{ "release_id": "c7fb95f1d15a7d13", "id": "maternal:postpartum-warning-signs", "owner": "maternal", "kind": "care_topic", "slug": "postpartum-warning-signs", "name": "Warning signs after birth", "aliases": [], "atlases": [ "maternal" ], "summary_plain": "Symptoms in the weeks and months after birth that need urgent care. This page does not list them, because the CDC page that does refused automated access and the nurses' programme that teaches them is copyrighted. MedlinePlus points to a CDC page of urgent maternal warning signs. WHO says women should be told to watch for worsening perineal or uterine pain, which can signal complications such as infection.", "summary_technical": "No list of maternal warning signs is recorded. The CDC Hear Her page that MedlinePlus links returned HTTP 403 to a script, and the AWHONN POST-BIRTH page offers its program materials under a permissions policy, so neither was read beyond the program description. What is recorded: WHO's remarks that women should be advised on danger signs including worsening perineal and uterine pain (examples, not a full list), and the list of danger signs for the newborn in WHO Recommendation 25, which is on the postnatal care page. US surveillance finds pregnancy-related deaths up to 1 year after delivery (see the outcome page). The AWHONN page is cite-only here.", "editorial_state": "draft", "last_substantive_edit": "2026-10-15", "last_evidence_check": "2026-10-15", "next_review_due": null, "identifiers": [], "navigation": { "maternal": { "life-stage": [ "postpartum" ], "care-area": [ "postpartum-recovery" ] } }, "payload": { "scope": "Urgent symptoms of the mother in the year after birth; the list of signs themselves is not recorded.", "life_stages": [ "Postpartum" ], "life_stage_terms": { "maternal": [ "postpartum" ] }, "care_setting": null }, "content_digest": "4492f07f49d2a057fa6fa8ead4db96457cf78a9ca150cd20cee37f70717e0a32", "review": { "content_digest": "4492f07f49d2a057fa6fa8ead4db96457cf78a9ca150cd20cee37f70717e0a32", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "claims": [ { "release_id": "c7fb95f1d15a7d13", "id": "maternal:claim-awhonn-post-birth-warning-signs-education", "owner": "maternal", "subject_entity_id": "maternal:postpartum-warning-signs", "category": "descriptive", "statement": "The Association of Women’s Health, Obstetric and Neonatal Nurses runs the POST-BIRTH Warning Signs Education Program, a course with program resources that teaches nurses and clinicians about serious illness and death of mothers in the postpartum period, and gives them ways to teach patients and families to recognise warning signs. The page says the course was updated in December 2023.", "context": { "id": "maternal:ctx-postpartum-women-education-pages", "label": "Women in the weeks and months after birth, as addressed by health education pages", "recipient": "maternal", "population": "Women after birth, as the audience of patient and clinician education pages. The pages describe education and information, not outcomes in a sample of women.", "care_setting": "Not applicable: education material", "geography": "United States (the pages are from US organisations)", "life_stage_note": "After birth, up to the first year postpartum", "life_stage_terms": { "maternal": [ "postpartum" ] }, "gestational_age_min_days": null, "gestational_age_max_days": null, "gestational_age_basis": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable", "eligibility": { "inclusion": [ "Women after birth" ], "exclusion": [ "Not stated in the source" ] } }, "evidence_stage": "not_applicable", "certainty": "not_assessed", "certainty_method": null, "limitations": "This describes a training programme from its own program page, which is cited and not quoted because the organisation asks for permission to reuse its copyrighted material. The page was not tested against any outcome, and the program materials and the course itself were not read.", "editorial_state": "draft", "checked_at": "2026-10-15", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "Why Is Postpartum Discharge Training Essential, paragraph 1", "applicability_note": "AWHONN program page; cite only.", "snapshot": { "id": "maternal:awhonn-post-birth-2026-10-15", "retrieved_at": "2026-10-15T13:52:49Z", "content_hash": "bb567bf0e1b96659e80d4bd884ca5a950c57148f2afb12990156fa2633547b2d", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:awhonn-post-birth", "source_type": "webpage", "title": "POST-BIRTH Warning Signs Education Program (AWHONN)", "canonical_url": "https://www.awhonn.org/education/post-birth-warning-signs-education-program/", "identifiers": [], "publication_date": null, "publisher": "Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN)", "edition": "The program page as shown on 2026-10-15; the page lists an update stamp of 2026-07-20. The handouts, the course and the linked PDF files were not read.", "reuse_basis": "The page directs requests to reuse its copyrighted material to AWHONN permissions and sets its own permissions policy for the handouts. No licence for reuse of its text was found, so it is cite_only here: facts are stated in the atlas's own words with a citation and link. The page bytes are not committed; only the hash is kept.", "public_text": "cite_only" } }, { "evidence_role": "supports", "locator": "Revised POST-BIRTH Warning Signs Education Now Available", "applicability_note": "AWHONN program page; cite only.", "snapshot": { "id": "maternal:awhonn-post-birth-2026-10-15", "retrieved_at": "2026-10-15T13:52:49Z", "content_hash": "bb567bf0e1b96659e80d4bd884ca5a950c57148f2afb12990156fa2633547b2d", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:awhonn-post-birth", "source_type": "webpage", "title": "POST-BIRTH Warning Signs Education Program (AWHONN)", "canonical_url": "https://www.awhonn.org/education/post-birth-warning-signs-education-program/", "identifiers": [], "publication_date": null, "publisher": "Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN)", "edition": "The program page as shown on 2026-10-15; the page lists an update stamp of 2026-07-20. The handouts, the course and the linked PDF files were not read.", "reuse_basis": "The page directs requests to reuse its copyrighted material to AWHONN permissions and sets its own permissions policy for the handouts. No licence for reuse of its text was found, so it is cite_only here: facts are stated in the atlas's own words with a citation and link. The page bytes are not committed; only the hash is kept.", "public_text": "cite_only" } } ], "review": { "content_digest": "8a2cb0525ec441887663722b35db67abd2c5bb0bd4a84c1b8a9473f1c64b4415", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "api_path": "api/v1/claims/maternal--claim-awhonn-post-birth-warning-signs-education.json" }, { "release_id": "c7fb95f1d15a7d13", "id": "maternal:claim-medlineplus-lists-cdc-urgent-maternal-warning-signs-page", "owner": "maternal", "subject_entity_id": "maternal:postpartum-warning-signs", "category": "descriptive", "statement": "The MedlinePlus Postpartum Care topic, under its Symptoms heading, links to a page from the Centers for Disease Control and Prevention called Signs and Symptoms of Urgent Maternal Warnings Signs. That CDC page returned an access error to a script, so its contents are not recorded here.", "context": { "id": "maternal:ctx-postpartum-women-education-pages", "label": "Women in the weeks and months after birth, as addressed by health education pages", "recipient": "maternal", "population": "Women after birth, as the audience of patient and clinician education pages. The pages describe education and information, not outcomes in a sample of women.", "care_setting": "Not applicable: education material", "geography": "United States (the pages are from US organisations)", "life_stage_note": "After birth, up to the first year postpartum", "life_stage_terms": { "maternal": [ "postpartum" ] }, "gestational_age_min_days": null, "gestational_age_max_days": null, "gestational_age_basis": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable", "eligibility": { "inclusion": [ "Women after birth" ], "exclusion": [ "Not stated in the source" ] } }, "evidence_stage": "not_applicable", "certainty": "not_assessed", "certainty_method": null, "limitations": "This records that a pointer exists on a government health information page. It says nothing about which signs the CDC page lists. The MedlinePlus page was read as shown on 2026-10-15.", "editorial_state": "draft", "checked_at": "2026-10-15", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "Symptoms section, first link", "applicability_note": "MedlinePlus health topic page; short quotation.", "snapshot": { "id": "maternal:medlineplus-postpartumcare-2026-10-15", "retrieved_at": "2026-10-15T13:50:49Z", "content_hash": "3cf394f87d512987af681ddf5d66a078422d5fe2b74ebc5fef56826562bba7ae", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:medlineplus-postpartumcare", "source_type": "webpage", "title": "Postpartum Care (MedlinePlus health