What are signs and symptoms of postpartum infection?

Your body has gone through a lot giving birth to your baby! While most women recover without having any problems there are a few signs to look out for that can indicate an infection after birth. Being able to recognise these signs means you will be able to get the treatment you need promptly.

Types of postpartum infections

There are a number of infections you can get after you give birth and they can affect various parts of your body from your breasts to your urinary tract. We run through some of these below.

Endometritis

Endometritis is an infection you can get up to six weeks after giving birth, and affects the lining of your womb, which becomes swollen and inflamed. The womb infection is caused by bacteria getting into your womb during the process of giving birth.

You can feel generally unwell if you have endometriosis. Other symptoms may include:

• A high temperature
• Pain in your tummy
• A smelly discharge from your vagina
• Bleeding from your vagina – it’s normal to bleed after giving birth, usually for up to six weeks but if you have endometritis, it may last longer and suddenly become heavier and you could have blood clots
• Pain if you have sex
• Pain when you pee

You’re more likely to get endometriosis if you have had a caesarean. Other things can make you more likely to get endometritis too, such as if you had a long labour, any difficulty removing the placenta and having to have lots of internal examinations during your labour.

Seek medical attention as soon as possible if you develop these symptoms. Antibiotics are prescribed to cure the infection, but if you are ill you may need to be admitted to hospital for treatment.

Mastitis and breast abscess

A mastitis infection occurs when there has been a build-up of milk in your breast, which then becomes infected by bacteria. An infection is more likely to enter the milk ducts if you have a cracked nipple.This then spreads to your breast tissue.

You might get flu-like symptoms which often develop quickly, such as aches and pains, a high temperature, chills and tiredness, which often develop quickly. Other symptoms of mastitis include:

• A red, swollen area on your breast that can feel hot and painful when you touch it
• A lump or hard area on your breast
• A burning pain in your breast – this may just happen when you breastfeed or be there all the time
• Pus or blood coming from your nipple

You will be advised to continue to breastfeed so you empty your affected breast of milk. A course of antibiotics for up to 14 days is prescribed when there are signs of infection.  Occasionally mastitis can develop into a breast abscess, where a very painful, red and hard lump forms in your breast.  This can make you feel very unwell and feverish. A surgical procedure to drain the abscess may be required, so seek medical attention as soon as you think you may be developing a breast abscess.

Wound infection

If you have a caesarean delivery, sometimes the wound can get infected.  Several factors increase your risk of a wound infection, such as being overweight, having diabetes, being a smoker or having a poor diet.

An infection will cause redness and swelling, and it can feel increasingly painful – there might be some smelly, yellow discharge coming from the wound too. If the infection spreads, the redness will spread to more areas of skin and you might feel generally unwell and have a temperature and aches and pains.

The hospital will take precautions to prevent infection in your wound such as giving you antibiotics prior to your surgery. You will also be advised on how to keep your wound clean and protected against infection. Seek urgent medical attention if your wound appears to be getting infected: a swab will be taken if there is a discharge and you may require a course of antibiotics to clear any infection.

Perineal infection

Your perineum is the area between your vagina and anus. Sometimes when you’re giving birth, your perineum tears as your baby comes out, or your doctor or midwife might need to make a cut in the area to allow your baby to come out more easily if there is a clinical need to do so. While some tears are minor and will heal naturally, a surgical cut (an episiotomy) will need to be closed  with stitches.Sometimes the wound can get infected.

Symptoms of a perineal infection include:

• Red and swollen skin
• A discharge or liquid coming out from the wound
• Pain
• A smell from the area

If you notice any of these symptoms, let your GP, midwife or health visitor know.

Urinary tract infection

A urinary tract infection (UTI) is an infection of your bladder, usually caused by bacteria from your gastrointestinal tract (digestive system) entering your urethra and travelling up to your bladder. 

Symptoms of a UTI include:

• Pain when you pee – you might feel a burning or stinging sensation
• Needing to pee more often than usual, particularly at night
• Feeling an urgent need to pee – you might not make it to the toilet in time
• Pee that looks cloudy or has a different smell or colour to what you usually have – it might look red or brown
• Discomfort or tenderness in your tummy

What to do if you think you have an infection

If you think you might have any of these signs of an infection after birth, let your midwife or GP know as soon as possible. They will be able to assess your condition and make sure you get the right treatment to help clear the infection.

If you have received treatment and are not improving as expected, or if your symptoms are becoming more severe with time or you are developing chills, fever or flu like symptoms or feel generally ill, seek urgent medical attention.

Sepsis

Sepsis is a serious complication of an infection anywhere in the body that can develop in women who have recently given birth.If it develops within six weeks of giving birth, it’s called postpartum sepsis or puerperal sepsis. Sepsis can happen due to a severe infection in any part of the body: for example, from mastitis, a caesarean section wound infection, a urinary infection, pneumonia or an infection of the womb. The most important cause of postpartum sepsis is infection with Group A Streptococcus ( GAS). This is a bacteria which can cause simple throat infections, such as tonsillitis, and skin infections, but can also cause serious infection and sepsis in a women who has given birth. Women who develop a sore throat or respiratory infection or who have contact with family or friends with these infections are at greater risk.

Symptoms of sepsis can include:

• A fever or a very low temperature
• A fast heartbeat
• Fast breathing or breathlessness
• Not going to the toilet to pee as much as usual
• Feeling faint
• Shivering and feeling flu-like
• Diarrhoea or vomiting
• A rash
• Tummy or pelvic pain and tenderness
• An abnormal, possibly smelly, discharge from your vagina

Sepsis is a medical emergency. If you have any of these symptoms, seek immediate medical attention. Sepsis is treated in hospital where you will be monitored and given intravenous antibiotics through a drip.

Ways to reduce your risk of an infection after birth

There are some steps you can take to reduce your risk of picking up an infection.

• Wash your hands regularly with soap and water especially after using the toilet and changing sanitary towels.
• Have a bath or shower regularly and make sure you wash around your genital area.
• Make sure you cook all your meals properly, especially if you eat meat.
• If you have bleeding, use sanitary towels, not tampons for the first six weeks after you give birth because tampons can increase your chance of getting an infection. And change your sanitary towels frequently.
• If you have stiches, bathe them every day as this will help to prevent an infection.
• Don’t share towels.
• Avoid close contact with family and friends with sore throats and respiratory infections.
• All of your family should practice good food hygiene.
• Eat a healthy, balanced diet that includes plenty of fruit and vegetables.

Contact your GP, doctor or midwife straight away if you have any symptoms of an infection.

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When should I worry about infection after giving birth?