Pregnancy is a time of profound physical changes, but symptoms such as fever, unusual weakness or difficulty breathing should never automatically be dismissed as part of pregnancy. In some cases, an infection can trigger sepsis, a life-threatening condition in which the body's response to infection causes organ dysfunction.

Maternal sepsis can occur during pregnancy, childbirth, after an abortion or during the postpartum period. The condition remains a major global maternal-health concern. The World Health Organization (WHO) identifies maternal sepsis as the third most common cause of maternal mortality, and says infections and sepsis can also increase the risk of adverse outcomes for newborns.

"Sepsis during pregnancy is a serious medical emergency in which the body develops an extreme response to an infection, potentially leading to organ damage and putting both the mother and baby at risk," says Dr Richa Arora Miglani, Head - Laparoscopic, Robotic and Cosmetic Gynaecology, RG Hospitals, Delhi.

The good news is that infection-related complications can often be reduced through preventive care, early recognition and timely treatment.

What causes sepsis during pregnancy?

Sepsis can develop when an infection is not contained and the body's response begins damaging its own tissues and organs. In pregnant and recently pregnant women, infections can originate from several sites.

"Common infections that may lead to sepsis during pregnancy include urinary tract infections, kidney infections, infections of the uterus or placenta, respiratory infections and infections following delivery or a procedure," Dr Miglani says.

A 2023 review of maternal sepsis found that genital-tract infections, pneumonia and urinary infections are among the important sources of infection in pregnancy and the postpartum period. The risk can continue after delivery. Postpartum infections may include endometritis, surgical-site or caesarean wound infections, urinary tract infections and mastitis.

Certain circumstances can also increase vulnerability. The CDC specifically lists premature rupture of membranes, recent caesarean delivery and retained pregnancy tissue among conditions that can increase the risk of infection that may progress to sepsis.

Sepsis symptoms during pregnancy: What should women watch for?

Recognising deterioration early is critical because sepsis can progress rapidly. "Warning signs include high or unusually low temperature, chills, rapid heartbeat, breathing difficulty, extreme weakness, confusion, dizziness, reduced urine output or feeling suddenly and severely unwell," Dr Miglani says.

WHO also lists fever or low body temperature, shivering, difficulty breathing, rapid heart rate, low blood pressure, reduced urine output, confusion and extreme pain or discomfort among possible signs of sepsis.

For women who have recently delivered, warning signs can also include foul-smelling vaginal discharge, severe or worsening abdominal or pelvic pain, redness or drainage from a caesarean incision, breast redness or pain, persistent fever and severe weakness.

Importantly, sepsis does not always present with a high fever. Pregnancy itself can alter normal physiological measurements, which can make recognition more challenging. A review of maternal sepsis literature notes that overlap between normal pregnancy changes and signs of infection can contribute to delays in diagnosis.

How can sepsis during pregnancy be prevented?

Prevention begins with identifying and treating infections before they become severe.

"Preventive care begins with regular antenatal check-ups," Dr Miglani says. Pregnant women should attend recommended antenatal visits and promptly report symptoms such as burning while urinating, persistent fever, unusual vaginal discharge, abdominal pain or a persistent cough.

Urinary infections deserve particular attention because an infection can spread from the bladder to the kidneys if untreated. Basic infection-prevention measures also matter. These include regular hand hygiene, safe food and water practices, adequate hydration and following recommended vaccination schedules. WHO identifies prevention of infection, good hygiene, access to vaccines and infection-prevention practices in healthcare settings as important measures for reducing the burden of sepsis.

Recent evidence also highlights the importance of infection-control practices within healthcare facilities. A WHO-led 2025 study involving more than 431,000 women giving birth across 59 hospitals in Malawi and Uganda found that a structured maternal-sepsis prevention programme was associated with a 32% reduction in infection-related maternal mortality and severe morbidity.

Why self-medication with antibiotics can be risky

An infection during pregnancy should be assessed by a healthcare professional rather than treated through self-medication. "Pregnant women should avoid self-medication, particularly antibiotics, because inappropriate antibiotic use may delay correct treatment and contribute to antibiotic resistance," Dr Miglani says.

This does not mean antibiotics should be avoided when medically indicated. Rather, the appropriate drug, dose and duration should be determined by a doctor based on the suspected infection and, where appropriate, laboratory testing.

WHO stresses that antimicrobial resistance can complicate sepsis treatment, while timely and appropriate antimicrobial therapy is an important part of management once sepsis is identified.

After delivery, don't ignore infection symptoms

The risk of infection does not disappear immediately after childbirth. Women should monitor their recovery and seek medical advice if they develop persistent fever, worsening abdominal or pelvic pain, foul-smelling vaginal discharge, redness or pus-like drainage from a surgical wound, breast pain or redness, increasing weakness or breathing difficulty.

This is particularly important after a caesarean section or other obstetric procedure. WHO guidelines specifically recommend infection-prevention and treatment measures around childbirth, including appropriate antibiotic prophylaxis for caesarean delivery and infection-prevention practices.

When is sepsis an emergency?

Suspected sepsis requires urgent medical assessment. A pregnant or recently delivered woman who has an infection and suddenly becomes severely unwell, develops breathing difficulty, confusion, very low blood pressure, markedly reduced urine output or extreme weakness should not wait for symptoms to resolve on their own.

Clinical guidance recommends immediate assessment and treatment when sepsis is suspected. The Society for Maternal-Fetal Medicine recommends that treatment and resuscitation begin immediately and that broad-spectrum antibiotics be administered as soon as possible when maternal sepsis is suspected.

"Sepsis is not an inevitable complication of pregnancy," Dr Miglani says. Preventing infections, attending antenatal and postnatal check-ups, reporting unusual symptoms early and following appropriate treatment can help reduce the risk of serious complications.

For pregnant and recently delivered women, the most important message is simple: do not ignore a sudden or significant change in how you feel. Early medical evaluation can make the difference between an infection that is treated promptly and one that progresses to a potentially life-threatening emergency affecting both mother and baby.



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