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Why you need a postpartum checkup
Your doctor or midwife will want to see you four to six weeks after you give birth to check on your physical recovery from pregnancy and delivery, see how you're doing emotionally, and address your needs going forward. (You may need to see your practitioner before this visit, as well. If you had a c-section, for example, she'll need to check your incision a week or two after delivery to make sure it's healing properly.)
You may still be dealing with some pregnancy- or childbirth-related aches and pains, and you may have some questions about how your body has changed. You may also have questions about your labor and delivery and about postpartum issues like breastfeeding, birth control, exercise, sex, and work. It helps to jot down the questions you want to ask and any other issues you'd like to discuss.
Don't feel constrained by the appointment date, though. Sometimes physical or emotional issues come up that need immediate attention and should prompt a call to your doctor or midwife before your scheduled visit.
(In fact, the American College of Obstetricians and Gynecologists has recommended that all women see their healthcare provider within three weeks after delivery and continue to receive follow-up care as needed, including a comprehensive checkup by 12 weeks postpartum. But it may take some time for providers to start routinely recommending these extra visits.)
Topics your healthcare provider will discuss with you
- You can raise any questions that have come up in the past six weeks. It may be helpful to write them down or note them on your smartphone, since sleep deprivation can take a toll on your memory. In addition to your specific concerns, your doctor or midwife will likely raise these topics: Any complications you had during pregnancy and delivery and what bearing, if any, they'll have on future pregnancies and your overall health.If you still have lingering questions about your labor and delivery, now's a good time to ask. Even if your healthcare provider explained at the time exactly what was happening and why, you may not remember everything that was said.
- What physical symptoms you're having, such as whether you're still bleeding on occasion, having any abdominal discomfort, vaginal or perineal pain, urinary or anal incontinence, or breast pain. If you have a bothersome symptom that your healthcare provider didn't cover, speak up.
- How you're doing emotionally. She'll want to know how you're adjusting to the demands of motherhood and about any emotional problems you may be having. Don't be shy. It's important to let her know if you're feeling overwhelmed, anxious, or depressed.
- Whether or not you're breastfeeding – and, if so, how it's going.
- Your options for birth control and what you need to know about the methods you're considering. If you're planning to use a diaphragm, be sure to let your healthcare provider know before she examines you so she can try to fit you for one at that time.
- Whether it's okay to start having sex again. You'll likely get the go-ahead, but don't worry if you don't feel up to it yet. Many women don't feel like having sex for several months after giving birth. Wait until you feel ready.
Diet and exercise, including Kegel exercises to help strengthen your pelvic floor muscles.
What happens during your physical exam
During your physical exam, your healthcare provider will:
- Check your weight and blood pressure.
- Check your abdomen. She'll feel your belly to be sure that there's no tenderness, and she'll check your incision if you had a c-section.
- Examine your breasts. She'll be on the lookout for lumps, tenderness, redness, and cracked nipples or abnormal discharge.
- Inspect your external genitalia, including your perineum. If you had an episiotomy, she'll check to see that it's healed.
- Do a speculum exam to look at your vagina and cervix. She'll be checking to see that any bruises, scratches, or tears have healed. And, if you're due for a Pap smear, she'll do that during the speculum exam.
- Do an internal pelvic exam to feel your uterus and check that it has shrunk appropriately, feel your cervix and ovaries to identify any problems, and check your vaginal muscle tone. She may do a rectal exam as well.
What else your healthcare provider will do
Before you go, your doctor or midwife will:
- Order lab tests, if necessary. If you were anemic during pregnancy or lost a lot of blood at delivery, for example, she'll order a blood test to check for anemia. If you had gestational diabetes, you'll need a glucose tolerance test.
- Order any immunizations you may need, such as a tetanus, diphtheria, and pertussis booster shot, a flu shot, or a rubella or chicken pox vaccine. (If you were not immune to rubella or chicken pox before your pregnancy, you should have been vaccinated before you left the hospital after delivery. If that didn't happen, you definitely should get vaccinated now.) The chicken pox vaccine requires two doses, so if you got your first dose immediately postpartum, you'll get the second dose now.
- Take care of necessary paperwork. If you're on maternity leave, for example, you may have forms for your healthcare provider to fill out. (Remember to bring them along.)
- Let you know when you should return for routine gynecological care (including any follow-up for your chosen contraceptive method) and give you any necessary referrals.
- Before you go, take a look at your notes and make sure that your healthcare provider has addressed all of your concerns.