We report the first case report of postpartum bilateral tension pneumothoraces. A 31-year-old primigravida presented with obstructive shock and respiratory failure five days following a normal spontaneous vaginal delivery. Bilateral surgical chest drains were inserted and following computed tomography suggestive of an underlying interstitial lung disease she was transferred to a tertiary cardiothoracic centre. Video-assisted thoracic surgery was carried out with left apicectomy and parietal pleurectomy. Histopathology supported a diagnosis of pulmonary lymphangioleiomyomatosis. We discuss the pathophysiology of labour-induced barotrauma and examine pertinent elements of the acute management of this case.