Postpartum Health Checkups

Your Health Matters Too

While your baby will have many well-child visits in the first year, you also need postpartum health checkups to ensure you’re recovering properly and address any concerns. Many new mothers focus entirely on their babies and neglect their own healthcare—but your health is essential for caring for your baby. This guide explains when you need checkups and what happens at each visit.

The 6-Week Postpartum Visit

When: Typically 6 weeks after delivery (earlier if you had complications)

Why This Visit Is Essential: This is not optional! Even if you feel completely recovered, this visit is crucial for:

• Ensuring your body has healed properly
• Screening for postpartum depression
• Discussing contraception
• Addressing any concerns or symptoms
• Getting clearance to resume normal activities

What Happens at Your 6-Week Visit:

Physical Examination:

• Blood pressure check: Screening for postpartum preeclampsia (can occur after delivery)
• Weight check: Assessing postpartum weight changes
• Abdominal examination: Checking uterus has returned to normal size
• Incision check: If you had cesarean section, examining incision healing
• Perineal examination: If you had vaginal delivery, checking healing of any tears or episiotomy
• Pelvic exam: May be performed to check cervix, uterus, and ovaries (not always necessary)
• Breast examination: Checking for lumps, assessing breastfeeding if applicable

Postpartum Depression Screening:

• Questionnaire about mood, anxiety, and emotional wellbeing
• Discussion of any emotional challenges
• Referral to mental health care if needed
• Be honest! This screening exists to help you

Discussion Topics:

Physical Recovery:

• Any pain or discomfort
• Urinary or fecal incontinence (common but treatable!)
• Constipation or hemorrhoids
• Sexual function concerns
• Return to exercise—when and how
• Any persistent bleeding or unusual discharge

Contraception:

• Discussing birth control options
• Important: You can get pregnant before your first period returns, even while breastfeeding
• Various options: hormonal (pills, IUD, implant, shot), barrier methods, permanent sterilization
• Choosing method that works with breastfeeding if applicable

Breastfeeding:

• How breastfeeding is going
• Any pain or problems
• Returning to work and pumping plans

Future Pregnancies:

• When it’s safe to conceive again (typically wait 18-24 months for optimal outcomes)
• Planning for future pregnancies
• Special considerations based on this pregnancy/delivery

General Health:

• Return to work plans
• Sleep and rest
• Nutrition and hydration
• Support system
• Self-care

Chronic Conditions:

• If you had gestational diabetes, preeclampsia, or other pregnancy complications, discussing ongoing management

Clearance:

• When you can resume sexual activity (typically cleared at this visit)
• When you can resume full exercise (typically cleared at this visit, but start gradually)
• Any ongoing activity restrictions

Come Prepared:

List Any Symptoms or Concerns:

• Pain anywhere
• Excessive bleeding
• Difficulty urinating or controlling bladder
• Bowel problems
• Mood changes
• Breastfeeding challenges
• Sexual concerns
• Any question is valid!

Bring Your Questions: Write them down beforehand so you don’t forget in the moment.

Possible Additional Tests: Depending on your health and pregnancy, you may need:

• Blood tests (anemia check, thyroid, etc.)
• Glucose tolerance test (if you had gestational diabetes)
• Blood pressure monitoring (if you had preeclampsia)

Early Postpartum Visit (If Complications)

When: 1-2 weeks after delivery

Who Needs This: Women who experienced:

• Gestational hypertension or preeclampsia
• Cesarean section
• Significant postpartum hemorrhage
• Third or fourth-degree perineal tears
• Other complications during delivery
• Emergency delivery

Why: Early check to ensure you’re healing properly and catch any complications early.

What’s Checked:

• Blood pressure (if you had hypertension or preeclampsia)
• Incision (if cesarean)
• Perineal healing (if severe tears)
• Any symptoms or concerns

GDM Postpartum Follow-Up (If You Had Gestational Diabetes)

When: 6-8 weeks postpartum

Essential Test: Oral Glucose Tolerance Test (OGTT) If you had gestational diabetes, you need this test to determine if diabetes persists after pregnancy.

