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Pregnancy & Childbirth

Although pregnancy is the same for women worldwide, their safety varies greatly depending on where the women live and the type of medical care they receive, if any.

Sepsis is an illness that can develop in some pregnant women, as well as in women who have recently delivered a baby or babies. Sepsis that occurs during pregnancy is called maternal sepsis. If it develops within six weeks of delivery, it is called postpartum sepsis or puerperal sepsis. Sometimes incorrectly called blood poisoning, sepsis is the body’s often deadly inflammatory response to infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment. Sepsis kills and disables millions, more than breast cancer, lung cancer, and stroke combined.

Sepsis and septic shock can result from an infection anywhere in the body, such as pneumonia, influenza, or urinary tract infections. Worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction (organs don’t work properly), and/or amputations.

Maternal and postpartum sepsis are more common in the developing countries, but they also do strike women in wealthier countries, including in the United States. According to the Centers for Disease Control and Prevention, sepsis is the second leading cause of pregnancy-related deaths. Between 2014 and 2017 infection or sepsis caused 12.7% of pregnancy-related deaths in the United States. Pregnancy-associated sepsis requires early detection, accurate diagnosis, and aggressive treatment. In the United Kingdom, a 2019 study found that sepsis accounted for as many as 25% of all maternal deaths in that country.

 

How does sepsis occur in pregnancy and after childbirth?

Sepsis can occur because of an infection related to the pregnancy or one that is totally unrelated, such as pneumonia or a urinary tract infection (UTI). A recent analysis of delivery hospitalizations and postpartum readmissions in the U.S. found that 23% of in-hospital deaths were related to sepsis. The most common infections that triggered maternal sepsis were caused by bacteria such as E. coli, but pregnant women are also at higher risk of complications from COVID-19.

Sepsis can develop as the result of many complications. Here are just a few:

  • Miscarriages (spontaneous abortions) or induced abortions:Infections are a risk after any miscarriage or abortion. Non-sterile abortions, those that may be done outside of a healthcare facility, are a particular risk. Women who have had one should watch for signs and symptoms of an infection (lasting or increasing pain, discolored or odorous (smelly) discharge, abdominal tenderness, high temperature, fatigue, feeling unwell).
  • Cesarean sections: Sepsis can develop after any type of surgery. Cesarean sections are major abdominal surgeries with all the associated risks. See Sepsis and Surgery for more information.
  • Prolonged or obstructed labor: An unusually long time of labor or labor that stops progressing.
  • Ruptured membranes: The longer the period between the “water breaking” and the baby’s birth, the higher the chance of an infection.
  • Infection following vaginal delivery: Although not common in the developed world among women who give birth in healthcare facilities, infections are very common in the developing world.
  • Mastitis: Infection in the breasts can trigger sepsis.
  • Viral or Bacterial Illnesses: Any illness that raises the risk of sepsis in the general population will do so in pregnant women as well.

Who is at risk?

Any woman who is pregnant, has miscarried or aborted, or who has delivered a child is at risk of developing maternal or postpartum sepsis. However, some women do have a higher risk than do others. Risk factors associated with developing maternal sepsis include not having given birth before (medically called nulliparity), being black, and having public or no health insurance. Other childbirth-related risk factors include having a C-section, using assisted reproductive technologies in order to become pregnant, and having multiple births (twins, triplets, or more).

Women who may be more prone to getting an infection, which can lead to sepsis, are those:

  • With diabetes
  • Who undergo invasive procedures to help them get pregnant
  • Who undergo invasive tests during pregnancy

Should women get vaccines during pregnancy?

The CDC recommends that women be up-to-date on their vaccines before becoming pregnant, if possible. Speak with your doctor about your immunity to the so-called childhood diseases and if you need booster shots. Women are also encouraged to get the seasonal flu vaccine even when pregnant. If you travel, you may need vaccines specific to your destination.

Is sepsis hard to detect in pregnant or postpartum women?

Diagnosing sepsis in a pregnant woman or one who has recently given birth can be challenging. Pregnancy and delivery cause many changes in the body, including a faster heart beat, changes in blood pressure, and faster breathing. Usually, these are signs that may alert a healthcare provider that there may be something wrong, such as an infection. Also, many women get chills and sweat heavily after giving birth. They may also have pain, or feel dizzy or light headed.

