A racing, pounding, fluttering or skipped heartbeat can occur after giving birth for many reasons. Sleep loss, stress, anemia, dehydration and hormonal changes may contribute, but the postpartum period also has several important medical causes that should not be overlooked.
Heart palpitations can occur after childbirth and are not automatically dangerous. Common contributors include sleep deprivation, anxiety, caffeine, dehydration and anemia after blood loss. However, new postpartum palpitations can also occur with postpartum thyroiditis, an arrhythmia, postpartum preeclampsia, pulmonary embolism or peripartum cardiomyopathy. Because some serious pregnancy-related complications can first appear after delivery, seek prompt assessment when palpitations are persistent, markedly irregular, worsening or associated with shortness of breath, chest pain, fainting, heavy bleeding, severe headache, vision changes or one-sided leg swelling.
Postpartum Palpitations: Warning Signs That Need Urgent Care
Seek urgent or emergency medical care for postpartum palpitations accompanied by:
- significant chest pain, pressure or tightness;
- severe or sudden shortness of breath;
- difficulty breathing while lying flat;
- fainting or loss of consciousness;
- severe dizziness or near-fainting;
- collapse;
- a sustained very rapid or markedly irregular heartbeat while feeling seriously unwell;
- coughing up blood;
- one-sided leg swelling, redness or pain;
- heavy or gushing vaginal bleeding with weakness or dizziness;
- a severe persistent headache or new vision changes;
- confusion, seizure or reduced responsiveness;
- blue or gray lips or skin; or
- rapidly worsening symptoms.
When seeking care, tell the medical team that you recently gave birth, even if delivery was several weeks or months ago.
Why Can Heart Palpitations Start After Giving Birth?
Pregnancy changes blood volume, heart rate, hormones and the workload of the cardiovascular system. Delivery is followed by another major period of physiologic adjustment.
At the same time, new parents may be experiencing:
- major sleep disruption;
- physical recovery from delivery or surgery;
- blood loss;
- pain;
- emotional stress;
- changes in caffeine intake;
- changes in fluid intake;
- new medicines; and
- large hormonal and immune-system changes.
Any of these may affect heart rate or make the heartbeat easier to notice.
Some important cardiovascular, thyroid and blood-clot complications occur specifically after delivery. Persistent or concerning symptoms deserve evaluation rather than being dismissed as tiredness, anxiety or the normal stress of caring for a newborn.
Common Causes of Postpartum Heart Palpitations
Sleep deprivation
Repeated nighttime waking can increase sympathetic nervous-system activity and make pounding or skipped heartbeats more noticeable.
Stress and anxiety
Adrenaline released during emotional stress or panic can increase heart rate and force of contraction. New-parent anxiety may therefore contribute to racing or pounding sensations.
Caffeine
Coffee, tea and energy drinks may be used more often to cope with disrupted sleep. Larger amounts or individual caffeine sensitivity can contribute to palpitations.
Dehydration
Inadequate fluid intake, vomiting, fever or other fluid losses can reduce circulating volume and produce a compensatory faster heartbeat.
Anemia after blood loss
Blood loss during or after delivery can reduce hemoglobin. The heart may beat faster or harder to maintain oxygen delivery.
Postpartum thyroiditis
An inflammatory thyroid condition can temporarily release excess thyroid hormone and cause palpitations, anxiety, tremor, insomnia and weight loss.
PACs and PVCs
Premature beats may feel like skips, pauses, fluttering or strong post-pause thumps and can occur even when the average heart rate is normal.
SVT or atrial fibrillation
A true arrhythmia may cause sudden racing, irregular palpitations, dizziness, breathlessness or weakness and should be documented with ECG.
Postpartum Blood Loss, Anemia and Palpitations
Some blood loss during childbirth is expected, but substantial blood loss can cause postpartum anemia.
Reduced hemoglobin means less oxygen can be carried to the body’s tissues. The cardiovascular system may compensate with a faster or stronger heartbeat.
Other clues may include:
- unusual fatigue;
- weakness;
- shortness of breath during ordinary activity;
- dizziness or lightheadedness;
- pale appearance;
- headache; and
- reduced exercise tolerance.
Heavy Postpartum Bleeding Needs Attention
Normal postpartum discharge, called lochia, should gradually become lighter.
Heavy or gushing bleeding, rapidly soaking sanitary pads, passing unusually large clots, or bleeding associated with faintness, weakness or a rapid heart rate may indicate postpartum hemorrhage.
