The endometrium is the inside lining of the uterus. Postpartum endometritis is an infection of the endometrium after childbirth.

Female Reproductive Organs

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Postpartum endometritis is caused by bacteria. The bacteria may be present in the mother before childbirth or enter the body during childbirth.

Risk Factors

Things that may increase the risk of postpartum endometritis include:

  • Cesarean section delivery
  • Postpartum hemorrhage
  • Prolonged labor
  • Prolonged ruptured membranes
  • Devices inserted into uterus before, during, or after birth
  • Newborn stool in amniotic fluid (meconium)
  • Pieces of the placenta remain in the mother after birth
  • Placenta was removed by hand
  • Bacterial infection of the membranes and amniotic fluid—chorioamnionitis
  • Presence of a specific bacteria in the vagina
  • Lack of proper prenatal care


Symptoms may include:

  • Fever and chills
  • General discomfort
  • Belly pain and tenderness
  • Foul smelling and/or bloody vaginal discharge
  • Pain when passing urine


The doctor will ask about symptoms and past health. A physical exam will be done. The diagnosis is often based on symptoms and recent childbirth. Tests to look for the specific bacteria may include:

  • Urine tests and cultures
  • Blood tests


Postpartum endometritis is treated with antibiotics. The antibiotics are usually given by IV.


Not all infections can be prevented. Proper prenatal care may to decrease the chance of some infections. Antibiotics may be given before a cesarean section to reduce risk.


American Congress of Obstetricians and Gynecologists

Family Doctor—American Academy of Family Physicians


Health Canada

The Society of Obstetricians and Gynaecologists of Canada


Bratzler DW, Dellinger EP, Olsen KM, et al; American Society of Health-System Pharmacists, Infectious Disease Society of America, Surgical Infection Society, Society for Healthcare Epidemiology of America. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013 Feb 1;70(3):195.

Endometritis (postpartum). EBSCO DynaMed Plus website. Available at: Updated July 23, 2019. Accessed March 19, 2020.

Karsnitz DB. Puerperal infections of the genital tract: a clinical review. J Midwifery Womens Health. 2013 Nov-Dec;58(6):632.

Postpartum endometritis. Patient UK website. Available at: Updated February 24, 2017. Accessed March 19, 2020.

Last reviewed September 2019 by EBSCO Medical Review Board Mary-Beth Seymour, RN  Last Updated: 5/1/2020