reading if you want to learn important red flags for postpartum.

This post is not made to scare you but rather be informative and provide awareness so you can be prepared. If you notice any of the following signs or symptoms, know the best course of action is to seek immediate medical attention rather than wait and see.

1. Numbness and tingling down both legs

Numbness and tingling down the legs following birth can be a side effect seen post epidural. This is likely from inflammation around the injection site of the needle around the spine, temporarily compressing and irritating nerves that send information down to the legs. The compression and irritation can present as numbness or tingling, and sometimes-even weakness in the leg.

However, usually this happens in just one leg, rarely ever both at the same time. If you’re experiencing numbness and tingling down both legs, especially if accompanied with the loss of bladder and/or bowel control, it’s time to reach out. The presence of these symptoms can indicate something more serious is involved with the spine, including spinal cord compression or injury.

2. Wound drainage, fever, redness or warmth

Wound care for perineal tears or cesarean scars can feel overwhelming to care for in the early postpartum weeks, especially if they were unexpected or your birth didn’t go according to plan.

For cesarean scars, keep your wound clean and initially covered, while providing some opportunity for the wound to breathe to open air. Too much moisture for the wound can promote a perfect breeding ground for bacteria to grow and you guessed it, infection.

Signs of infection for wounds include any foul smelling, yellow/green/pus drainage, increased warmth and redness at and surrounding the wound site, and body temperature above 100.4 degrees. Pain can also accompany the infection, however, pain alone is not necessarily indicative of infection. Call your doctor immediately if you have concerns of infection.

3. Sudden onset one sided calf pain, swelling and redness

Not often talked about, blood clots or a deep vein thrombosis (DVT) can occur postpartum. This can occur from the lack of movement or time spent in bed resting from your delivery, which of course we want, but balance is key.

If experiencing any increased pain in the calf region, accompanied by swelling, tenderness to touch, or redness, this may be a sign of a DVT. DVTs’ more commonly occur unilaterally as opposed to both legs at the same time, although it is possible. If you have history of blood clots or blood clotting disorder, or experiencing sudden onset calf pain that is not improving with movement, it’s time to seek help.

4. Headache, blurred vision, and swelling

Preeclampsia is not just something that happens during pregnancy, but can also occur postpartum once you’re home resting with your new family member. In fact, up to 27% of women may experience preeclampsia following birth1. Swelling in the extremities, headache and blurred vision are all signs of high blood pressure that requires medical intervention, and can be serious if left untreated.

If monitoring your blood pressure at home, any reading at 140/90 mm Hg or higher warrants a call to your provider.

5. Heavy bleeding and passing clots

Bleeding postpartum can be an overlooked part of birth healing, especially if you had a cesarean and thought you might have escaped wearing diapers with your newborn. 

Locia, or postpartum bleeding, can range in length from 4-6 wks. The expectation is bleeding will taper from bright red to darker burgundy and then to essentially spotting as the wound within the uterus heals where the placenta was attached.

Passing small clots, especially in the first 1-2 weeks, is normal and expected as the uterus begins to shrink back down to its’ pre baby size. If noticing clots greater than the size of a plum or soaking more than 1 extra absorbent pad per hour, you may be hemorrhaging and it’s time to call your doctor and book it to the nearest ER.

I hope this post on red flags postpartum was enlightening and you now feel empowered and well informed.

References:

1. Rosi, S., & Tan, Y. (2020). Molecular mechanisms of resistance to immune checkpoint inhibitors in cancer. PubMed Central (PMC). https://pmc.ncbi.nlm.nih.gov/articles/PMC8857508/