Postpartum hemorrhage most often occurs soon after delivery but delayed bleeding can occur later as well.
See our detailed guide to low iron, anemia and heart palpitations .
Postpartum Thyroiditis and Heart Palpitations
Postpartum thyroiditis is an autoimmune inflammation of the thyroid gland that develops after childbirth.
The American Thyroid Association estimates that it occurs in approximately 5% to 10% of women in the United States, with higher rates in some high-risk groups.
The condition may progress through two phases.
| Phase | Typical timing | Possible symptoms |
|---|---|---|
| Thyrotoxic phase | Often about 1–4 months after delivery | Palpitations, faster heart rate, anxiety, irritability, insomnia, fatigue and weight loss. |
| Hypothyroid phase | Often about 4–8 months after delivery | Fatigue, weight gain, constipation, dry skin, depressed mood and poor exercise tolerance. |
Not everyone develops both phases.
Anxiety, insomnia and fatigue are common after having a baby, so the thyrotoxic phase can be mistaken for ordinary postpartum stress. Recurrent palpitations with tremor, unexplained weight change or persistent heat intolerance are good reasons to discuss thyroid testing.
See our broader article on thyroid disease and heart palpitations .
Can Breastfeeding Cause Heart Palpitations?
Breastfeeding itself should not automatically be considered the cause of an abnormal heart rhythm.
However, symptoms may be noticed during the breastfeeding months because other factors often occur at the same time, including:
- sleep deprivation;
- stress;
- inadequate fluid intake;
- postpartum anemia;
- postpartum thyroiditis; or
- increased caffeine use.
If medication becomes necessary for a thyroid disorder, arrhythmia, hypertension or another condition, tell your clinician that you are breastfeeding so treatment can be selected appropriately.
The priority is to identify the cause of the symptoms and then choose treatment compatible with your overall postpartum and breastfeeding needs.
Postpartum Palpitations and Peripartum Cardiomyopathy
One of the most important diagnoses not to miss is peripartum cardiomyopathy (PPCM), sometimes called postpartum cardiomyopathy.
PPCM is an uncommon form of heart failure in which the heart muscle becomes weakened late in pregnancy or during the months after childbirth.
It is most commonly diagnosed in the last month of pregnancy and during the first weeks postpartum, but the classic diagnostic window extends into the months following delivery.
Possible symptoms include:
- new shortness of breath;
- breathlessness with light activity;
- difficulty breathing while lying flat;
- waking at night because of breathing difficulty;
- unusual or extreme fatigue;
- ankle or leg swelling;
- rapid weight gain from fluid retention;
- cough or chest congestion;
- chest pain or tightness;
- racing or skipped heartbeats;
- dizziness; or
- near-fainting.
Do Not Dismiss New Breathlessness as “Just Postpartum Recovery”
New shortness of breath at rest, difficulty breathing while lying flat, rapidly worsening swelling or palpitations associated with breathing difficulty deserve prompt assessment.
Heart failure symptoms can overlap with ordinary pregnancy and postpartum symptoms, which is one reason diagnosis may be delayed.
How is PPCM evaluated?
Evaluation may include:
- physical examination;
- ECG;
- blood tests;
- BNP or NT-proBNP in appropriate cases;
- chest imaging; and
- an echocardiogram to assess heart pumping function.
If breathlessness is a major symptom, see heart palpitations and shortness of breath .
Postpartum Blood Clots, Pulmonary Embolism and Palpitations
Pregnancy increases the tendency of blood to clot, and the risk of venous thrombosis remains elevated after delivery.
ACOG identifies pregnancy and approximately the first 4–6 weeks after childbirth as an important period of increased DVT risk.
A clot in a deep leg vein can travel to the lungs and cause a pulmonary embolism (PE).
Possible pulmonary embolism symptoms include:
- sudden unexplained shortness of breath;
- rapid breathing;
- a rapid heart rate;
- sharp chest pain, particularly with breathing;
- sudden cough;
- coughing up blood;
- dizziness or fainting; and
- one-sided leg swelling, tenderness, warmth or redness.
Sudden Breathlessness + Palpitations Postpartum Is Not a “Wait and See” Combination
Particularly during the first weeks after delivery, sudden breathing difficulty with a rapid heartbeat, chest pain, coughing blood or one-sided leg symptoms requires urgent medical assessment for pulmonary embolism.
Can Postpartum Preeclampsia Cause Palpitations?
