Your Postpartum Checkups

Just a little while ago, you were pregnant. Since then, you’ve had a baby, you may be breastfeeding and you’re definitely tired.

With so many changes happening to your body and in your life in such a short time, it’s comforting — and necessary — to go to your scheduled postpartum checkup (or checkups) with your OB/GYN or midwife. That way, your health care provider can make sure everything is going as it should and you can get any help, advice, care and reassurance you need.

What is a postpartum checkup?

A postpartum checkup is a post-birth appointment with your doctor or midwife to check how you're doing physically, mentally and emotionally after having a baby. 

Your practitioner will examine you to make sure you're recovering as expected physically and also ask you questions about how you're handling your life with a new baby.

You may only have one or two, or you may have more doctor's visits after you give birth, depending on your specific situation and circumstances.

When is my first postpartum checkup?

Though previously it was routine to have your first and only postpartum checkup around four to six weeks after you deliver (with some moms, like those who had C-sections or pregnancy conditions like preeclampsia, going earlier), it's now recommended that women see their OB/GYNs or midwives within three weeks of giving birth.

They should also have regular check-ins as needed before and after, along with a comprehensive visit within 12 weeks postpartum, according to the American College of Obstetricians and Gynecologists (ACOG). 

ACOG also says in its latest guidelines that doctors should be informing new moms of their risks upfront, and insurance should cover postpartum health care.

Is there still a six-week postpartum checkup?

While some practitioners may stick to scheduling your first (and potentially only) postpartum checkup within six weeks of giving birth — commonly known as the six-week checkup — the official recommendation is that your and your OB/GYN or midwife have that initial appointment sooner, within three weeks of your baby's birth.

Regular check-ins with your health care provider before and after that three-week (or sooner) visit, along with a more in-depth exam within 12 weeks of delivery day, are also suggested.

How to prepare for your postpartum checkups

How can you get ready for meeting with your health care provider after having your baby? Bring a list of your questions and concerns so you don’t forget anything (sleep deprivation and everything else you're dealing with can make those written or typed to-do's especially handy!).

Don't forget to arrange for child care in advance if you aren't planning to bring your baby (and/or other children) with you.

Can I bring my baby to my postpartum checkups?

Yes, usually you'll be allowed and able to bring your new baby to your postpartum checkup or checkups, though you should definitely ask your practitioner ahead of time whether that's okay. Try to schedule the appointment when your baby isn't overly tired or hungry (tricky with a newborn, yes).

If you do bring your little one, pack your diaper bag with the usual essentials: diapers and wipes, a bottle or two if you're bottle-feeding, any breastfeeding supplies you use, a bib and burp cloth, a change of clothes for baby, a snack and water for you, etc.

If you decide not to have baby be your plus-one, you should arrange for someone to watch your little bundle in advance so you're not scrambling when it's time to go.

What happens at my postpartum checkup?

In addition to answering any and all questions you have, here’s what else your doctor will do at your postpartum appointment (s):

Give you an annual exam

Your postpartum checkup counts as your annual gynecological visit, so you can expect the usual, like a pelvic exam — including a pap smear — and a breast check.

Your health care provider will also perform a lot of the same tests you undergo at a physical — checking your weight and blood pressure, for example — and ask diet- and nutrition-related questions to determine whether you need supplements like calcium and iron. It’s even more important to eat right if you’re nursing but it's a good idea to follow a healthy, nutrient-filled diet regardless of how you're feeding your baby.

If you had a pregnancy condition like gestational diabetes, your doctor may test your blood sugar and suggest dietary changes or medication if you need it (and aren't already taking anything).

And if you had a more serious pregnancy complication like preeclampsia, you'll likely have already been in touch with your practitioner often after you gave birth and by the time you have a more thorough postpartum checkup.

Examine your post-pregnancy body

While performing a pelvic exam, your practitioner will check that your uterus is close to its pre-pregnancy dimensions (about the size of a pear), a shrinking process that usually takes around two months. 

If you had an episiotomy or a C-section, your health care provider will make sure that the incision is healing correctly.

You'll probably chat about other common postpartum symptoms like bladder issues, normal postpartum bleeding and cramping as your uterus empties itself and contracts, bowel problems and hemorrhoids, fatigue and anything else you've been experiencing — all par-for-the-course concerns at postpartum exams.

Your doctor or midwife may also check your thyroid gland, which works overtime producing hormones during pregnancy and can become enlarged in the process. That can lead to a condition called postpartum thyroiditis, which can mimic the symptoms of an overactive thyroid (like nervousness and trouble sleeping).

Make sure no serious health issues have cropped up since you delivered

Your practitioner will also want to make sure that none of your postpartum symptoms have been on the more serious side (though if that's the case, it's important to know the post-baby warning signs and get medical help ASAP). If you had any pregnancy complications, you may discuss those too.

Get the go-ahead of when to start working out again and go back to normal activities

If everything looks as it should, you’ll probably the green light to start exercising again soon if not immediately, and if you had a C-section, you'll be able lift heavy objects and start driving again once you've hit the four-to-six-week mark after baby's arrival, depending on the progress of your recovery.

Discuss your mental health and how you're feeling

Postpartum depression (PPD), postpartum anxiety and some other postpartum mental health conditions are common and treatable. Your doctor will likely ask about your mood and your overall wellbeing at your postpartum checkups and do a PPD screening.

Your practitioner will want to know how you’re bonding with your baby, and if you’re feeling overwhelmed or anxious about the more challenging aspects of new parenthood, like getting a reluctant baby to breastfeed or a fussy newborn to stop crying.

Don’t be afraid to be open with your practitioner. If you’re honest, your doctor or midwife will be able to suggest an appropriate course of action and treatment. If you’re depressed or anxious, therapy and/or medication may be prescribed. 

Talk about resuming sex after baby and get you back on birth control

For most women, postpartum checkups mean that an end to the (typically) six-week no-sex dry spell is near, so it’s also a good time to discuss whether you've gotten the green light to have sex again, as well as your birth control options. 

If you were on the pill before, your doctor will probably switch you to the progesterone-only “minipill” if you’re breastfeeding.

If you use a diaphragm, you’ll need to get refitted. You may also want to consider an IUD, which can be inserted and stay in place until you’re ready to start trying for another baby, so you don’t need to remember to take your pill.

Chat about any future baby plans (if applicable!)

While another baby may be the furthest thing from your mind, if you plan on having a second child sooner rather than later, your doctor may use this postpartum exam to get a sense for when you'll want to try again and remind you that the safest time is around 18 months after the end of your previous pregnancy, for both you and your baby.

Your postpartum checkup or checkups are the best way to ensure that you're getting the support and care you need after delivery, and that your recovery is going as planned.

Remember: Your health is important, and taking good care of yourself helps you take good care of your baby. That's why it's necessary to schedule and attend your postpartum doctor's appointments. An added bonus? You'll probably feel better and more reassured after the visit with your practitioner too.