Postpartum

What to Expect and What to Ask at Your 6-Week Appointment

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You’re required to attend a lot of doctor’s appointments throughout pregnancy. I really looked forward to these appointments (hearing the baby’s heartbeat always offered a much-needed sense of reassurance) even though it felt like a lot. Based on the amount of time I spent with my midwife, I wondered whether she considered me one of her closest friends? It kind of felt like that for me (honestly, I really miss her now!).

But then once your baby is actually born, the visits stop, and it’s a solid six weeks before you’re expected for your first post-baby checkup. Excuse me, come again? A baby literally just came out of my vagina, and I’m now going to wait six weeks to make sure everything is healing correctly? Six weeks of healing felt like an eternity.

Of course over those six weeks, your newborn baby will attend several checkups, but not you mom, you’re good to hang out and we’ll all assume things are healing just fine down there.

 

Of course over those six weeks, your newborn baby will attend several checkups, but not you mom, you’re good to hang out and we’ll all assume things are healing just fine down there.

 

With so much anticipation, you’d think a lot happens at this appointment. But I’m here to tell you (after my own experience and in speaking with other women), not much actually happens. And if you ask me, I think a lot more should be happening, so it’s important to know the right questions to ask before you head into this appointment.

Editor’s Note: If you feel that things are not healing correctly, you’re experiencing pain, you’re concerned about your mental health, or anything else doesn’t seem right, it’s perfectly OK to ask for an appointment sooner. Just because six weeks is the standard first post-birth appointment, it doesn’t mean you have to suffer in silence waiting for that date.

 

What to Expect at Your Six-Week Appointment

 

Every practitioner is different, so we can’t say exactly what you’ll encounter, but it’s likely that you’ll fill out paperwork to get a feel for how you’re doing mentally. Your doctor will check your incision if you had a C-section and will do a pelvic exam if you delivered vaginally to ensure any tears you may have experienced have healed.

It’s likely that your doctor will perform a breast exam, a pap smear, and may request blood draws (to test for anemia, among other things).

Additionally, your doctor may ask about how you are feeling, ask about your bladder control, and may check-in to discuss your birth control plans (even if you’re breastfeeding and/or haven’t gotten your period yet, you can indeed still get pregnant!).

After your exam and discussion, your doctor will usually give you the green light to start working out and is likely to say it’s OK to start having sex again. In most cases, don’t expect much more than this.

 

Source: @luckyandi

 

What to Ask at Your Six-Week Appointment

 

While I wish the standard six-week appointment was more thorough, the reality is that it can be pretty quick and not that informative. Before heading to your appointment, review what to expect and know what to ask for if some of these things are not done (for example, I’m 99 percent sure my appointment did not include a breast exam or pap smear).

In addition, there are things you may want to ask your healthcare provider so you can feel the informed and empowered to move forward after this appointment. Here are some things to consider.

 

Ask your doctor to check for Diastasis Recti (DR)

DR is the separation of the ab muscles and is incredibly common during pregnancy. According to one study, around 60 percent of women experience DR during pregnancy (though I’ve seen much higher estimates as well). For some women, this goes away on its own, but for others, it requires work to get the gap to close (and in some serious cases, surgery). Your doctor can do a simple check to examine if you have DR and to see how severe it is. If it is severe or you are concerned about making it worse (which can happen), your doctor can refer you to a women’s health physical therapist for further help.

 

Ask about how to safely return to physical activity

Women are typically given the green light to start working out again, but the advice tends to be vague. Most doctors will tell you to start slow and ease back into working out. At first, this lack of specific guidance annoyed me; shouldn’t they be able to give me more specific advice? But doctors aren’t personal trainers, though, and it doesn’t hurt to ask for more specific advice, as some doctors may be able to provide more information. However, if they cannot share more insights, seeing a women’s health physical therapist might be a good option for you.

 

Request a referral for a women’s health physical therapist

And speaking of physical therapy, in some countries (France, for example), physical therapy following birth is a standard of care. Unfortunately, this is not the case in the United States. Women’s bodies go through a lot during pregnancy and childbirth, and often things don’t simply go back to the way they were. A women’s health PT can help with a variety of things, including pelvic floor dysfunction or prolapse, incontinence, healing DR, as well as helping women who may experience pain during sex, among other things.

If you’re hoping to jump back into a fitness routine, a women’s health PT can help you to go about this in a safe and effective way. Sometimes you won’t know at six weeks if you want to visit a women’s health PT (for example, since you haven’t had sex yet, you won’t know if it’s going to be painful), so it’s best to go ahead and ask for a referral at this appointment so you have it should you decide to use it.

 

 

Discuss any discomfort or pain you’re feeling

If you are feeling anything that doesn’t seem quite right, now is the time to talk about it. You may hope that over time things will feel better, and hopefully, they will, but that’s not always the case.

Yes, healing from childbirth can be painful, and you may assume that the pain and discomfort you’re feeling is a normal part of the healing process. It may be, but it doesn’t hurt to ask and make sure.

 

Ask questions about breastfeeding

From an outside perspective, breastfeeding might seem like it should come naturally to new mothers. In reality, I think many mothers would agree this isn’t the case. Breastfeeding can be incredibly challenging, sometimes painful, as well as frustrating. If you have been experiencing issues or have questions, bring those up during your appointment. Your doctor may be able to help, can provide resources, or may refer you to a lactation specialist.

If you are experiencing breastfeeding challenges, you do not need to wait until your six-week appointment to address them. Make an earlier appointment with your doctor or with a lactation specialist.

 

Be honest about your mental health

Some hospitals or doctor’s offices will have you fill out a questionnaire about your mental health before you leave the hospital or at your postpartum appointment. But answering a few yes or no questions doesn’t always go deep enough. While some baby blues are normal in the early weeks following childbirth, affecting between 70-80 percent of mothers, another 10-20 percent of mothers could be experiencing postpartum depression. Be honest and open with your healthcare provider about how you’re feeling. They can help you navigate the best next steps.

Editor’s Note: If you, or someone you know, are experiencing postpartum depression, please seek help from your healthcare provider or reach out to a close friend or loved one. If you are having suicidal thoughts, or thoughts of hurting your baby, please call the National Suicide Prevention Lifeline immediately at 1-800-273-TALK.

 

Ask for another appointment

If you are experiencing any lingering pains from pregnancy or childbirth, it’s OK to set up another appointment, even though this is typically “the last” appointment of your pre/postnatal care (confession: I saw my midwife three times after giving birth). Don’t try to power through discomfort, pain, anxiety, or worry. If you need another check-up, don’t be shy about getting one on the books.

 

Read More: What No One Tells You About Postpartum Life—And How to Manage It