Congratulations – you’ve done the hard work of labor and now you have a beautiful baby to nurture and love. But your health is important too. Your body endured the physical demands of labor and delivery – you may even have undergone a surgical cesarean section or episiotomy – so your doctor will want to see you again soon after delivery to make sure you’re healing properly and to ask about your emotional well being and adjustment to motherhood.
Post-partum Checkup: An Overview
The frequent OB/GYN visits you had during pregnancy are almost a thing of the past. You’ll need a post-partum checkup roughly six weeks after delivery, possibly sooner if you’ve had a C-section or some other complication.
“This exam is the graduation from a woman thinking of herself as an ‘ob’ patient to a ‘gyn’ patient,” says Shari Brasner, MD, associate professor of Obstetrics and Gynecology at Mount Sinai Hospital in New York, NY, and author of Advice From a Pregnant Obstetrician.
You may not return to the doctor for another year after the post-partum checkup, so it’s important to get all of your questions answered during this visit. You’ll want to tailor this discussion to your own individual situation, but some common questions and issues to come armed with during this visit include:
At the post-partum checkup, your practitioner will perform a thorough physical examination, including an abdominal, pelvic and breast exam. Your practitioner will check to see that any tears or surgical incisions from labor and delivery are healing properly, and check your breasts to determine whether there is any infected breast tissue. This is the perfect time to ask any questions about breastfeeding, particularly if you are experiencing problems with the baby latching on, bleeding or pain. A referral to a lactation consultant may be necessary.
In addition, your doctor will take a pap smear because this visit typically serves as a woman’s yearly gynecologic exam as well. Many health care providers also take a thyroid-stimulating hormone (TSH) blood test, which detects problems affecting the thyroid gland. This is done because frequently thyroid hormones fluctuate during pregnancy and your doctor will want to make sure levels have returned to normal. Other tests may be needed if you experienced a complication during pregnancy, such as gestational diabetes.
Sex and Intimacy
If you’ve had a C-section, your clinician will probably say it’s okay to resume sexual intercourse at the 6-week mark. If you’ve had a vaginal delivery with no stitches or tears, you may receive your doctor’s okay earlier, at 2-4 weeks. In reality, many women may not feel like having sex for quite some time. The emotional and physical demands of caring for an infant, lack of sleep and dramatic hormonal shifts may all contribute to a decreased sex drive. This is normal, so try to be patient. Get help caring for your baby if you can, and make time for you and your spouse to enjoy a night out or some time alone. For some women, it can take months to feel like having sex again.
At some point, though, you will need to start thinking about birth control. Since you’re not likely to see your healthcare practitioner again for another year, it’s important to review birth control options during the post-partum checkup. There are some newer birth control options – including birth control patches, extended-cycle birth control regimens and vaginal rings – that may be particularly appealing to new mothers. Here is a general overview of birth control options:
When a woman begins ovulating again after pregnancy depends on whether she is breastfeeding. If a woman is not breastfeeding, she usually will get her first period around 6 weeks postpartum. Many women think they can’t become pregnant if they’re breastfeeding, which is not always the case. “If a woman is still breastfeeding, I tell her that fertility can return at any time. By the time she has that first period, she will have already ovulated. I counsel all women to assume that they are fertile again after they leave my office for the 6-week post-partum checkup,” says Dr. Brasner.
Exercise and Diet
The post-partum checkup is usually the time when healthcare practitioners ease any restrictions they may have placed on women concerning exercise during pregnancy. If you had a vaginal delivery, your doctor may tell you it’s okay to start light exercise, such as brisk walking, as soon as 2 weeks after delivery.
Be sure to take it slow, exercise gradually at first and realize it may take time to resume your previous fitness level as well as your pre-pregnant shape. It can take 9 months or more for a woman to lose the weight gained during pregnancy.
Talk to your doctor about nutritional needs if you are breastfeeding. Women will need an extra 500 calories a day for lactation.
Your clinician may ask how you’re handling the emotional demands of motherhood. The “baby blues” are common, affecting 50-80% of new mothers during the first few days and weeks after delivery. Symptoms are usually mild and short-lived and include insomnia, fatigue, sadness and trouble concentrating. Approximately 10-15% of new mothers develop true postpartum depression within six months of delivery. Symptoms of postpartum depression include overly intense worries about the baby, lack of interest in the baby and fear of harming the baby. If you have been diagnosed with clinical depression, you may be at greater risk for postpartum depression. Your doctor can refer you to counseling if necessary.
e sure to get plenty of rest. Lack of sleep can make you more irritable and compound any stress you may be feeling as a new mother caring for an infant, so be sure to take naps when the baby sleeps and, if possible, enlist the help of friends and relatives or hire a babysitter. Stay connected with friends and try to build a network of other new mothers for emotional support.
© 1996-2010 by NYBOR, LLC All rights reserved.
The Doctor visit after giving birth - post partum check up