By PPH Foundation

The birth of a baby does not necessarily mark the end of a mother's health risks. In the days following delivery, an infection that initially appears manageable can sometimes trigger a dangerous response in the body known as sepsis. For a mother who has also experienced complications such as postpartum haemorrhage, PPH, sepsis can further complicate recovery and place additional strain on an already vulnerable body.

Sepsis occurs when the body's response to an infection causes injury to its own tissues and organs. If it is not recognized and treated promptly, it can progress to septic shock, multiple organ failure and death. When this occurs during pregnancy, childbirth or the postpartum period, it is referred to as maternal sepsis (WHO, 2024).

The postpartum period can present several opportunities for infection. A woman may develop an infection following a caesarean section, prolonged labour, retained products of conception, tears or wounds sustained during childbirth, or other infections affecting the reproductive or urinary tract. Poor infection prevention and control practices can also increase the risk.

According to WHO, maternal sepsis can develop from infections acquired in the community or within healthcare settings, making infection prevention, early recognition and timely treatment important components of maternity care. WHO further identifies pregnant and recently pregnant women among groups at increased risk of sepsis (WHO, 2024).

The danger is that the early symptoms may not always appear dramatic. A mother who has just given birth may already be exhausted, experiencing body aches or discomfort and adjusting to caring for a newborn. Fever may therefore be dismissed as ordinary postpartum discomfort. But fever or unusually low body temperature, chills, rapid breathing, difficulty breathing, a fast heart rate, confusion, low blood pressure, reduced urine output and severe body pain can signal a serious infection progressing towards sepsis (WHO, 2024).

Dr Eunice Atsali, Co-Lead of the End PPH Initiative and a midwife, emphasises that maternal infections need to be considered in relation to other complications rather than treated as isolated events. “Maternal infections do not occur in isolation,” she says. “When a woman enters labour with an untreated infection, the risks extend beyond infection itself to complications such as postpartum haemorrhage.”

This connection is important because infection and haemorrhage can interact in ways that make a mother's condition more difficult to manage. An infection can contribute to severe maternal illness, while significant blood loss can weaken the body's ability to cope with further complications. For women recovering from PPH, the development of an infection can therefore add another layer of risk.

The global burden also illustrates why maternal sepsis deserves attention. In a 2025 analysis of the Global Burden of Disease Study 2021, researchers examined maternal sepsis and other maternal infections across 204 countries and territories. They estimated that the global incidence declined between 1990 and 2021, but substantial disparities remained, with poorer regions continuing to carry a disproportionate burden (GBD 2021 Maternal Sepsis and Other Maternal Infections Collaborators, 2025).

For a woman at home after delivery, recognising when something is wrong is therefore critical. A high fever, chills, foul-smelling vaginal discharge, worsening abdominal or pelvic pain, difficulty breathing, extreme weakness, confusion or a general deterioration in health should not simply be attributed to the demands of new motherhood.

WHO recommends that women receive information before leaving a health facility on how to recognise danger signs of infection and seek care promptly when they occur. Its maternal and newborn care guidance also recommends assessing women for signs of infection during the postnatal period alongside monitoring vital signs and vaginal bleeding (WHO, 2022).

The response within health facilities is equally important. Sepsis is a time-sensitive emergency, and treatment cannot wait for a woman to become critically ill. According to WHO's 2024 clinical management guidance, effective sepsis care depends on early recognition, resuscitation, appropriate antimicrobial treatment, identification and control of the source of infection, close monitoring and management of organ dysfunction (WHO, 2024).

This means that preventing maternal sepsis extends beyond prescribing antibiotics. It begins with clean and safe maternity care, appropriate infection prevention and control, timely identification of infections, effective postnatal monitoring and a health system capable of responding quickly when a woman's condition deteriorates.

For families, the message is equally important: a mother who has already returned home after giving birth should not be expected to simply endure worsening symptoms. If she develops a high fever, severe pain, foul-smelling discharge, difficulty breathing, confusion, extreme weakness or other concerning changes, she needs medical assessment.

The arrival of a healthy baby can understandably shift everyone's attention towards the newborn. But the mother's health remains just as important.

The days after childbirth are still part of the journey to a safe birth. Recognising infection early, seeking care promptly and ensuring that health facilities are prepared to respond can prevent an infection from becoming a life-threatening emergency.

References

GBD 2021 Maternal Sepsis and Other Maternal Infections Collaborators. (2025). The global, regional, and national burdens of maternal sepsis and other maternal infections and trends from 1990 to 2021 and future trend predictions: Results from the Global Burden of Disease Study 2021. [Journal details to be verified from the final publication record].

World Health Organization. (2022). WHO recommendations on maternal and newborn care for a positive postnatal experience. World Health Organization.

World Health Organization. (2024). Sepsis. World Health Organization.

World Health Organization. (2024). Guidelines on the clinical management of sepsis. World Health Organization.

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