The days right after you go home
The highest-risk, least-watched window of the whole year is roughly day three to day ten.
An analysis of 5.9 million deliveries across California, Florida and New York between 2004 and 2011 found that about 2 in 100 women are readmitted to hospital within six weeks of giving birth, and that the rate rose from 1.72% in 2004 to 2.16% in 2011.
| Leading reason for readmission | Share of readmissions | Typical day it happens |
|---|---|---|
| Infection | 15.5% | Day 5 after discharge |
| High blood pressure | 9.3% | Day 3 after discharge |
| Psychiatric illness | 7.7% | Day 9 after discharge |
Day three. That is before almost anyone has an appointment.
Preeclampsia can begin after you have gone home, in a pregnancy that was entirely normal. The diagnosis should be considered in women with new-onset hypertension 48 hours to 6 weeks after delivery,
and most women with delayed-onset postpartum preeclampsia present within the first 7 to 10 days after delivery, most frequently with neurologic symptoms, typically headache.
Older age, Black race, obesity and cesarean delivery are all associated with higher risk.
more than one half of postpartum strokes occur within 10 days of discharge.
Which is why, for anyone who had any hypertensive disorder in pregnancy, ACOG recommends a blood pressure check no later than 7 to 10 days after delivery, and within 72 hours if the hypertension was severe. Some experts recommend day 3 to 5. A home blood pressure cuff for anyone in this group is entirely ordinary practice, and worth asking for before you leave.
If you had a heavy bleed at delivery, the risk of coming back for another one is real and front-loaded. In a national database of 15.7 million deliveries, 82% of readmissions for postpartum hemorrhage occurred within 20 days of discharge, and the authors concluded that for women who undergo large hemorrhage during delivery, shorter interval postpartum follow-up may be indicated.
None of these are things to mention at a follow-up appointment. They are things to have a blood pressure checked for that day.