topic)", "canonical_url": "https://medlineplus.gov/postpartumcare.html", "identifiers": [], "publication_date": null, "publisher": "National Library of Medicine (MedlinePlus)", "edition": "The health topic page as shown on 2026-10-15. The page carries no edition date. The summary is credited on the page to the Dept. of Health and Human Services Office on Women's Health.", "reuse_basis": "MedlinePlus health topic summaries are in the public domain (page https://medlineplus.gov/about/using/usingcontent/, fetched earlier as mj-medlineplus-using-content.html, sha256 31267ce9db016893b80c5665312d92ffc8c34ec86916f84708c353936ba52228; see core:medlineplus-using-content). The page asks users to acknowledge MedlinePlus as the source. The page bytes are not committed; only the hash is kept. Short quotations only. Links on the page to CDC, March of Dimes, ACOG and other pages are pointers; none of those pages was read.", "public_text": "quote" } } ], "review": { "content_digest": "474ea36b34bbf41806bfc571507d6b5a4ad26bf0e80e402290db51a22e482496", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "api_path": "api/v1/claims/maternal--claim-medlineplus-lists-cdc-urgent-maternal-warning-signs-page.json" }, { "release_id": "c7fb95f1d15a7d13", "id": "maternal:claim-who-2022-advise-women-on-danger-signs", "owner": "maternal", "subject_entity_id": "maternal:postpartum-warning-signs", "category": "descriptive", "statement": "In remarks beside two recommendations, on perineal pain relief and on pain from uterine cramping, WHO says women should be told about danger signs and symptoms. Its examples are worsening perineal pain, which can point to complications such as haematoma, haemorrhoids or infection, and worsening uterine pain, which can point to complications such as endometritis.", "context": { "id": "maternal:ctx-who-2022-women-after-birth-remarks", "label": "Women after birth, remarks beside WHO 2022 recommendations 4 and 6", "recipient": "maternal", "population": "Women after birth who have perineal pain or pain from uterine cramping. The statements are remarks the guideline group added beside its recommendations on perineal pain relief and on pain from uterine cramping.", "care_setting": "Facility- or community-based postnatal care", "geography": "Global (WHO guidance)", "life_stage_note": "The weeks after birth", "life_stage_terms": { "maternal": [ "postpartum" ] }, "gestational_age_min_days": null, "gestational_age_max_days": null, "gestational_age_basis": null, "postnatal_age_min_days": null, "postnatal_age_max_days": null, "gestational_age_status": null, "postnatal_age_status": null, "followup_description": "Not applicable: guideline remarks", "eligibility": { "inclusion": [ "Women after birth" ], "exclusion": [ "Not stated in the source" ] } }, "evidence_stage": "guidance", "certainty": "not_assessed", "certainty_method": null, "limitations": "These are examples WHO gives in remarks, not a full list of postpartum warning signs. The guideline does not set out one list of maternal danger signs. The remarks were read from the English PDF.", "editorial_state": "draft", "checked_at": "2026-10-15", "next_review_due": null, "valid_from": null, "valid_to": null, "citations": [ { "evidence_role": "supports", "locator": "Recommendation 4, Remarks", "applicability_note": "WHO guideline PDF (CC BY-NC-SA 3.0 IGO); short quotation.", "snapshot": { "id": "maternal:who-9789240045989-pdf-2026-10-15", "retrieved_at": "2026-10-15T13:51:32Z", "content_hash": "f4cbef197fdf40d33e1c53987ba6f4e099265fe0d867724c8c2e4fb91051a071", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:who-2022-postnatal-care", "source_type": "guideline", "title": "WHO recommendations on maternal and newborn care for a positive postnatal experience", "canonical_url": "https://www.who.int/publications/i/item/9789240045989", "identifiers": [ { "scheme": "isbn", "value": "978-92-4-004598-9", "normalized_value": "9789240045989", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2022-03-30", "publisher": "World Health Organization", "edition": "First edition, 2022. The date is the who.int page date, 30 March 2022, which the atlas uses for WHO sources and decisions; the WHO IRIS record 10665/352658 lists an issue date of 2022-03-29 for the same document. The English PDF was read from IRIS (bitstream 73dec697-c033-449c-8323-1cd04a8d8f20). The who.int page lists a corrigendum dated 26 May 2022 beside the web supplement on the evidence base (ISBN 978-92-4-004617-7), not beside the guideline; the corrigendum (mk-who-9789240046177-corrigendum.pdf) changes one