Having attended numerous doctor appointments during the entire course of your pregnancy, an additional postpartum check-up may not come as a surprise to you. Yet, how aware are you of the importance of this appointment? Read on to find out more about this postnatal visit and what normally happens.

Why is the postpartum check-up important and, how you can prepare for it well?

This postpartum check-up is one you certainly should not skip even if you are feeling healthy. It ensures that you are recuperating well, physically and emotionally, after childbirth. It is also important for you as it allows for the early discovery of any serious or life-endangering postnatal health issues to alleviate its consequences.

The postpartum check-up will generally be arranged by your doctor four to six weeks after your delivery¹. If you developed certain medical issues during your pregnancy, it may be scheduled earlier. Before this doctor’s appointment, you may want to prepare a list of questions or challenges you have faced after the delivery of your baby to discuss during the session. Some topics you may want to consider asking include your delivery process, breastfeeding, exercising, contraceptive options, and sex².

What happens during the postpartum check-up?

1. Your General Health
The appointment will begin with basic checks such as measuring your weight and blood pressure. At times, your doctor might take your pulse and listen to your heartbeat as well. He/she will then move on to postnatal-related issues such as bowel issues, thyroid check, and your intake of supplements. If you had gestational diabetes, your doctor will conduct an oral glucose tolerance test to determine whether your blood sugar levels have fallen to normal levels and decide whether drug treatment will be required. Do remind your doctor in the event you are breastfeeding and your doctor prescribes you medication^3,4.

2. Your Breasts
As it is normal for your breasts to change pre and postnatal, your doctor will have to be kept updated on these changes to monitor for any abnormalities. Hence, he/she will check if you experience breast engorgement issues postnatal and examine your breasts for blocked milk ducts to prevent bacterial infection known as mastitis. The symptoms of mastitis include redness and warmness around the breast area, coupled with fever and body aches⁵. If you suffer from such symptoms before your scheduled appointment, you should immediately contact your doctor and report these symptoms to seek help.

3. Your Abdomen and Incision
The doctor will check your abdomen for any tenderness such as soreness or pain felt when pressure is applied to the abdomen area. If you had a caesarean section (c-section) delivery, an initial incision examination will usually be conducted at two weeks followed by another check at six weeks to ensure that your wound is not inflamed⁴.

4. Pelvic Examination
Your pelvic examination will check for areas such as your vagina, uterus, and cervix. Your uterus will be checked for infections and a pap smear will be conducted to ensure that there are no unusual cervical cells. However, do note that the pap smear is usually only performed a minimum of six weeks after birth.⁴ If you went through natural childbirth and had an episiotomy or tear during the delivery process, your doctor will also examine whether the wound has healed fully.

5. Your Mental Health
Despite a large part of the examination being focused on your physical wellbeing, your emotional health is not neglected as well. During the consultation, your doctor will enquire about your overall feelings and emotional stability since childbirth. If you have been experiencing frequent pangs of sadness or feel overwhelmed by motherhood, do not be afraid to be candid with your doctor. This will allow him/her to better assess your mental health and determine whether you should be examined for postnatal depression ^4,6.

6. Available Contraceptive Options
Your contraceptive options are advised to wait at least one and a half years between pregnancies to reduce their likelihood of experiencing premature labour. Hence, if you are planning for another baby, you may want to reconsider and look into the available birth control methods most suited for your lifestyle. Do note that it is essential to take these precautions early, especially if you are not breastfeeding, as you may regain fertility relatively quickly⁴.

To sum up

Even though your doctor may have scheduled an appointment several weeks after the delivery of your baby, you should not feel compelled to wait until the scheduled date if you experience severe discomfort beforehand. Should you experience any emotional problems or physical problems such as discharge from the incision, extreme abdominal pain, or swollen incision, you should arrange for a visit to the doctor as soon as possible. Additionally, the guidelines provided on what you should expect during your visit should act as mental preparation for you rather than a checklist or boundary for your actual postnatal examination. Now that you are mentally prepared and aware of the importance of this visit, don’t forget to note your appointment date down and turn up for it as scheduled³!

Disclaimer: Tips and suggestions mentioned in the article are for general information purposes only and should not be construed as professional medical advice. Please consult your doctor or a nutrition advisor for any specific health and wellness concerns or questions.

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References:

1. HEATHER L. PALADINE, MD, MEd, CAROL E. BLENNING, MD, AND YORGOS STRANGAS, MD. Postpartum Care: An Approach to the Fourth Trimester. Am Fam Physician. 2019;100(8):485-491.

2. Haran, C., van Driel, M., Mitchell, B.L. et al. Clinical guidelines for postpartum women and infants in primary care–a systematic review. BMC Pregnancy Childbirth 14, 51 (2014). https://doi.org/10.1186/1471-2393-14-51.

3. Ramos, D. (2022) What to Expect at a Postpartum Checkup—And Why the Visit Matters, American College of Obstetricians and Gynecologists. American College of Obstetricians and Gynecologists. Available at: https://www.acog.org/womens-health/experts-and-stories/the-latest/what-to-expect-at-a-postpartum-checkup-and-why-the-visit-matters (Accessed: November 30, 2022).

4. ACOG Committee on Obstetric Practice. Presidential task force on redefining the postpartum visit committee on obstetric practice. Obstet Gynecol. 2018;131(5):e140-50.

5. Cooney F, Petty-Saphon N. The burden of severe lactational mastitis in Ireland from 2006 to 2015.

6. Silver, N.E. (2021) What I Tell My Pregnant and Postpartum Patients About Depression and Anxiety, American College of Obstetricians and Gynecologists. American College of Obstetricians and Gynecologists. Available at: https://www.acog.org/womens-health/experts-and-stories/the-latest/what-i-tell-my-pregnant-and-postpartum-patients-about-depression-and-anxiety (Accessed: November 30, 2022).