women
At about four to eight weeks following the birth, you will have a postpartum checkup with a doctor at your ob/gyn’s practice. This checkup is to see if you are physically and emotionally well. Your baby will also have a physical and developmental checkup around this time.

Your six-week postpartum checkup is the ideal time to talk to your doctor about any problems or concerns you have, and to receive reassurance that you have recovered well after the birth.

Your assessment

In the first couple of months following the birth of their baby, the majority of women don’t experience any major health concerns and will revert back to their prepregnant health status. However, it’s good practice to have a general assessment to reassure you that you are well and coping with the early transition to motherhood.

Your postpartum checkup is an ideal opportunity for you to consult your doctor about any concerns you have following the birth of your baby. Any worries about yourself can be discussed at this appointment, from your mood to any apprehensions about having sex again. Your doctor will offer you advice and possibly treatment, and will also be able to refer you to a specialist for further treatment if necessary.

Your physical checkup

Your doctor will do routine checkups, such as taking your blood pressure. He or she will also ask if you have any concerns, how you’re feeding your baby, and, if you are breast-feeding, whether you’ve had any problems with your breasts and lactation.

Your uterus will have returned to nearly its prepregnancy size (about the size of the palm of your hand) and will not be able to be felt. However, your doctor may check your abdomen to see if the muscles are returning to normal since occasionally the abdominal muscles separate after birth, known as “diastasi recti.” If the muscles are more than four fingers apart, you may be referred to a physical therapist. Pilates and core conditioning exercises can help and your doctor may talk to you about these exercises.

Backaches can be a problem after the birth, exacerbated by the pregnancy hormone relaxin , which softens muscles and ligaments and remains in the body for a few months after pregnancy. If you’re suffering from backaches, your doctor may talk to you about your posture, particularly when you’re carrying or feeding your baby, and about the benefits of exercise.

If you had a cesarean, the incision will be looked at to check that it has healed well. You may still feel numbness around the site of the incision, but sensation should gradually return as the nerve endings renew themselves.

If you haven’t had a Pap smear in the last three years, you will likely be given one on the spot, unless you’re bleeding heavily.

Checking your bladder

You will be asked if you have problems urinating, and may be asked for a urine sample if you have symptoms such as frequent urination or stinging when passing urine. Stress incontinence, or leaking urine , is common after childbirth, so don’t feel embarrassed to mention this to your doctor. He or she may encourage you to do Kegel exercises , and if the problem persists you may be referred to a physical therapist for bladder-training exercises.

Your stitches

If you’re still sore from stitches, your doctor will check that these are healing properly. Although most stitches are absorbable, they can take up to three months to completely absorb. Bathing can sometimes help the stitches absorb, but if you continue to have problems your doctor may recommend Sitz baths two or three times a day or a topical anesthetic cream .

Your emotional well-being

In addition to checking you physically, the doctor will also assess your emotional and mental health. Many women feel extremely tired in these early weeks, as night feedings and constant demands begin to take their toll. However, if you are feeling low, overly tired, or depressed a lot of the time, you may be suffering from postpartum depression, so it’s important not to ignore these symptoms. Talk to your doctor about how you are feeling; he will be able to offer support and refer you to experts in treating depression.

Looking at your lifestyle

Your doctor will advise you on healthy eating and lifestyle measures. If you smoke, you’ll be given information about support groups in your local area to help you stop smoking.

Assessing your baby

Your baby’s checkup

A pediatrician will want to see your baby at around 4 days, 1 month, and 2 months to do a physical checkup and look at how your baby is growing and developing.

The doctor will perform a similar examination to the newborn checkup . He or she will examine your baby’s hips, spine, eyes, heart, and the pulses at the top of the legs. In boys, it’s important to check that the testes are located in the scrotum. This is also a chance to look for subtle problems such as a heart murmur, which can develop after birth. Your baby will be weighed and his head circumference measured. The doctor will ask how your baby is feeding and check for signs of jaundice. Your baby’s development will be checked too: whether he has head control, is starting to smile, and can focus on an object or face a foot away, and follow a moving object. Your baby should receive some immunizations during these early visits. All of these findings will be recorded in a record of your baby’s growth and development.

The head circumference is taken and the fontanelles, the soft areas on your baby’s head, are checked.

Your baby’s heart rate will be listened to and the doctor will monitor and check his breathing.

To check head control, your doctor will gently lift your baby up by his arms to see how he holds his head.

Q: Is it true that I don’t need to worry about getting pregnant again while I’m breast-feeding?
A: If you are breast-feeding, you may not have a period for a while after giving birth. Although this means you are less likely to conceive, you can still ovulate, so you shouldn’t assume that you don’t need to use contraception. The doctor or nurse will discuss contraception and sexual health with you and may recommend the progesterone-only pill, which can be prescribed from 21 days if you’re breast-feeding.
Q: I’m bottle-feeding my baby and am worried about getting pregnant again. How soon could this happen?
A: If you decided to bottle-feed, you will probably have had your first period prior to this checkup and so certainly could become pregnant again. Although your doctor will have already discussed contraception with you, this will be addressed again at your six-week checkup. The doctor or nurse will want to check that you have contraceptive measures in place; if not, he or she will offer you guidance and advice.
Q: I had stitches and have felt too anxious to have sex since the birth. Is this normal?
A: Yes, plenty of women feel this way and many wait to resume sex until after their postpartum checkup. During this checkup, the doctor or nurse will be able to confirm that your incision has healed, and offer reassurance about resuming sex. On the other hand, there is nothing wrong with having sex before this checkup as long as you have stopped bleeding. When you do have sex, you may need to use a lubricant (KY jelly), particularly if you’re breast-feeding since your hormones can cause some vaginal dryness.
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