source citation on page 93 of that supplement, and the supplement was not read.", "reuse_basis": "Licensed CC BY-NC-SA 3.0 IGO, as stated in the IRIS record (dc.rights.uri https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Only short quotations with attribution are used, and neither the PDF nor the pages are committed. The non-commercial and share-alike terms need a licensing decision before any text is adapted.", "public_text": "quote" } }, { "evidence_role": "supports", "locator": "Recommendation 6, Remarks", "applicability_note": "WHO guideline PDF (CC BY-NC-SA 3.0 IGO); short quotation.", "snapshot": { "id": "maternal:who-9789240045989-pdf-2026-10-15", "retrieved_at": "2026-10-15T13:51:32Z", "content_hash": "f4cbef197fdf40d33e1c53987ba6f4e099265fe0d867724c8c2e4fb91051a071", "source_effective_date": null, "public_archive_url": null, "source_state": "current" }, "source": { "id": "maternal:who-2022-postnatal-care", "source_type": "guideline", "title": "WHO recommendations on maternal and newborn care for a positive postnatal experience", "canonical_url": "https://www.who.int/publications/i/item/9789240045989", "identifiers": [ { "scheme": "isbn", "value": "978-92-4-004598-9", "normalized_value": "9789240045989", "match": "exact", "version": null, "label": null, "from_source": false } ], "publication_date": "2022-03-30", "publisher": "World Health Organization", "edition": "First edition, 2022. The date is the who.int page date, 30 March 2022, which the atlas uses for WHO sources and decisions; the WHO IRIS record 10665/352658 lists an issue date of 2022-03-29 for the same document. The English PDF was read from IRIS (bitstream 73dec697-c033-449c-8323-1cd04a8d8f20). The who.int page lists a corrigendum dated 26 May 2022 beside the web supplement on the evidence base (ISBN 978-92-4-004617-7), not beside the guideline; the corrigendum (mk-who-9789240046177-corrigendum.pdf) changes one source citation on page 93 of that supplement, and the supplement was not read.", "reuse_basis": "Licensed CC BY-NC-SA 3.0 IGO, as stated in the IRIS record (dc.rights.uri https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Only short quotations with attribution are used, and neither the PDF nor the pages are committed. The non-commercial and share-alike terms need a licensing decision before any text is adapted.", "public_text": "quote" } } ], "review": { "content_digest": "7d3441b4db5d3f2f4864cd3a0d70f0bdf8fcfff9071cf9e96355f9585a0083f4", "current": [], "conflicting": [], "stale": [], "inactive": [] }, "api_path": "api/v1/claims/maternal--claim-who-2022-advise-women-on-danger-signs.json" } ], "decisions": [], "milestones": [], "relationships": { "outgoing": [ { "predicate": "related_to", "label": "MedlinePlus links to a CDC page of urgent maternal warning signs (the CDC page was not read)", "clinical_claim_not_fact": false, "family": "navigation", "other_entity_id": "core:cdc", "other_entity_in_atlas": true, "claim_id": null, "evidence": null, "primary": false, "role": null, "valid_from": null, "valid_to": null }, { "predicate": "related_to", "label": "Eclampsia, which can also happen after the birth (page on the condition; not a list of warning signs)", "clinical_claim_not_fact": false, "family": "navigation", "other_entity_id": "maternal:eclampsia", "other_entity_in_atlas": true, "claim_id": null, "evidence": null, "primary": false, "role": null, "valid_from": null, "valid_to": null }, { "predicate": "part_of", "label": "Education before and after discharge is part of postnatal care", "clinical_claim_not_fact": false, "family": "navigation", "other_entity_id": "maternal:postnatal-care", "other_entity_in_atlas": true, "claim_id": null, "evidence": null, "primary": false, "role": null, "valid_from": null, "valid_to": null }, { "predicate": "part_of", "label": "Filed under this front", "clinical_claim_not_fact": false, "family": "navigation", "other_entity_id": "maternal:front-care-programmes-and-follow-up", "other_entity_in_atlas": true, "claim_id": null, "evidence": null, "primary": true, "role": null, "valid_from": null, "valid_to": null } ], "incoming": [ { "predicate": "related_to", "label": "Related to", "clinical_claim_not_fact": false, "family": "navigation", "other_entity_id": "maternal:awhonn", "other_entity_in_atlas": true, "claim_id": null, "evidence": null, "primary": false, "role": null, "valid_from": null, "valid_to": null } ] }, "page_path": "care-topics/postpartum-warning-signs/", "context_path": "api/v1/context/maternal--postpartum-warning-signs.md" }