Why This Matters:

• About 5-10% of women with GDM have diabetes that persists postpartum
• 50% of women with GDM will develop Type 2 diabetes later in life
• Early detection allows for intervention and prevention

The Test:

• Fasting blood draw
• Drink glucose solution
• Blood drawn 2 hours later
• Results show if you have diabetes, prediabetes, or normal glucose metabolism

Results:

Normal Glucose Tolerance:

• Fasting: Less than 100 mg/dL
• 2-hour: Less than 140 mg/dL
• Great news! But continue healthy lifestyle and regular screening

Prediabetes:

• Fasting: 100-125 mg/dL OR
• 2-hour: 140-199 mg/dL
• Lifestyle changes can prevent progression to diabetes
• Recheck annually

Diabetes:

• Fasting: 126 mg/dL or higher OR
• 2-hour: 200 mg/dL or higher
• Requires ongoing treatment
• Work with doctor to manage

Long-Term Monitoring: Even if postpartum test is normal, you need:

• Blood glucose screening every 1-3 years for life
• Lifestyle modifications (healthy diet, regular exercise, maintain healthy weight)
• Breastfeeding (reduces your risk of developing Type 2 diabetes!)
• Extra attention to diabetes risk factors

Future Pregnancies:

• Higher risk of GDM in subsequent pregnancies (about 50% chance)
• May need earlier testing in future pregnancies
• Importance of preconception counseling and optimal control before next pregnancy

Preeclampsia Postpartum Follow-Up

When: Usually 3-7 days postpartum, then 6-12 weeks postpartum

If You Had Preeclampsia or Gestational Hypertension:

Early Postpartum (First Week):

• Blood pressure monitoring (high blood pressure can persist or worsen postpartum)
• Watch for postpartum preeclampsia symptoms:
  • Severe headache
  • Visual changes
  • Severe upper abdominal pain
  • Nausea/vomiting
  • Difficulty breathing
• May need continued medication

6-12 Week Follow-Up:

• Blood pressure check
• Assessment of whether hypertension has resolved
• Discussion of long-term cardiovascular risk
• Some women need ongoing blood pressure treatment

Long-Term Implications:

• Women who had preeclampsia have increased lifetime risk of:
  • High blood pressure
  • Heart disease
  • Stroke
• Need for:
  • Regular blood pressure monitoring
  • Cardiovascular health screening
  • Healthy lifestyle (diet, exercise, weight management)
  • Informing all future doctors about preeclampsia history

Future Pregnancies:

• Higher risk of preeclampsia in subsequent pregnancies
• May need low-dose aspirin in future pregnancies
• Closer monitoring throughout pregnancy
• Preconception counseling recommended

Ongoing Postpartum Care

Beyond the 6-Week Visit:

Return to Annual Exams: Resume your annual well-woman checkups:

• Pap smear (as per guidelines for your age)
• Breast examination
• General health screening
• Contraception management
• Any ongoing concerns

Mental Health:

• Postpartum depression can develop any time in first year
• Don’t hesitate to reach out if mood changes occur
• Support available

Pelvic Floor:

• If you have urinary incontinence, pelvic pain, or pelvic organ prolapse, ask for referral to pelvic floor physical therapist
• These conditions are common but treatable
• Don’t accept “it’s normal after having a baby”—treatment can help!

If Breastfeeding:

• Menstruation may not return for months while exclusively breastfeeding
• When it does return, it may be irregular initially
• You can still get pregnant even without period

Don’t Skip Your Postpartum Visits

Why Women Skip:

• Too focused on baby
• Feel fine and don’t think visit is necessary
• Difficulty finding childcare for baby during appointment
• Transportation or scheduling challenges
• No insurance or cost concerns

Why You Shouldn’t Skip:

Hidden Problems: You may feel fine but have:

• High blood pressure
• Postpartum thyroid dysfunction
• Anemia
• Healing issues
• Early signs of postpartum depression

Future Health: Complications during pregnancy and delivery affect your long-term health. Your postpartum visits establish baseline and ongoing care plan.

Your Baby Needs You Healthy: Your health directly affects your ability to care for your baby. Taking care of yourself is taking care of your baby.

Solutions to Common Barriers:

• Bring baby to appointment (most offices expect this)
• Ask partner, family, or friend to watch baby during appointment
• Ask about telehealth options for some appointments
• Discuss financial concerns with office—payment plans may be available
• Don’t let barriers prevent essential care

When to Call Doctor Before Scheduled Visit

Call Immediately If You Experience:

• Heavy bleeding: Soaking through more than one pad per hour
• Large blood clots: Larger than golf ball
• Severe abdominal pain
• Fever: 100.4°F (38°C) or higher
• Severe headache with visual changes (possible postpartum preeclampsia)
• Chest pain or difficulty breathing
• Leg pain, swelling, warmth (possible blood clot)
• Foul-smelling vaginal discharge
• Incision concerns: Red, swollen, hot, draining, opening
• Breast concerns: Red, hot, very painful area (possible mastitis)
• Urinary problems: Pain, burning, inability to urinate
• Thoughts of harming yourself or baby
• Severe anxiety or depression

Don’t wait for scheduled appointment if you have concerning symptoms!

Your Health Matters

The intense focus on your newborn is natural and appropriate, but don’t neglect your own health. Attending your postpartum checkups, addressing concerns promptly, and taking care of yourself ensures you’re healthy and able to care for your baby for years to come.

You matter. Your health matters. Make your postpartum care a priority.