Postpartum preeclampsia is another important condition that may develop after childbirth — even in someone whose blood pressure was normal during pregnancy.
It is most commonly recognized during the first days after delivery, but it can occur up to about 6 weeks postpartum.
Palpitations are not the defining feature of preeclampsia, but a fast or pounding heart may occur alongside pain, anxiety, cardiovascular stress or another postpartum complication.
More characteristic warning signs include:
- high blood pressure;
- a severe or persistent headache;
- vision changes;
- swelling of the face or hands;
- upper abdominal or right-sided shoulder-area pain;
- nausea or vomiting;
- sudden weight gain; and
- shortness of breath.
Check Blood Pressure if Your Obstetric Team Has Asked You To
ACOG advises postpartum patients to contact their clinician for a blood-pressure reading of 140/90 mm Hg or higher.
Severe headache, vision changes, breathing difficulty, neurological symptoms, seizure or severe illness requires more urgent evaluation rather than simply repeating the blood-pressure measurement at home.
See our guide to heart palpitations and blood pressure .
Postpartum Anxiety, Panic and Heart Palpitations
Anxiety can produce very real cardiovascular sensations.
Adrenaline may cause:
- a faster heartbeat;
- strong pounding contractions;
- rapid breathing;
- chest tightness;
- trembling;
- sweating;
- dizziness; and
- an intense sense that something is wrong.
Sleep deprivation can amplify these symptoms.
New palpitations with breathlessness, fainting, heavy bleeding, significant chest pain, one-sided leg swelling, abnormal blood pressure or progressive swelling deserve medical assessment even if you also feel anxious.
When Do Postpartum Heart Palpitations Usually Start?
Timing can sometimes provide an important clue, although it cannot diagnose the cause by itself.
| Timing after delivery | Examples to consider |
|---|---|
| First hours to days | Blood loss, anemia, pain, dehydration, medication effects, postpartum hemorrhage, blood-pressure complications or arrhythmia. |
| First several weeks | Sleep deprivation, anxiety, anemia, pulmonary embolism risk, postpartum preeclampsia, cardiomyopathy or arrhythmia. |
| 1–4 months | Postpartum thyroiditis becomes especially relevant, alongside anemia, anxiety, caffeine, arrhythmias and peripartum cardiomyopathy. |
| Later postpartum months | Thyroid dysfunction, persistent anemia, sleep/stress-related symptoms, medication or stimulant triggers and unrelated arrhythmias remain possible. |
CDC advises paying attention to urgent maternal warning signs throughout pregnancy and during the year after delivery because some pregnancy-related complications can occur well after leaving the hospital.
What If My Heart Is Racing at Night After Giving Birth?
Nighttime postpartum palpitations may be especially noticeable because the environment is quieter and you are lying still.
Possible contributors include:
- sleep deprivation;
- anxiety;
- caffeine;
- premature beats;
- postpartum thyroiditis; or
- an underlying arrhythmia.
However, waking at night because you cannot breathe, needing several pillows to breathe comfortably, new cough or rapidly increasing leg swelling is a different pattern and deserves prompt assessment for heart failure.
How Are Postpartum Heart Palpitations Evaluated?
The evaluation should take both the heart rhythm and the recent pregnancy into account.
History
Your clinician may ask:
- how long ago you delivered;
- whether delivery was vaginal or cesarean;
- whether there was significant blood loss;
- whether you had anemia during pregnancy;
- whether you had high blood pressure or preeclampsia;
- whether you have shortness of breath or swelling;
- whether one leg is painful or swollen;
- whether the heartbeat begins and ends suddenly;
- whether it feels regular or irregular;
- medicines and supplements;
- caffeine, nicotine or other stimulants;
- thyroid history;
- sleep and anxiety symptoms; and
- known heart disease or previous arrhythmia.
Physical examination
Heart rate, blood pressure, oxygen saturation and examination of the heart, lungs and legs can help identify which tests are appropriate.
ECG
A 12-lead ECG can identify AF, SVT, premature beats, sinus tachycardia, bradycardia or another electrical abnormality if it is present during the recording.
A Holter, patch or event monitor may be appropriate when symptoms keep returning but are not captured during the office ECG.
See heart palpitations despite a normal ECG .
Blood tests
Depending on the presentation, tests may include:
- complete blood count for anemia or infection;
- ferritin or iron studies when iron deficiency is suspected;
- thyroid function;
- electrolytes;
- kidney function; and
- other tests directed by the symptoms.
