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The Postpartum Visit
by Marjorie Greenfield, M.D.
reviewed by Marjorie Greenfield, M.D.
After you deliver your baby, you will want to schedule an appointment with your practitioner to follow your recovery and to proceed with normal healthcare. The classic time for this appointment is about six weeks after childbirth, although you may want to schedule your appointment earlier than that if any issues come up, particularly if you think that you may be experiencing postpartum depression, have medical problems, or if you had a cesarean and need to have stitches or staples removed.
What happens at the postpartum checkup?
- Interval history--Typically, you will be asked a lot of questions: Overall, how are you doing? How exhausted are you? How are your spirits? How is the baby? How are you recovering from birth? Also, your weight and blood pressure will be measured.
- Breast examination--If you are breastfeeding, how are your nipples holding up? Most women are pain free after breastfeeding for a few weeks, even those who struggle with severe nipple soreness at first.
- Abdominal examination--Your uterus should be almost back to normal size by six weeks postpartum. While your tummy may still feel slack, the muscle tone is usually beginning to recover. If you had a cesarean, the incision will be examined and should be pretty well healed.
- Pelvic examination--Vaginal bleeding is usually mostly resolved by six weeks, although you may have some spotting for a few weeks more. A pelvic examination allows your practitioner to see how well your uterus has returned to its prepregnancy size, to see that the cervix is closed--a sign that there are not any retained placental fragments, which can cause bleeding and infection--and to see how well any episiotomy or laceration has healed. You will be questioned about loss of urine and your pelvic support will be noted on your examination. You will be asked about constipation and might be checked for hemorrhoids.
Most practitioners recommend a postpartum examination before resuming sexual intercourse. If you've already started having sex again, let your practitioner know if you are experiencing any difficulties, including pain or lack of lubrication.
- Contraceptive counseling--It's possible that you have already decided on a birth control method. If you haven't, however, this is a good time to discuss the options with your practitioner.
- Lab tests--If you were anemic during the pregnancy, or had excessive blood loss during or after childbirth, a blood count will be done. If you're due for a Pap test, this visit usually can count as your annual examination.
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Created March 29, 2001
Reviewed August 25, 2004
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