Postpartum Warning Signs You Shouldn't Ignore: What New Ontario Research Shows
We spend a lot of time teaching women what to watch for during pregnancy.
Bleeding. Decreased fetal movement. High blood pressure. Contractions too early. Severe headaches.
Then the baby is born, everyone checks that you're stable, and suddenly so much of the attention shifts to the baby.
But your risk of serious pregnancy-related complications does not disappear when the placenta comes out.
And new Ontario research is giving us a pretty important reminder of that.
A 2026 Ontario study looking at more than 1 million births found that severe maternal morbidity—serious complications such as severe hemorrhage or sepsis—occurred at a rate of 27.24 per 1,000 births from pregnancy through six weeks postpartum.
What stood out to me most?
Almost 30% of those severe complications occurred after the birth.
In fact, when researchers looked beyond labour and delivery itself, a significant portion of serious maternal complications happened either during pregnancy or after the birth rather than during labour itself.
You can read the Ontario study summary through ICES here.
As someone who worked in Labour & Delivery and postpartum nursing, this doesn't surprise me.
What does bother me is how little we prepare women for it.
We tell you what diapers to buy. We teach you how to swaddle. We talk endlessly about birth plans.
But do you know what postpartum bleeding is too much?
Would your partner recognize the symptoms of postpartum preeclampsia?
Would you know that chest pain or one swollen painful leg after birth needs to be taken seriously?
Would you know that you can develop preeclampsia after you've already had your baby—even if your blood pressure was completely normal throughout pregnancy?
These are things I think every pregnant woman should know before she goes home with a newborn.
If you're preparing for postpartum, I've also put this information—and much more about what to expect after birth—into my free Fourth Trimester Postpartum Guide. Download it before baby arrives, save it to your phone and send it to your partner too.
→ [DOWNLOAD THE FREE POSTPARTUM GUIDE]
New Ontario Research Shows Why Postpartum Warning Signs Matter
The Ontario study, published in 2026, followed 1,095,228 births between 2012 and 2021.
Researchers didn't only look at what happened during labour and delivery. They tracked severe maternal complications from pregnancy through six weeks postpartum.
The overall severe maternal morbidity rate was 27.24 per 1,000 births.
Of those cases:
15.63% occurred before labour
55.02% occurred during the intrapartum period
29.34% occurred postpartum
Sepsis was the most common type of severe maternal morbidity identified during the postpartum period.
You can read more about the study through ICES: Severe Maternal Morbidity From Conception to 6 Weeks Postpartum in Ontario.
That last piece matters.
Because postpartum is often treated as though the dangerous part is over.
You had the baby. You're discharged. Now you're recovering.
Except recovery and complications can happen at the same time.
Ontario's Provincial Council for Maternal and Child Health also released new Postpartum Warning Signs resources to help women, families and healthcare providers recognize concerning symptoms earlier.
You can view those resources directly through PCMCH's Postpartum Warning Signs page.
This isn't meant to make postpartum feel scary.
It's meant to make you informed.
Because there is a big difference between knowing:
“This bleeding is expected.”
and sitting at home wondering:
“Am I overreacting?”
How Much Postpartum Bleeding Is Too Much?
Bleeding after birth is normal.
Whether you have a vaginal birth or a C-section, you will have vaginal bleeding called lochia because your uterus is shedding blood and tissue left from pregnancy.
In the beginning, it can look like a heavy period. It should generally become lighter and change colour over the following days and weeks.
So bleeding itself isn't automatically concerning.
Very heavy bleeding is.
Ontario's postpartum guidance advises seeking care if you're soaking a maxi pad within an hour or passing clots larger than an egg.
You can see the full patient warning-sign sheet from PCMCH here.
Other concerning symptoms include suddenly increasing bleeding after it had been improving, feeling faint or dizzy, having a racing heart or feeling unusually weak.
Postpartum hemorrhage doesn't only happen in the delivery room.
There is also such a thing as secondary or delayed postpartum hemorrhage, which can occur after you've already gone home.
If you're bleeding heavily and feeling faint, weak or unwell, don't sit at home trying to decide whether you're being dramatic.
Get assessed.
Postpartum Preeclampsia Can Happen After a Normal Pregnancy
This one surprises a lot of people.
You can develop postpartum preeclampsia after birth even if you never had high blood pressure or preeclampsia during pregnancy.
The American College of Obstetricians and Gynecologists notes that postpartum preeclampsia can develop after childbirth and discusses it among the important conditions women should know about after birth.
