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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. 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, between 2011 and 2013 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 fact, a new study published in October 2013 reported  that “Sepsis is currently the leading cause of direct maternal death in the United Kingdom.”


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). An article published by the American College of Emergency Physicians in 2012, said that women with maternal sepsis can make up as many as 30% of pregnancy-related sepsis cases admitted to intensive care units in countries like the U.S. The authors found that the most common infections that triggered maternal sepsis were caused by bacteria such as E. coli.

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. This includes women who have a history of congestive heart failure, liver disease, or lupus, according to a report presented at the American Society of Anesthesiologists Meeting in 2012.

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.

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Sepsis: Pregnancy and Childbirth
Amanda’s Story – Maternal Sepsis
Kayleigh’s Story – Maternal Sepsis
Maile’s Story – Maternal Sepsis

Faces of Maternal Sepsis

LaTera L.

On July 8, 2018 I delivered my baby boy. I had a perfect pregnancy without any complications. I was sent home without knowing I was hemorrhaging from a uterine rupture. (Sepsis and Pregnancy & Childbirth) I didn’t start to feel extremely ill until the beginning of August. I couldn’t eat, walk, suffered diarrhea, constantly urinating on myself and bad back pains. My face and stomach was pale and turning blue/purple. I was dying right then and there. Arrived at the hospital and my blood count was a 4.6. I had to get a total of 4 surgeries with a piece …

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Michelle B.

I am sepsis survivor. My story was a whirlwind that seemed like a movie. On the 13th of May 2019, I called an ambulance to my flat, as I was bleeding at 30 weeks pregnant. (Sepsis and Pregnancy & Childbirth) After being rushed to the hospital, I was rushed to the theatre for an emergency C-section. Fast forward, the surgeon told me they took out a full placenta with infection. My son survived and never caught it. Fast forward few days later, I started deteriorating and had numerous tests done, during which they realised the infection had spread throughout my …

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Mandalyn Adams

Back in early March of 2014, I went in for surgery to get my C-section done to have my set of boy/girl twins. Never did I know that I would be setting myself up for failure. (Sepsis and Pregnancy & Childbirth) Not only did they go fishing around in my spine trying to give me a local after I told them I was born with congenital scoliosis and they weren’t going to find my spine, but then they weren’t even able to use it and put this face mask on me to give me anesthesia and gave me too much. …

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Caitlin Forsyth

My name is Caitlin Forsyth and I am 20 years old, living in Scotland. This is my story. I gave birth to my beautiful son on 7th September, 2015, by emergency C-section. It was quite a traumatic time and for the weeks following it, I struggled greatly with recovery. Things did start to improve though and we were enjoying being new parents. On November 15th, 2015, I began to feel quite unwell, a sort of unwell that felt very much like the flu. My symptoms included having a high temperature, so much so that my body went into rigors, pain …

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Tara Johnson

My story of sepsis began in December 2012. Shortly after the birth of our second child, I developed mastitis from breastfeeding and was prescribed antibiotics. (Sepsis and Pregnancy & Childbirth) Over the course of 24 hours, instead of getting better my fever continued to climb and wasn’t responding to Tylenol or Advil. When my fever reached 104.2, I became delirious and was rushed to the emergency room. I have no memory of the nightmare that was about to unfold. I was told that shortly after arriving at the hospital, my blood pressure dropped 50 points, my heart rate spiked to …

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Pregnancy & Childbirth