Postnatal Care, Sepsis & Mental Health
Assess recovery after birth and recognise physical and psychological emergencies.
Quick revision ↓ Medical Dictionary
01Routine recovery
Review bleeding, pain, wound or perineal healing, bladder and bowel function, mobility and feeding concerns. Ask about support at home and the patient’s experience of birth. Normal recovery varies, but worsening symptoms require reassessment. Give a clear contact route and ensure follow-up is feasible rather than relying only on written discharge information.
02Infection and sepsis
Consider uterine, urinary, wound, breast and other sources when infection is suspected. Marked illness, altered mental state, breathlessness, poor perfusion or reduced urine output requires urgent assessment even without a high fever. Use the pregnancy-specific sepsis pathway, obtain relevant samples without delaying treatment, and arrange timely antimicrobial therapy and source control according to risk.
03Thrombosis and other warnings
Chest pain, unexplained breathlessness, collapse or unilateral painful leg swelling needs urgent evaluation for thromboembolism and other serious causes. Risk assessment should be revisited after delivery or new complications. Severe headache, visual symptoms and upper abdominal pain can signal hypertensive disease postpartum. Do not attribute every new symptom to exhaustion or normal recovery.
04Emotional health
Ask sensitively about mood, anxiety, sleep and safety, considering function and support rather than a screening score alone. Persistent depression or disabling anxiety requires assessment and treatment. Sudden confusion, mania, delusions or hallucinations after birth may indicate postpartum psychosis and requires immediate specialist assessment, with attention to the safety of both parent and infant.
05Feeding and ongoing care
Offer practical feeding support without blame and review painful breasts or systemic symptoms. Discuss contraception and medicine compatibility individually; fertility can return before the first period. Arrange medical follow-up for pregnancy complications and a debrief where needed. The postnatal plan should integrate physical recovery, mental health, infant needs and the patient’s own priorities.
High-Yield Revision
- Serious postpartum infection may present without high fever.
- Postpartum psychosis needs immediate specialist assessment.
- Fertility may return before menstruation resumes.
Common Pitfalls
- Dismissing breathlessness as tiredness after birth.
- Using a screening score as a substitute for safety assessment.
References & Further Reading
Read the relevant guideline sections alongside these original clinical teaching cases. Local pathways, available services and individual patient factors determine care.
Reference review: 28 September 2026. Consult current local protocols for prescribing, procedures and escalation.