After giving birth, your body goes through rapid physical and hormonal adjustments. The uterus contracts, breasts begin milk production, and your immune system recalibrates after delivery stress. A mild fever in the first few days is common, but one that persists beyond 24 hours, spikes above 100.4°F (38°C), or is accompanied by pain or foul-smelling discharge should never be ignored.



What Is Postpartum Fever?Postpartum fever refers to a temperature of 38°C (100.4°F) or higher on any two occasions within the first 10 days after delivery, excluding the first 24 hours. Doctors use this benchmark, recommended by the World Health Organisation (WHO) and American College of Obstetricians and Gynaecologists (ACOG), to differentiate mild, expected rises in temperature from infections requiring treatment.



During labour and shortly after birth, a mild fever can occur due to:

• Dehydration from long labour or epidural anaesthesia
• Milk coming in
• The body’s inflammatory response to tissue healing
• Normal hormonal shifts, causing warmth or flushing

However, any sustained or recurrent fever warrants medical assessment to rule out infection.



Why It MattersFever after delivery isn’t just about discomfort. It can be a warning sign of postpartum infections that spread quickly if untreated. Such infections are a leading cause of maternal morbidity worldwide, including in India.



Prompt evaluation helps detect conditions such as:

• Endometritis: Infection of the uterine lining
• Mastitis or breast abscess: Infection in milk ducts or breast tissue
• Urinary tract infection (UTI): Often due to catheter use during labour
• Wound infection: In caesarean or episiotomy sites
• Sepsis: A life-threatening spread of infection into the bloodstream

Each of these requires a different treatment plan. Hence, identifying the cause early is crucial.



Common Causes of Postpartum FeverFever after delivery often originates from one of the “five W’s” that clinicians use as a memory aid: Wind, Water, Womb, Wound, and Weaning (breasts).



1. Womb: Endometritis

Infection of the uterine lining occurs when bacteria enter during or after delivery.

• When it happens: 2–5 days postpartum
• Symptoms: Lower abdominal pain, foul-smelling lochia (vaginal discharge), chills, uterine tenderness
• Risk factors: Prolonged labour, multiple vaginal exams, caesarean birth without prophylactic antibiotics

2. Wound: Surgical or Episiotomy Infection

Small tears or incisions can harbour bacteria.

• When it happens: 3–7 days postpartum
• Symptoms: Redness, swelling, pus, or pain around stitches
• Risk factors: Poor hygiene, diabetes, or delayed wound care

3. Water: Urinary Tract Infection

Catheterisation during labour or dehydration can increase risk.

• When it happens: Within the first week
• Symptoms: Burning during urination, pelvic pain, frequent urge to urinate, cloudy urine

4. Weaning: Mastitis or Breast Abscess

Blocked milk ducts or cracked nipples allow bacteria to enter the breast tissue.

• When it happens: 1–3 weeks postpartum
• Symptoms: Localised pain, swelling, redness, chills, and fever
• If untreated: May develop into an abscess requiring drainage

5. Wind: Respiratory or Anaesthetic-related Infection

In rare cases, post-surgical chest infections can occur after a C-section under general anaesthesia, especially in women with pre-existing respiratory issues.



When a Fever Is NormalSome mild fevers resolve without antibiotics. These include:

• Engorgement fever: When milk production begins, breasts feel warm, tight, and slightly painful. Temperature is usually mild (<100.4°F) and subsides with milk expression and rest.
• Mild postpartum dehydration or exhaustion: Long labour and fluid loss may cause low-grade fever that settles after hydration.
• Hormonal or inflammatory reaction: Your body’s repair process can temporarily elevate temperature.

If your fever resolves within 24 hours without severe pain, chills, or discharge, it is usually not concerning.



When It’s a Red FlagYou should contact your doctor immediately if you notice:

• Persistent fever above 100.4°F for over 24 hours
• Foul-smelling vaginal discharge or heavy bleeding
• Pain, redness, or pus at the episiotomy or incision site
• Severe pelvic pain, chills, or rigours
• Breast pain with swelling, cracks, or flu-like symptoms
• Burning urination or back pain
• Dizziness, confusion, or extreme fatigue

Infections can escalate quickly. In severe cases, they can lead to puerperal sepsis, a major cause of preventable maternal deaths.



Diagnosis and TestsYour doctor may perform:

• Physical examination: Checking uterine tenderness, wound healing, and breast inflammation
• Blood tests: Complete blood count (CBC) and C-reactive protein (CRP) to detect inflammation
• Urine analysis and culture: To rule out UTI
• Vaginal or wound swabs: For bacterial culture
• Ultrasound: To check for retained placental tissue or abscess

Early diagnosis allows prompt antibiotic or supportive therapy, reducing hospital stay and complications.



Treatment and Management OptionsTreatment depends on the underlying cause:

• Endometritis: Broad-spectrum IV antibiotics (usually clindamycin + gentamicin). Hospitalisation may be needed.
• UTI: Oral antibiotics and hydration.
• Mastitis: Warm compresses, continued breastfeeding to drain milk, and antibiotics like flucloxacillin if infection persists.
• Wound infections: Proper wound cleaning, dressing changes, and antibiotics.
• Sepsis: Immediate hospital care with IV fluids and antibiotics.

Self-care measures that help recovery:

• Stay hydrated and rest.
• Wear loose cotton clothing and keep stitches clean.
• Continue breastfeeding unless advised otherwise. It helps reduce engorgement and the risk of infection.
• Avoid self-medicating or using leftover antibiotics.

Your physical recovery and mental health are deeply linked. Caring for both helps prevent burnout and supports long-term well-being.



Fever after childbirth isn’t always a sign of trouble, but knowing when to act can save serious complications. While mild temperature rises are part of postpartum adjustment, persistent or severe fever always deserves medical attention. With timely treatment, supportive nutrition, rest, and emotional care, most women recover fully and return to their rhythm of motherhood safely.



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FAQs on Postpartum Fever: When It’s Normal and When It’s a Red Flag

How long does postpartum fever usually last?

Mild engorgement or dehydration-related fever often resolves within 24 hours. Persistent or high fever needs medical evaluation.

Can I breastfeed if I have a fever?

In most cases, yes. Breastfeeding helps prevent engorgement and is safe unless your doctor identifies a contagious infection or prescribes contraindicated medication.

What are the signs of uterine infection after birth?

Foul-smelling discharge, pelvic pain, tenderness, and persistent fever within a week of delivery.

Can Ayurvedic tonics or herbs replace antibiotics?

No. They may support recovery but cannot treat bacterial infections. Always use them under medical supervision.

When should I go to the hospital?

If fever exceeds 100.4°F for more than a day, or if accompanied by chills, pain, or discharge, seek immediate medical care.