For most women with preeclampsia, the condition will develop during pregnancy — but in rarer instances, it can appear after you’ve given birth. 

What is postpartum preeclampsia?

Postpartum preeclampsia is a serious health condition that crops up after you've had your baby rather than during pregnancy. It is characterized by high blood pressure and a build-up of protein in the urine. Left untreated, it can lead to eclampsia (seizures), HELLP syndrome and other problems.

What are the symptoms of postpartum preeclampsia?

The symptoms of postpartum preeclampsia are similar to those that develop during pregnancy, and may include:

  • High blood pressure (140/90 mm Hg or higher)
  • Too much protein in your urine (proteinuria)
  • Headaches that can often be severe
  • Vision changes, including blurry vision, light sensitivity and a temporary loss of sight
  • Abdominal pain (particularly under the ribs of the upper, right-hand side of the stomach)
  • Nausea or vomiting
  • Shortness of breath
  • Swelling

When does postpartum preeclampsia typically start?

For most women, postpartum preeclampsia appears within 48 hours after giving birth. But it can also develop up to six weeks after delivery, which is known as late postpartum preeclampsia.

What causes postpartum preeclampsia?

Experts aren’t sure what causes postpartum preeclampsia, but the American College of Obstetricians and Gynecologists (ACOG) points out that fluid shifts that occur after giving birth can possibly cause a rise in blood pressure levels during the three- to six-day period after labor and delivery.

How common is postpartum preeclampsia?

Some researchers have estimated that between 4 and 6 percent of women with preeclampsia and eclampsia are diagnosed with the disorder during the postpartum period.

If you have preeclampsia during pregnancy (i.e. high blood pressure and signs of liver or kidney damage that occur after week 20), you have a higher risk of developing the condition during the postpartum period than women without preeclampsia, but this disorder can also appear in women who had normal blood pressure levels throughout their pregnancies.

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What are the risk factors for postpartum preeclampsia?

Women who have preeclampsia during pregnancy have an increased risk for the disorder after giving birth, but even mothers with healthy blood pressure levels can develop the condition postpartum.

In fact, one study found that about 60 percent of women who were diagnosed with postpartum preeclampsia (which sometimes also included eclampsia, or seizures) didn’t have either of these disorders when they were pregnant.

While more research is needed to pinpoint what increases a woman’s odds of having postpartum preeclampsia, the following risk factors may play a role in its development:

  • Having gestational diabetes or preexisting type 1 or type 2 diabetes
  • High blood pressure that develops after week 20 of pregnancy
  • Obesity
  • Carrying multiples
  • Having heart disease due to high blood pressure
  • Being 40 years old or older
  • Black mothers are also more likely to develop preeclampsia and postpartum preeclampsia

How is postpartum preeclampsia diagnosed?

After you give birth, your doctor will check your blood pressure levels at the hospital, then again at your postpartum doctor's appointments.

If your health care providers suspect that you have postpartum preeclampsia — for example, your blood pressure levels are high — they will give you a blood test and urine test to confirm or rule out the disorder.

If you were diagnosed with preeclampsia earlier in your pregnancy, your providers will keep a close eye on your blood pressure levels for 72 hours after you give birth, either at the hospital or while you’re recovering at home.

Since postpartum preeclampsia can develop up to six weeks after delivery, it’s important to keep tabs on your own symptoms. If you experience problems like headaches, trouble breathing and vision changes, call your doctor right away. 

You may need to be readmitted to the hospital, as there’s some evidence that postpartum preeclampsia is linked to a higher risk of complications than preeclampsia that develops during pregnancy.

What are the complications associated with postpartum preeclampsia?

The risk of complications for women with postpartum preeclampsia may be more serious (and escalate more quickly) than those for women whose preeclampsia appeared during pregnancy. Regardless of when the disorder appeared, it’s important to tell your doctor if you’re experiencing any of the above symptoms.

If left untreated, some of the complications include:

  • Postpartum eclampsia, a serious medical condition that results in seizures and can cause organ damage. (About 1 in 3 cases of eclampsia occur after a woman gives birth; almost half the time, the seizures appear more than 48 hours after delivery.)
  • Pulmonary edema, or a build-up of fluid in the lungs.
  • HELLP syndrome, a rare but serious liver and blood-clotting disorder. HELLP stands for hemolysis (a breakdown of red blood cells in the body), elevated liver enzymes (a sign that the liver isn’t processing toxins adequately) and low platelet count (an inability of the blood to clot as well, which can result in more bleeding).
  • Stroke, which interrupts blood flow to the brain.

How do you treat postpartum preeclampsia?

Postpartum preeclampsia can quickly progress to eclampsia, so it’s important to be treated for the condition right away. Your doctor may recommend the following medications:

  • Blood pressure medications, or antihypertensive medications, which will bring down your blood pressure.
  • Magnesium sulfate, which can help prevent seizures. Typically, women will take this for 24 hours, and continue to be monitored for other symptoms after they’ve finished the treatment.

Chances are, you’ll be able to breastfeed while taking these medications, but you should always check with your doctor before doing so.

What can you do to prevent postpartum preeclampsia?

It’s unclear whether postpartum preeclampsia can be prevented, but your doctor may recommend the following lifestyle changes:

  • Follow a healthy diet. Moms in their second trimester usually need to up their calorie intake by 300 to 350 calories a day, and then by 500 calories a day in their third trimester. Likewise, if you’re breastfeeding, you may need to eat about 500 more calories per day than you were eating efore you got pregnant. Try to include plenty of leafy green vegetables, whole grains and lean sources of protein in your diet.
  • Stay active. If your pregnancy is normal, you should try to exercise for at least 150 minutes a week (or 30 minutes of moderate-intensity aerobic exercise a day) and do a minimum of two weekly sessions of strength training.
  • Consider taking baby aspirin during your next pregnancy. If you get pregnant again, your doctor may want you to take baby aspirin to help prevent preeclampsia from occurring again.
Thankfully, postpartum preeclampsia is a rare disorder. But because it can cause serious complications like eclampsia — and because you may no longer be in the hospital when the symptoms appear — you’ll want to seek medical treatment right away if you notice any of these signs.