The period following the delivery of a child is a transition for the body and mind that requires careful attention. Here’s what new mothers and their loved ones need to know.

“The postpartum visit is an important safety net that helps ensure a mother’s physical recovery, emotional stability and long-term health,” says Dr. Edwin Thorpe Jr., a medical director for BlueCross BlueShield of Tennessee.

Why your postpartum visit matters

Dr. Thorpe: The period following delivery is often called the fourth trimester. It’s the physical, hormonal and emotional transition from pregnancy. Self-care during this period is very important for mothers.

The postpartum visit is a checklist for physical healing and overall health. During the visit, your provider will review:

• Physical healing (uterus, incisions, pelvic floor)
• Whether conditions such as high blood pressure or diabetes have resolved or require additional management
• Emotional and mental health
• Nutrition and breastfeeding
• Contraception and family planning
• When it’s safe to resume sexual activity

Understanding pregnancy-related death

Dr. Thorpe: Maternal mortality is the death of a woman during pregnancy or within one year after the end of pregnancy, from any cause related to the pregnancy. It doesn’t include death from accidental or incidental causes.

In the U.S., the leading causes include:

• Infection
• Mental health conditions, such as substance use disorder or severe depression
• Cardiovascular conditions (heart problems, high blood pressure, stroke)
• Severe bleeding
• Blood clots
• Amniotic fluid embolism (a rare but sudden reaction to amniotic fluid entering the bloodstream)

In Tennessee, overall maternal health outcomes are improving. Pregnancy-related deaths dropped 15 percent between 2021 and 2022.

Warning signs that need immediate attention

Dr. Thorpe: Recognizing warning signs in the postpartum period is critical and potentially lifesaving.

Call 911 or go to the emergency room if you experience:

• Heavy bleeding: soaking a pad in less than an hour or passing large clots
• Severe abdominal or pelvic pain that doesn’t get better with pain medication
• Fever of 100.4°F or higher (possible infection)
• Foul-smelling vaginal discharge or drainage from a C-section incision
• Shortness of breath, chest pain, or coughing up blood may signal a blood clot
• Severe headache, vision changes, or swelling of face or hands could mean postpartum preeclampsia
• Leg pain, redness or swelling (especially in one leg): possible deep vein thrombosis
• Feeling faint, dizzy or having a rapid heartbeat (possible blood loss or infection)

Mental and emotional warning signs

Dr. Thorpe: Emotional and psychological symptoms are as serious as physical ones. Mental health symptoms require immediate attention:

• Feeling sad, hopeless or worthless most of the day for more than two weeks
• Severe anxiety, panic attacks or constant worry about the baby’s health
• Feeling disconnected or unable to bond with the baby
• Experiencing rage, irritability or uncontrollable mood swings
• Thoughts of harming yourself or the baby
• Unable to sleep or eat, even when exhausted or hungry
• Feelings of confusion, agitation or hallucinations

Available resources

Dr. Thorpe: Here are the general outreach sources for mothers following delivery:

• Health care professionals (doctor, midwife) for physical recovery
• Mental health specialists for emotional wellbeing
• Community-based programs for practical help and parenting support 

If you’re experiencing a mental health crisis, call or text 988 for the Suicide and Crisis Lifeline, or text “POSTPARTUM” to 741741 to reach the Crisis Text Line.

More from Dr. Thorpe on WellTuned

Get more information about specific health terms, topics and conditions to better manage your health on bcbst.com. BlueCross BlueShield of Tennessee members can access wellness-related discounts on fitness products, gym memberships, healthy eating and more through Blue365®. BCBST members can also find tools and resources to help improve health and well-being by logging into BlueAccess and going to the Managing Your Health tab.