The Postpartum Period
The time of your life after you have a baby is called the postpartum or postnatal period. It is broken down into three phases.
When to See the Doctor
In the past, a postpartum check-up was a one-time visit scheduled between four and six weeks after delivery. However, thoughts on postnatal care have changed in recent years. Health experts now consider postpartum care an ongoing process based on each individual’s needs. The World Health Organization (WHO) guidelines published in 2013 recommend at least four postnatal interactions after delivery: in the first 24 hours, on the third day, between 7-14 days, and at six weeks. In 2018, the American College of Obstetricians and Gynecologists (ACOG) updated its guidelines to reflect an ongoing process.
Why You Need to Go
After you have a baby, you experience physical and emotional changes. A visit with your doctor during this time can help prevent complications. If something isn’t right, the doctor can catch it and treat it early before it becomes a problem. This appointment is also time set aside to talk to your doctor about sensitive issues and get answers to questions you may have about bleeding, your sex drive, birth control, the baby blues, postpartum depression, and more. All pregnant women should receive postpartum care even if the pregnancy ends with a devastating loss. Physical and emotional care and support are even more critical during a very difficult time.
What to Expect
You should see your doctor or talk to your doctor on the phone within three weeks of giving birth. If you have a c-section, complications, or other health issues such as gestational diabetes or high blood pressure, you may see your doctor sooner and keep in touch with the doctor more often as you heal. At your first contact, you will spend some time talking to your doctor. The doctor may also check your blood pressure or follow up with any other concerns. As your care continues, the health care team can keep in touch with you in a variety of ways. You may go to the office, see a health care provider at home, or talk to the doctor on the phone or by text message. As postpartum care nears its end, you should have a thorough health and wellness examination before you transition to well-care. Your comprehensive exam can take place as early as four weeks after birth, but no later than 12 weeks, depending on your situation. This visit is a complete check-up of your physical, social, and psychological health. During this appointment, you will have a full physical exam. The doctor may:
Check your weight Take your blood pressure Check your perineum to see how you’re healing Check an episiotomy, tear, or c-section wound if you have one Check to see if your uterus is shrinking as expected Check your breasts and talk about breastfeeding Discuss any health issues you have Talk to you about the postpartum blues and depression Answer questions about your labor and delivery if you have them
You may also have your general gynecological screening if you are due for it. It may include a Pap smear, bloodwork to check for anemia or high blood sugar, and a urine test if you have urinary problems or symptoms of a urinary tract infection. The doctor will also talk to you about:
How your body is recovering from childbirth Your emotions and how you feel about motherhood Your mood Any anxiety or depression that you may be feeling Your social support system How you are sleeping Nutrition and your eating habits How caring for your baby is going How bottle-feeding or breastfeeding is going If you are considering having more children Any concerns about sex Birth control Managing any health concerns such as high blood pressure, diabetes, or other conditions Following up with other health practitioners for any issues you may have Continuing to tend to your health through routine care
Bring Your Questions
You are bound to have questions, especially if you just had your first baby. But, since pregnancy and birth can be very different with each child, experienced moms can have questions, too. As questions come up, write them down so you can bring them to your appointment. If you don’t write them down, you may not remember everything you want to ask once you’re sitting in the office. And remember, there are no silly questions. You shouldn’t feel uncomfortable or embarrassed about asking your doctor anything. That’s one of the reasons they’re there, and they want to help. Some of the things you may want to ask about are:
Your delivery The healing process Preventing problems now and in the future Birth control Sex Tampons Exercise Breastfeeding Breast issues such as pain or lumps Caring for your newborn Returning to work
Symptoms to Bring Up
Those pesky pregnancy symptoms may finally be gone, but the postpartum period has its own set of discomforts. Most of the time, postpartum symptoms are common and expected. However, sometimes they can be a sign of a complication. So, you should discuss all your symptoms with your doctor. The doctor can reassure you of what’s normal and help you find relief, but also look into any concerning symptoms. You should talk to your doctor about:
The amount and color of any bleeding you are experiencing Headaches Pain Hemorrhoids Constipation Leaking urine Sweating Fatigue How you’re feeling If you are sad or under a lot of stress
When to Call the Doctor
You do not have to wait for your scheduled postpartum appointment to talk to or see the doctor if you have urgent concerns. You should call the doctor or go to the hospital if you have:
A fever over 100.4 FBleeding that is getting heavierSevere painSwelling in your body, especially your hands or faceNausea and vomitingA headache that is not going away or getting worseFoul-smelling vaginal bleeding or dischargeDifficulty caring for yourself and your babyFeelings of depressionPainful, burning urination or urinary frequency
Skipping It
Not all women get postpartum care. Up to 40% of women do not follow up with a doctor after giving birth. There are many reasons for this, such as:
Not knowing about itNot knowing who to callBeing too busyHaving too many other things to doThinking it isn’t necessaryFeeling goodNot having anyone to watch the babyHaving been through it before many timesConcerns about the costThe insurance will not cover it
While there are things that make can make it difficult or inconvenient to get there, you should make every effort to see the doctor. If you have to bring your baby with you, you can. If you’re concerned about the cost or your insurance, talk to the hospital staff or your health care provider for helpful resources. Skipping out on postpartum care can have some unintended consequences.
You may not realize you have an infection or a postpartum complication.You may not heal well. You could get pregnant again quickly.You could have undiagnosed postpartum depression.
A Word From Verywell
During pregnancy, prenatal visits are plentiful. But, the attention to an expecting mom’s health and wellness seems to fade once the baby is born. Care during the postpartum period can be overlooked at a time when many women need it most. The body changes so much during pregnancy, birth, and the postpartum period. It is incredible what the body goes through in less than one year. And, it’s true that some women feel wonderful after childbirth. But, for others, the physical and emotional challenges of the fourth trimester can be a struggle. The continuation of care after pregnancy is so important. Just as you need ongoing care during pregnancy, labor, and delivery, you need it while you’re healing in the days, weeks, and months after your baby is born. Postpartum care should be part of your overall pregnancy care. You and doctor should work together to make sure your health is monitored and managed throughout the entire process. So, talk about it with your doctor while you’re pregnant, be sure to make your appointments, and don’t skip out on them even if you’re feeling good.