Echocardiogram
An echocardiogram is particularly important when peripartum cardiomyopathy, structural heart disease or heart failure is suspected.
Blood-clot evaluation
Sudden shortness of breath, chest pain, low oxygen, coughing blood or one-sided leg symptoms may prompt urgent evaluation for DVT or pulmonary embolism.
Blood-pressure assessment
New headache, visual symptoms, breathlessness, swelling or elevated postpartum blood pressure raises concern for postpartum preeclampsia.
How Are Postpartum Palpitations Treated?
Treatment depends on the diagnosis rather than the palpitation sensation alone.
Sleep, stress or stimulant-related symptoms
Reducing an excessive caffeine trigger, improving rest where practical and treating significant anxiety may help when the rhythm is otherwise reassuring.
Anemia
Confirmed iron-deficiency anemia may require iron replacement and evaluation of ongoing blood loss.
Postpartum thyroiditis
Treatment depends on whether the patient is in the temporary thyrotoxic or hypothyroid phase and how severe the symptoms are.
Arrhythmia
Treatment depends on the documented rhythm and may include observation, medication, cardioversion or electrophysiology treatment in selected cases.
Peripartum cardiomyopathy
This requires specialist heart-failure treatment. Medication selection must also take postpartum status and breastfeeding into account.
Pulmonary embolism
Pulmonary embolism requires urgent medical treatment, usually involving anticoagulation and additional treatment according to severity.
Postpartum preeclampsia
Treatment may include blood-pressure medication and, in selected patients, intravenous medication to reduce seizure risk.
Do Not Self-Treat an Unknown Postpartum Rhythm
Do not take extra beta-blockers, antiarrhythmics, potassium, magnesium, thyroid medicine, iron or someone else’s prescription medicine solely because your heart is racing. The safest treatment depends on the actual cause and must also consider breastfeeding when relevant.
Dr. Albana’s Note
When a new mother tells me, “My heart keeps racing since I gave birth,” I do not automatically assume it is anxiety or lack of sleep. I first ask how long ago she delivered, whether there was heavy bleeding, whether she had high blood pressure or preeclampsia, and whether there is breathlessness, swelling, chest discomfort, dizziness or one-sided leg pain. The timing also matters: palpitations several months after delivery together with tremor, weight loss and insomnia make me think about postpartum thyroiditis, while new breathlessness when lying flat makes heart failure much more important to exclude. Many postpartum palpitations do have straightforward causes, but the postpartum setting gives us several additional diagnoses that are important not to miss.
When Should You Make a Medical Appointment?
Contact your healthcare professional if postpartum palpitations:
- keep returning;
- occur every day or several times a day;
- last for several minutes or longer;
- feel persistently fast or irregular;
- are becoming more frequent;
- occur with unusual fatigue or weakness;
- occur with new exercise intolerance;
- are associated with dizziness;
- occur after significant blood loss;
- occur with tremor, weight loss or heat intolerance;
- are associated with new swelling;
- began after a medication change; or
- simply feel significantly different from anything you experienced before pregnancy.
For broader risk guidance, see when to worry about heart palpitations .
Urgent Postpartum Warning Signs
Seek urgent or emergency care for:
- chest pain or pressure;
- severe or sudden shortness of breath;
- difficulty breathing while lying flat;
- fainting or collapse;
- severe dizziness or near-fainting;
- a sustained very rapid or markedly irregular heartbeat while feeling seriously unwell;
- coughing blood;
- one-sided leg pain or swelling;
- heavy or gushing postpartum bleeding with weakness or dizziness;
- severe persistent headache;
- new vision changes;
- seizure;
- confusion or markedly reduced responsiveness;
- blue or gray lips or skin; or
- rapidly worsening symptoms.
Tell emergency or urgent-care staff that you recently gave birth.
Most Asked Questions
Are heart palpitations normal after giving birth?
Palpitations can occur postpartum because of sleep disruption, stress, anemia, dehydration, caffeine and hormonal changes. They should not automatically be labeled normal, especially when persistent, worsening or accompanied by breathing difficulty, fainting, chest pain, heavy bleeding or other warning signs.
Why is my heart racing after giving birth?
Possible causes include pain, stress, dehydration, anemia, fever, postpartum thyroiditis, medication effects, sinus tachycardia or a true arrhythmia. Serious postpartum causes such as pulmonary embolism or peripartum cardiomyopathy must be considered when other warning symptoms occur.
Can postpartum anemia cause heart palpitations?