It also may be more difficult to diagnose infections in pregnant and postpartum women. For example, urinary tract infections usually cause a frequent need to urinate, but this can happen because of pregnancy alone. So if a woman is going to the bathroom a lot, she may just chalk it up to being pregnant and not realize that she has an infection.

If you suspect sepsis, call 9-1-1 or go to a hospital and tell your medical professional, “I AM CONCERNED ABOUT SEPSIS.” 

The information here is also available as a Sepsis Information Guide, which is a downloadable format for easier printing.

Would you like to share your story about sepsis or read about others who have had sepsis? Please visit Faces of Sepsis, where you will find hundreds of stories from survivors and tributes to those who died from sepsis.

Updated December 14, 2017

Maternal Sepsis Week

Join Sepsis Alliance for Maternal Sepsis Week, the week of Mother’s Day, to raise awareness of maternal sepsis, honor survivors, and remember those who have passed.

Get Involved

Resources

Sepsis: Pregnancy and Childbirth
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Amanda’s Story – Maternal Sepsis
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Kayleigh’s Story – Maternal Sepsis
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Maile’s Story – Maternal Sepsis
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SEPSIS “Pregnancy and Childbirth” – PSA (0:23)
Video PSA
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SEPSIS “Pregnancy and Childbirth” – PSA (0:23)

SEPSIS “Pregnancy and Childbirth” – Español PSA (0:55)
Video PSA
PreviewDownload

SEPSIS “Pregnancy and Childbirth” – Español PSA (0:55)

Faces of Maternal Sepsis

Michaela Porter

Thankfully I am able to share my story and hopefully bring some light to this and awareness. I was induced at 39 weeks and didn’t advance very far so they decided to preform a c section to get my baby out safely. (Sepsis and Pregnancy & Childbirth) I was doing great up until 24 hours after my surgery I had gotten up to go pee and came back and was shivering cold. I then felt my head and was super hot. I called my nurse to let her know that I thought I had a fever. She came in to …

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Shay and Amelia B.

It was Friday, October 24, 2014. I was 27 weeks pregnant and just finished two long days of parent teacher conferences. I was so tired I could barely keep my eyes open. My husband and I had scheduled a long overdue date night, but I was so tired I ended up sleeping through it. (Sepsis and Pregnancy & Childbirth) I woke up in the middle of the night to uncontrollable chills and could not stop shaking; violently shaking. The next day my husband had planned to go golfing, but I was to tired to move so my mom said she …

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Shelley P.

Almost 32 years ago, I suffered sepsis during the C-section birth of my son after a long labor. (Sepsis and Pregnancy & Childbirth) A midwife broke my water and labor was induced but I failed to dilate sufficiently. Infection set in, an OB was finally called in, and he thought there was fetal-pelvic disproportion as my son was a very big baby. I delivered him after 22 hours, began to be very nauseous, my blood pressure dropped, and due to it not being known if he was actually septic, he was whisked quickly to NICU. I was semi-conscious for several …

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Annmarie Williams

Hi I am Annmarie. In 2010 I got a stomach bug and it’s changed my life. What ever the bug did affected my motility, then my gallbladder was removed. I ended up on IV nutrition in 2019. I have gastroparesis and likely severe sibo (small intestinal bacterial overgrowth). In 2020 January, I had sepsis, a bad pseudomonas infection. Luckily antibiotics worked. I then had another infection in April 2020 and a yeast infection after. (Sepsis and Bacterial Infections, Sepsis and Fungal Infections) Some how I fell pregnant with twins in June but didn’t know until September when I was 18 …

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Erza H.

I got sepsis after a miscarriage that caused my heart and kidneys to fail. After a long hospital stay and several surgeries I am now recovered and living my best life. (Sepsis and Pregnancy & Childbirth)

Read storyView All Faces

Pregnancy & Childbirth

Although pregnancy is the same for women worldwide, their safety varies greatly depending on where the women live and the type of medical care they receive, if any.