Feeling unwell

Infections

Infections following birth are rare; however some women may contract infections which require treatment with antibiotics. Infections may occur in perineal stitches, caesarean section wounds, the uterus, breasts or in urine and can worsen rapidly.

Signs/symptoms:

• a high temperature (more than 37.5°C)
• feeling unusually hot or cold/shivery
• feeling unusually lethargic and sleepy
• flu-like aches and pains in the body.

Stitches or caesarean wound infection

If your stitches or wound are infected you may notice pus, an offensive smell or an unusual amount of pain or tenderness in the area. You may also notice the skin is red and hot to touch.  

Uterine infection

An infection in the uterus may cause symptoms of excessive vaginal bleeding, passing of clots and offensive smelling blood loss. You may also note severe pain and/or heat on touching the lower abdomen.

Breast infection

If breasts become infected (known as mastitis) they may appear red, swollen and be painful/hot to touch. You may notice a burning sensation during feeds. Seek help urgently and read more about this here.

Urinary infections

Symptoms include the increased need to pass urine or pain on passing urine. If you are experiencing any of these symptoms please speak to your midwife or GP urgently, or attend the local maternity triage/assessment unit where you had your baby.

Other infections

If you experience other infections no directly linked to having had a baby, like a severe cold/flu or chest infection, or diarrhoea and vomiting, seek help urgently.

Deep vein thrombosis/Pulmonary embolism

Read more about this here.

Deep vein thrombosis (DVT) and pulmonary embolism (PE)

Are you at increased risk of developing a blood clot?

After giving birth, women are at a slightly increased risk of developing blood clots in the veins in their legs, known as deep vein thrombosis (DVT). This risk is increased for roughly six weeks following birth. On rare occasions, these blood clots can become very large and travel in the body to the lungs. This is known as pulmonary embolism (PE) and can be very serious.

Signs/symptoms:

• pain/tenderness in the leg behind the knee or in the calf
• feeling of heat in the affected area or a red discolouration of the skin
• swelling of the affected area
• a pulmonary embolism may cause shortness of breath and chest pain, which comes on suddenly and worsens with deep breaths, coughing or chest movement.

If you have any of these symptoms you should speak to a health professional immediately, or attend your local A&E department.

Treatment

These conditions are serious and will require urgent treatment in hospital with medications that prevent the clot from getting bigger and breaking off and travelling to another part of the body.

Prevention:

• keep mobile and rotate your ankles regularly
• wear compression stockings if your midwife or doctor have advised you to do so
• consider taking short walks when you feel up to it
• stay well hydrated
• avoid sitting/lying down for prolonged periods i.e. in a car/on a train.

Some women will be prescribed injections to self-administer at home to reduce the risk of blood clots if they are considered to be at a higher risk of developing them. Staff use a venous thromboembolism risk scoring system to determine each women’s risk. These include caesarean section, postpartum haemorrhage, pre-eclampsia and preterm birth, or any family or medical history that makes the risk higher. Before you are discharged you will be shown how to administer the pre-filled syringe and safely dispose of the sharp into a sharps container. If you have been prescribed injections it is very important to complete the course – and to disposes of the needles safely. Your midwife will explain this to you before you go home.

Recovery from caesarean birth

Following a caesarean you may feel sore and swollen for a few days. To help with pain, regular pain relief is recommended in combination with early and gentle movement. Always wash your hands before caring for your caesarean wound. Your scar will take up to six weeks to heal, and to assist with healing you should:

• look out for any signs of infection such as severe pain, parting of the wound, redness, oozing of pus and bleeding
• bath or shower daily and clean your incision site gently with warm water and pat dry
• keep the scar dry and exposed to the air when possible
• wear loose, comfortable clothing and cotton underwear
• avoid lifting anything heavier than your baby.

Gentle activity such as a daily walk is recommended to prevent the formation of blood clots. Advice on resuming exercise can be found elsewhere in this section.

Perineal after-care

• Always wash your hands before caring for your stitches or changing your sanitary towels. This is particularly important if anyone in your household has a cough or cold
• shower or bath daily if possible for the first two weeks. Prolonged bathing can cause the stitches to dissolve too quickly. Rinse with warm water and avoid soaps and perfumed products. Dry with a clean towel and avoid rubbing the area
• do not apply any creams, salts, oils or lotions to the stitches
• sanitary towels should be changed frequently, and leaving the stitches exposed to the air can assist with healing
• when passing urine, some mild stinging can be expected in the first few days. Avoid dehydration which can worsen this sensation. Rinsing with plain water during or after urination may reduce this discomfort
• when opening your bowels the stitches won’t come apart. Avoid constipation or excessive straining and ensure good personal hygiene is maintained to reduce the risk of infection
• mild/moderate discomfort is to be expected in the first few days after birth and can be relieved with common pain relief medications such as paracetamol and/or ibuprofen. Please speak to your midwife regarding the recommended dose and other methods to relieve discomfort of your stitches
• using ice can reduce inflammation and pain. You can use ice wrapped in a clean towel or use a sanitary pad that has been placed in the freezer for couple of hours. Place over the tender part of your perineum for 10 minutes. Repeat the process three to four times each day for the first few days
• if your stitches are gaping, oozing, severely painful, offensive in smell or unusually hot, please contact your GP, midwife or local maternity triage/assessment unit urgently.