What Is Postpartum Endometritis?

Medically Reviewed by Traci C. Johnson, MD on April 23, 2023
3 min read

Giving birth is an amazing experience for many women. After your baby is born, it’s normal to focus all your attention and efforts on your little one. But it’s just as important to remember to take care of yourself. Giving birth isn't easy, and your body needs plenty of time to recover.

Recovering from birth takes time. Many women start to feel like themselves in about 6 to 8 weeks, but it could take a few months. As your body adjusts, it’s normal to feel some aches and pains.

During your recovery period, your hormones can fluctuate, and you could experience mood shifts, temporary hair loss, and increased sweating at night. You may also experience constipation, water retention, and weight loss.

Some of the more uncomfortable changes you may experience are:

While discomfort after giving birth is normal, certain pains or symptoms related to postpartum endometritis aren’t. So, what is postpartum endometritis, and how can it be treated?

Postpartum endometritis is an infection that some women develop after giving birth. The infection occurs in the lining of the uterus (the endometrium) or the upper genital tract.

This postpartum infection is caused by bacteria. These bacteria may already be inside you before birth, or they can enter during childbirth. Typically, the bacteria come up from the lower genital or gastrointestinal tract. These organisms then enter the endometrial cavity during birth and cause an infection.

Typically, most cases of postpartum endometritis are diagnosed within 10 days of giving birth. However, some cases can take up to 6 weeks to fully develop.

Bacteria of any kind can cause postpartum endometritis. However, the most common culprits are group B streptococci and staphylococcus (staph).

The main symptom of postpartum endometritis is a fever that develops up to 72 hours after giving birth. Other signs of a postpartum infection include:

If you notice any of these signs, especially if they're paired with a fever, you may have postpartum endometritis.

Research shows that between 5% and 7% of women develop postpartum infections after giving birth. Any woman can get postpartum endometritis, but the rate of infection is 5–10 times higher in cesarean section (C-section) deliveries than in vaginal deliveries.

Only about 1–3% of women who give birth vaginally develop postpartum endometritis, but 2% of women who undergo planned C-sections and up to 7% for C-sections done when the patient is already in labor, go on to develop the infection. 

Apart from C-sections, other risk factors that contribute to developing postpartum endometritis include:

  • Prolonged labor
  • Prolonged rupture of the fetal membranes
  • Infection during pregnancy
  • Internal examinations during labor
  • Postpartum hemorrhage 
  • Removal of the placenta by hand or incomplete removal
  • Bacterial vaginosis
  • Newborn stool inside the amniotic fluid

Infections within the first 24 hours of delivery are usually caught while you’re still in the care of medical staff. Outside of this window, you should make an appointment with your doctor if you suspect that you have a postpartum infection.

Your doctor can give you a physical exam and ask about your symptoms to diagnose you. They may perform a vaginal swab, blood test, or urine test to confirm the infection.

Postpartum endometritis is treated with antibiotics. There are several different kinds of antibiotics that are prescribed to treat postpartum endometritis, and most are typically administered with an IV. Occasionally, these antibiotics can be given by injection.

Three of the most effective antibiotics to fight off this type of infection are clindamycin, gentamicin, and ampicillin. Your doctor may prescribe one or a combination of the three.

There are usually no lasting effects if postpartum endometritis is caught and treated quickly. If the infection is left untreated for too long, it could turn into sepsis, an infection that spreads to your bloodstream and can be life threatening.