You can read their guidance here: ACOG: 3 Conditions to Watch for After Childbirth.
One of the biggest symptoms to pay attention to is a new, severe or persistent headache.
And yes, postpartum women get headaches for all kinds of reasons.
You haven't slept.
You might be dehydrated.
You've been feeding a baby around the clock.
You may have had an epidural or spinal.
That's exactly what can make this tricky.
A postpartum headache that is sudden, unusually severe, feels different from your typical headaches, doesn't improve with usual medication or is accompanied by vision changes deserves medical assessment.
Other concerning symptoms can include:
Blurred vision
Flashing lights or spots in your vision
Sudden swelling, particularly of the face or hands
Shortness of breath
Nausea or vomiting
Pain in the upper abdomen
Ontario's full list of postpartum warning signs is available in the PCMCH patient information sheet.
Please don't assume that because the baby has been born, preeclampsia is no longer possible.
One Swollen Leg Is Different From Two Puffy Postpartum Feet
Postpartum swelling can be dramatic.
Especially after IV fluids, a long labour or a C-section.
Your ankles may disappear.
Your shoes may not fit.
Your feet can sometimes look more swollen after you've given birth than they did when you were pregnant.
Generalized swelling in both legs can be part of normal postpartum fluid shifts.
What we don't want you ignoring is new pain, redness, warmth or swelling that is significantly worse in one leg, particularly in the calf, thigh or groin.
Pregnancy and the postpartum period increase the risk of blood clots.
A clot in a deep vein is called a deep vein thrombosis, or DVT. If part of that clot travels to the lungs, it can cause a pulmonary embolism.
Shortness of breath, chest pain, coughing up blood, fainting or significant difficulty breathing after birth are emergency symptoms.
The Government of Canada's postpartum health guide lists symptoms such as chest pain, shortness of breath, coughing up blood, seizure and fainting among reasons to seek emergency care.
You can read the full guide here: Government of Canada: Postpartum Health Guide.
This is not the moment to wait until morning and see if it gets better.
Fever After Birth Isn't Something to Brush Off
You have just given birth.
You're exhausted.
You're sweating through your clothes at night.
Your breasts may be hot and engorged.
So I understand how easy it would be to think:
Of course I feel terrible. I just had a baby.
But a temperature of 38°C or higher, particularly when accompanied by chills, weakness or feeling generally unwell, needs attention.
Ontario's postpartum warning-sign guidance includes fever among the symptoms women should contact their healthcare provider about.
You can view the full list in the PCMCH Postpartum Warning Signs patient sheet.
Postpartum infection can occur in several places.
It may involve the:
Uterus
Urinary tract
C-section incision
Perineal wound
Breast
Foul-smelling vaginal discharge, increasing abdominal or pelvic pain, worsening tenderness, burning when you pee, redness or drainage around an incision, or a hot red painful area of the breast—particularly with fever or feeling unwell—are all reasons to contact your healthcare provider.
And importantly:
Pain should generally be getting better as you recover, not progressively worse.
Severe or Worsening Abdominal Pain Deserves Attention
Cramping after birth is expected.
Your uterus has a lot of shrinking to do, and those afterpains can be surprisingly uncomfortable—especially with subsequent babies and while breastfeeding.
But there is a difference between expected uterine cramping and strong abdominal pain that is worsening, unusually severe or very tender when the area is touched.
PCMCH includes strong or worsening abdominal pain among its postpartum warning signs.
You can review their full guidance here: PCMCH Postpartum Warning Signs.
You don't have to figure out what is causing it before asking for help.
That's what an assessment is for.
Extreme Exhaustion Isn't Always “Just Newborn Life”
This one is difficult because obviously you're tired.
You have a newborn.
You may be breastfeeding every couple of hours.
You have recently gone through pregnancy and birth.
Of course there is going to be fatigue.
But there is a point where exhaustion feels different.
Ontario's postpartum guidance includes extreme tiredness that continues even after resting and makes normal daily tasks difficult among symptoms worth discussing with a healthcare provider.
You can find that guidance in the PCMCH patient information sheet.
Significant anemia, infection, thyroid problems, cardiac complications and other postpartum conditions can sometimes present with symptoms that are very easy to blame on having a newborn.
Pay attention to the bigger picture.
Are you extremely weak?
Dizzy?
Short of breath?
Is your heart racing?
Do you feel dramatically worse rather than gradually better?
That deserves attention.
Postpartum Mental Health Symptoms Are Warning Signs Too
Not every postpartum emergency is physical.
