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 also need to see your healthcare practitioner before this visit. If you had a c-section, for example, she will need to check your incision a week or two after delivery to make sure it is 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 would like to discuss.
Do not 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 caregiver before your scheduled visit.
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Here are the topics your caregiver will discuss with you:
- 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 is a good time to ask. Even if your caregiver 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 are still bleeding on occasion, having any abdominal discomfort, vaginal or perineal pain, urinary or anal incontinence, or breast pain. Do not hesitate to bring up something that your caregiver hasn’t asked about. If you have a bothersome symptom that she didn’t cover, speak up.
- How you are doing emotionally. Your healthcare provider will want to know how you are adjusting to the demands of motherhood and about any emotional problems you may be having. Don’t be shy. It is important to let her know if you are feeling overwhelmed, anxious, or depressed.
- Whether or not you are breastfeeding and, if so, how it is 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 caregiver know before she examines you so she can try to fit you for one at that time.
- Whether it is okay to start having sex again. You will 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.
During your physical exam, your caregiver 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.
Before you go, your caregiver 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 will need a glucose tolerance test.
- Order any immunizations you may need, such as 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 will get the second dose now.
- Take care of necessary paperwork. If you’re on maternity leave, for example, you may have forms for your caregiver to fill out. Remember to bring them along.
- Let you know when you should return for routine gynaecological care including any follow-up for your chosen contraceptive method and give you any necessary referrals.
Always remember that even though you have your postpartum exam scheduled 4 to 6 weeks after your delivery, it does not mean you cannot call or see your healthcare provider before then if you have concerns or issues.