Guide

Postpartum warning signs: when to encourage her to call

This is the highest-care page on this site, so we are going to be extremely plain about what it is and is not.

What it is: a list, sourced to the American College of Obstetricians and Gynecologists (ACOG), of physical and emotional warning signs that show up during postpartum recovery and are worth a call to her OB or midwife, or emergency care, the same day they appear.

What it is not: a diagnostic tool, a quiz, or a substitute for her provider’s judgment. We are not doctors. Nothing below tells you what she has. It tells you when to say “call your provider” or “let’s go get you seen,” today, not next week.

The framing, one more time

Your job reading this is not to become a clinician. It is to know the list well enough that if one of these shows up, you say something the same day instead of waiting to see if it passes. ACOG’s own patient education materials describe warning signs in exactly this spirit: most postpartum symptoms are normal recovery, and a specific short list is not.

Signs that mean call her provider the same day

• A fever of 100.4°F (38°C) or higher.
• Bleeding that soaks through a pad within an hour, or passing clots larger than an egg.
• A C-section or perineal incision that is increasingly red, swollen, warm, or draining.
• A red, swollen, or painful area on one leg (a possible sign of a blood clot).
• A severe headache that does not improve with rest or usual pain relief, especially with vision changes.
• Swelling in the hands or face that comes on suddenly or gets noticeably worse.
• Overwhelming fatigue that goes beyond ordinary new-parent exhaustion, especially paired with dizziness or fainting.
• Thoughts, feelings, or behaviors that feel like more than “baby blues”: persistent sadness, anxiety that will not let up, or trouble bonding, especially past the first two weeks.

Signs that mean emergency care, right away

• Chest pain, trouble breathing, or a racing heartbeat.
• A seizure.
• Thoughts of harming herself or the baby.
• Heavy bleeding that does not slow down, or signs of shock (pale, clammy skin, confusion, a very fast heartbeat).

If you are ever unsure which category something falls into, treat it as urgent. A same-day call that turns out to be nothing costs an afternoon. The alternative can cost much more.

What your actual job is here

• Read this list once, together, before you think you need it. Week 0 of our week-by-week checklist links here for that reason.
• If you notice one of these signs before she does, say so, out loud, the same day. She may be too exhausted, too used to discomfort, or too focused on the baby to flag it herself.
• Do not try to talk her out of calling if she is unsure. “Let’s just call and ask” costs nothing.
• If a sign in the emergency list shows up, do not wait for a callback. Go.

Where this list comes from

This page summarizes patient-facing warning-sign guidance published by the American College of Obstetricians and Gynecologists (ACOG), part of its broader postpartum-safety education for new parents. We link it here rather than reproducing ACOG’s materials in full; for the complete, current, clinician-authored version, read it directly through your provider’s patient portal or ask at any postpartum visit. If ACOG updates its published guidance in a way that changes this list, we update this page and its reviewed date.

This page is not a substitute for a relationship with her actual OB or midwife. If something feels wrong and it is not on this list, that is still a reason to call.