Hormonal shifts, enormous life changes and severe sleep deprivation can make the early postpartum period emotionally intense.
Crying easily during the first days postpartum can happen.
Feeling overwhelmed sometimes can happen.
Needing help does not mean you're doing motherhood wrong.
But feeling persistently very sad, intensely anxious, unable to function, disconnected from reality, or having thoughts that scare you is different.
Ontario's postpartum warning-sign resource tells women to seek help for significant changes in mood or behaviour, intense worry, or thoughts about harming themselves or their baby.
You can read the full resource here: PCMCH Postpartum Warning Signs.
If you are having thoughts of harming yourself or your baby, feel unsafe, are experiencing a severe change in your mental state or feel disconnected from reality, seek emergency help.
In Canada, you can call or text 9-8-8 for the Suicide Crisis Helpline.
You can learn more at 988.ca.
In an immediate emergency, call 911.
Your mental health is part of postpartum healthcare.
It should be treated that way.
The Problem Is That So Many Postpartum Warning Signs Can Look Like “Normal Postpartum”
This is the part I think deserves more conversation.
Postpartum is messy.
You're bleeding.
You're sore.
Your breasts hurt.
You're tired.
You're swollen.
You're emotional.
You're waking constantly.
Your body feels unfamiliar.
And then we expect a woman who hasn't slept properly in three days, is trying to figure out breastfeeding and is caring for a brand-new baby to determine whether her headache is dehydration or preeclampsia.
Whether her exhaustion is normal or anemia.
Whether her bleeding is heavy-but-normal or too much.
Whether that painful leg is from sitting in bed feeding all day or something that needs urgent assessment.
This is why education before birth matters so much.
Not because I want women staring at themselves anxiously looking for complications.
Quite the opposite.
When you know what normal postpartum recovery can look like and you know the warning signs, you have a much better frame of reference.
Your Partner Should Know These Postpartum Warning Signs Too
This information shouldn't live entirely in the postpartum woman's brain.
Your partner or whoever will be supporting you after birth should know what to watch for too.
Because sometimes they're the one who notices that you look unusually pale.
They're the one who hears you say for the third time that your headache is getting worse.
They're the one who can see that one leg looks dramatically more swollen.
They're the one who might realize that you're not acting like yourself.
And they're also the one who can say:
“Nope. We're getting this checked.”
When you're newly postpartum, exhausted and focused completely on your baby, it can be surprisingly easy to put yourself last.
The people caring for you need to know that postpartum care includes you, too.
What Should You Do If You're Worried About a Postpartum Symptom in Ontario?
You do not need to diagnose yourself.
If you notice a concerning postpartum symptom, contact your midwife, family doctor, obstetrician or other healthcare provider.
Ontario's PCMCH guidance says that if you cannot reach your provider, you should go to an urgent care clinic or the nearest emergency department.
If your symptoms are severe or you feel unsafe, call 911.
Ontario residents can also call 811 for health advice.
You can find more information through Health811 Ontario.
And when you seek care:
Tell them you're postpartum.
Tell them how many days or weeks it has been since you gave birth.
Tell them about pregnancy complications, your delivery, medications and any changes you've noticed.
Your recent pregnancy is medically relevant information—even if the reason you went to the emergency department initially doesn't seem pregnancy-related.
Ontario's new provider guidance specifically emphasizes considering recent pregnancy when assessing postpartum patients.
You can see PCMCH's resources for both patients and healthcare professionals here: PCMCH Postpartum Warning Signs.
You Shouldn't Have to Learn All of This While Holding a 3-Day-Old Baby
This is exactly why I care so much about preparing for postpartum before birth.
We put so much emphasis on the birth itself—and obviously birth matters.
But you're going to spend hours or maybe days giving birth.
You're going to spend weeks and months postpartum.
You deserve to know what your body might feel like.
What bleeding can look like.
What happens when your milk comes in.
Why your uterus is cramping.
What newborn feeding actually looks like.
What's normal.
What isn't.
And when it's time to ask for help.
I've put all of that into my Fourth Trimester Postpartum Guide, and you can download it completely free.
Read it during pregnancy.
Save it to your phone.
Send it to your partner.
And keep it somewhere easy to find once your baby arrives—because trying to Google every symptom at 3 a.m. with a newborn on your chest is not the postpartum preparation I want for you.
→ [GET THE FREE FOURTH TRIMESTER POSTPARTUM GUIDE]
Birth preparation matters.
Postpartum preparation does too.
