Postpartum Infections (Endometritis)
What is Postpartum Infections (Endometritis)?
Postpartum infections are bacterial infections that develop in the weeks after childbirth. The most common type is endometritis, an infection of the uterine lining. These infections occur when bacteria enter the uterus during labor, delivery, or in the days immediately following birth.
Endometritis affects between 1% and 8% of all new mothers. The risk is higher after cesarean section births, affecting up to 20% of C-section deliveries. Your body normally sheds the uterine lining after delivery, but sometimes bacteria can multiply in this healing tissue. This causes inflammation and infection that needs prompt treatment.
Most postpartum infections respond well to antibiotics when caught early. Your immune system is already working hard after childbirth, so recognizing the warning signs is essential. Blood tests can help identify infection by measuring white blood cell counts, which rise when your body fights bacteria.
Symptoms
- Fever above 100.4°F that develops within 10 days after delivery
- Lower abdominal pain or tenderness that worsens over time
- Foul-smelling vaginal discharge or lochia
- Heavy vaginal bleeding with large clots
- Increased heart rate or rapid pulse
- Chills and body aches beyond normal postpartum discomfort
- General feeling of illness or extreme fatigue
- Pale skin or dizziness from severe infection
Some women notice only mild symptoms at first, like slight fever or cramping. Others develop severe symptoms quickly within 24 to 48 hours. Early treatment prevents complications, so contact your doctor if you notice any concerning signs after delivery.
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Causes and risk factors
Bacteria normally present in the vagina can enter the uterus during labor and delivery. Cesarean section delivery increases risk because surgery creates an entry point for bacteria. Prolonged labor, especially with ruptured membranes lasting more than 18 hours, also raises infection risk. Internal monitoring devices and multiple vaginal exams during labor can introduce bacteria into the uterine cavity.
Other risk factors include retained placental fragments, which provide a breeding ground for bacteria. Manual removal of the placenta increases infection risk. Women with bacterial vaginosis or other infections during pregnancy face higher rates of postpartum infection. Obesity, diabetes, and weakened immune systems also make postpartum infections more likely. Very young mothers under age 20 have slightly higher risk compared to older women.
How it's diagnosed
Your doctor will perform a physical exam to check for uterine tenderness and assess vaginal discharge. Blood tests measure white blood cell count, which typically rises above 15,000 cells per microliter with infection. Normal postpartum WBC can be elevated up to 12,000, so doctors look for counts significantly higher than this baseline. Rite Aid's blood testing panel includes white blood cell count to help identify signs of infection.
Your doctor may also collect samples of vaginal discharge or lochia for laboratory culture. Ultrasound imaging can reveal retained placental tissue or fluid collections in the uterus. In severe cases, CT scans help identify abscesses or complications. Most diagnoses rely on clinical symptoms combined with blood test results showing elevated white blood cells and other infection markers.
Treatment options
- Broad-spectrum antibiotics given intravenously in the hospital for moderate to severe infections
- Oral antibiotics for mild cases or to complete treatment after hospital discharge
- Rest and adequate hydration to support immune system recovery
- Pain relievers like ibuprofen or acetaminophen to manage fever and discomfort
- Continued breastfeeding if desired, as most antibiotics are safe during nursing
- Surgical removal of retained placental tissue if present
- Follow-up blood tests to confirm white blood cell counts return to normal
- Monitoring for complications like abscess formation or sepsis
Concerned about Postpartum Infections (Endometritis)? Get tested at Rite Aid.
- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
Most postpartum infections develop within the first 10 days after delivery. Endometritis typically appears between 2 and 5 days postpartum. Some infections can develop up to 6 weeks after birth, so remain alert to symptoms throughout your entire recovery period.
Yes, cesarean delivery significantly increases infection risk. About 5% to 20% of women who have C-sections develop endometritis, compared to 1% to 3% after vaginal delivery. The surgical incision creates an entry point for bacteria into the uterus.
Most women can continue breastfeeding during treatment for endometritis. The antibiotics commonly used are safe for nursing babies. Breastfeeding actually helps your uterus contract and heal. Talk to your doctor if you have concerns about specific medications.
White blood cell count is the primary blood test for detecting postpartum infections. Normal postpartum WBC ranges from 9,000 to 12,000 cells per microliter. Counts above 15,000 often indicate infection. Your doctor may also check C-reactive protein and other inflammatory markers.
Most women receive intravenous antibiotics for 24 to 48 hours until fever resolves. Treatment typically continues with oral antibiotics for 7 to 10 days total. Symptoms usually improve within 48 to 72 hours of starting antibiotics. Complete recovery takes about 2 weeks.
When treated promptly, most postpartum infections resolve without lasting effects. Untreated or severe infections can lead to pelvic abscesses, blood clots, or sepsis. Rarely, severe infections may affect future fertility. Early treatment prevents these complications in nearly all cases.
Risk factors include cesarean delivery, prolonged labor, and ruptured membranes lasting over 18 hours. Retained placental tissue, multiple vaginal exams during labor, and internal monitoring also increase risk. Existing conditions like diabetes or obesity raise your chances of developing infection.
Mild cramping and bleeding are normal after delivery. Warning signs include fever above 100.4°F, foul-smelling discharge, or worsening abdominal pain. If your symptoms get worse instead of better, or you feel very ill, contact your doctor immediately.
Prophylactic antibiotics given during C-section reduce infection risk by about 70%. Minimizing vaginal exams during labor and prompt delivery after membranes rupture also help. Good hygiene practices and treating infections during pregnancy lower your risk. Some risk factors cannot be prevented.
Go to the emergency room if you have high fever over 101°F, severe abdominal pain, heavy bleeding, or feel extremely ill. Rapid heart rate, confusion, or difficulty breathing require immediate care. These symptoms may indicate severe infection or sepsis that needs urgent treatment.