Yes. Significant blood loss can reduce hemoglobin, causing the heart to pump faster or harder to maintain oxygen delivery. Fatigue, weakness, dizziness and breathlessness may occur as well.
Can postpartum thyroiditis cause heart palpitations?
Yes. The thyrotoxic phase of postpartum thyroiditis often occurs about 1–4 months after delivery and may cause a fast heart rate, palpitations, anxiety, insomnia, irritability and weight loss.
Can postpartum anxiety cause heart palpitations?
Yes. Anxiety can increase adrenaline, heart rate and heartbeat awareness. However, new postpartum palpitations should not automatically be diagnosed as anxiety when anemia, thyroid disease, blood pressure problems, cardiomyopathy, blood clots or arrhythmia remain possible.
Can lack of sleep cause postpartum heart palpitations?
Sleep deprivation can increase autonomic arousal and make normal or premature heartbeats more noticeable. Persistent or clearly irregular symptoms still deserve evaluation.
Can breastfeeding cause heart palpitations?
Breastfeeding itself is not usually considered a direct cause of an abnormal rhythm. Palpitations during the breastfeeding months may instead relate to sleep loss, dehydration, anemia, thyroid changes, caffeine, anxiety or another rhythm condition.
Can postpartum cardiomyopathy cause palpitations?
Yes. Peripartum cardiomyopathy can cause racing or skipped heartbeats, breathlessness, fatigue, swelling, chest discomfort, dizziness and near-fainting. New breathlessness after delivery deserves prompt evaluation.
How long after delivery can postpartum cardiomyopathy occur?
It is most commonly diagnosed in late pregnancy and the early weeks after delivery, while the traditional definition includes heart failure developing during the months following childbirth, commonly up to about five months postpartum.
Can postpartum preeclampsia cause a racing heart?
A racing heart is not the defining symptom, but cardiovascular stress, pain or another complication can accompany postpartum preeclampsia. Severe headache, vision changes, high blood pressure, swelling, upper-abdominal pain or shortness of breath are more characteristic warning signs.
Can a pulmonary embolism cause postpartum palpitations?
Yes. Pulmonary embolism may cause a rapid heartbeat together with sudden shortness of breath, chest pain, rapid breathing, cough, coughing blood, dizziness or fainting. It requires urgent medical assessment.
Why do I have postpartum palpitations at night?
Sleep disruption, anxiety, caffeine, thyroid disease, premature beats and increased heartbeat awareness while lying quietly are possibilities. Waking because you cannot breathe or developing difficulty breathing while lying flat deserves prompt heart-failure evaluation.
Can postpartum palpitations happen with a normal ECG?
Yes. If the episode stops before the ECG is recorded, an intermittent arrhythmia may not appear. Holter, patch or event monitoring may be useful when symptoms continue to recur.
When should I go to the ER for postpartum heart palpitations?
Seek emergency care for palpitations with significant chest pain, severe or sudden breathlessness, fainting, collapse, severe dizziness, coughing blood, one-sided leg swelling, heavy bleeding, seizure, severe neurological symptoms or rapidly worsening illness.
Related Heart Palpitation Guides
Medical References
- American Heart Association. Peripartum Cardiomyopathy. Last reviewed May 28, 2024. American Heart Association .
- American Heart Association. Heart Failure Occurring in the Perinatal Period: Scientific Statement. Circulation. Published June 24, 2026. American Heart Association .
- National Heart, Lung, and Blood Institute. Peripartum Cardiomyopathy and Pregnancy Issues. NHLBI .
- Centers for Disease Control and Prevention. Urgent Maternal Warning Signs and Symptoms. CDC Hear Her .
- American College of Obstetricians and Gynecologists. 3 Conditions to Watch for After Childbirth. ACOG .
- American College of Obstetricians and Gynecologists. Preventing Deep Vein Thrombosis. ACOG .
- American Thyroid Association. Postpartum Thyroiditis. American Thyroid Association .
- American Heart Association. How Serious Are Heart Palpitations? Causes, Symptoms and When to Worry. Published February 9, 2026. American Heart Association .
About the Medical Team
Dr. Albana Greca, MBBS, MMedSc
Family Physician / General Practitioner
Dr. Albana Greca has more than 20 years of experience in primary care, general medicine, chronic disease management, prevention, patient education and digital health.
Dr. Benard Shehu, MBBS, MS
Cardiologist
Dr. Benard Shehu has more than 19 years of cardiovascular experience, including clinical experience relevant to arrhythmias and cardiovascular disease.