An inconvenient truth about American prenatal and postnatal care is that our nation has it higher maternal mortality rate among developed countries, with a large share of these deaths following childbirth. Due to the overall shortage of maternal care providers – for example obstetricians, gynecologists and midwives – compared to the number of births, postpartum women can easily fall through the cracks when it comes to postnatal health care. So how can you make sure you get the most out of every interaction with your healthcare provider? We’ve put together some information to help you understand what to expect at your postpartum checkup and how to maximize that fleeting time with your doctor.
Why you need a postpartum exam
As many as 40% of new mothers never get a checkup after giving birth. This may be a result of not having a designated OB/GYN during pregnancy to follow up, geographic barriers such as lack of transportation, cultural traditions, limited health care coverage, or the assumption that they don’t need to because they “feel good. ” The reality is that pregnancy can act as a window to your health for the rest of your life. If you develop pre-eclampsia (high blood pressure) while you’re pregnant, it can indicate heart health problems later down the road for you. This same rule applies to gestational diabetes and the possible link to the development of type II diabetes. More pressing is the need to check your overall mental, physical and emotional health in the weeks after giving birth. New mothers are at risk for serious and sometimes fatal complications after childbirth, and early treatment of these problems is critical.
How often should you see your provider after delivery?
Previously, women were only advised to come in for a four- to six-week postpartum check-up. New guidelines set forth by the American College of Obstetricians and Gynecologists (ACOG) recommend a more staggered exam schedule spanning several weeks.
ACOG now recommends that new mothers meet with their OB/GYN several times within the first 12 weeks postpartum:
The initial exam should be scheduled within 3 weeks postpartum.
The second test should be scheduled at 6 weeks postpartum – additional tests may be scheduled as needed between this point and your final check-up.
The final check should be scheduled for 12 weeks.
If you experienced loss –miscarriage, stillbirth or neonatal death, it is recommended that you visit your health care provider within 3 – 10 days after delivery. Your OB/GYN may recommend that you speak with a genetic counselor to determine the cause of your loss and determine if you are at risk for complications in future pregnancies.
What happens at a postpartum exam?
During a postpartum exam, your doctor should perform a physical exam, including a pelvic exam and a breast exam.
The physical examination it will be similar to your annual physical minus the blood donation. They will record your blood pressure and weight, take your pulse and listen to your heart and lungs. In addition, the doctor will want to check your abdomen to see that your uterus is contracting in its pre-pregnancy state – if you had a C-section, he will inspect the incision to check for any signs of infection. The breast exam looks for lumps, redness, tenderness, cracked nipples, or abnormal discharge. Depending on where you are in your treatment journey, your doctor may approve you to return to work and physical activity such as exercise and sexual activity. Take this opportunity to talk to your provider right now with:
Discussing breastfeeding concerns: If you’re having trouble getting into a routine with breastfeeding, ask your doctor for a referral to a lactation consultant. If there is someone on staff, ask to meet with them briefly before you leave.
Find useful tools: Ask if they can recommend any literature or apps for tracking things like sleep, feeding, baby milestones, etc. Is there a nipple shield or cream they recommend for cracked nipples? A great postpartum vitamin? What technology exists today that can help you as a new parent?
During the pelvic exam they will check your external genitalia – if you had an episiotomy or a tear that required stitches, they will inspect it. They will also check how you are healing internally with a speculum exam. They’re looking to see that your vagina and cervix are healing (or healing) from any injuries sustained during labor, and if you need to have your annual Pap smear, they may do that too. Questions to ask during this part of your exam that can help you feel like you’re getting the most out of your appointment include:
Ways to encourage healing: Do they recommend sitz baths? Frozen maxi pads? What works versus what doesn’t? Asking them how to help your body heal postpartum is a proactive question they should be happy to answer.
Express your concerns: Are you still bleeding heavily? How much blood loss is normal at your stage? Are you experiencing any odors or discharges that concern you? Speak. You know your body and you are your own best advocate. Don’t miss this opportunity because you are shy or otherwise.
Discuss family planning: It’s possible to get pregnant at any point after giving birth (spoiler alert: even if you’re breastfeeding or haven’t had your period yet). Talk about your birth control options – if you plan to have an intrauterine device or implant inserted, ask if they can take care of it while you’re in the office. If you are breastfeeding, ask about the “mini pill”, which is safe for nursing mothers, and get the prescription while you are there.
In addition, they should conduct a mental and emotional health screening to determine if you are experiencing perinatal depression or postpartum anxiety. It is important to be honest with your provider when completing the screening questionnaire. If you’re dealing with even mild postpartum depression or anxiety, it can get much worse if left untreated. Take advantage of this time with your provider:
It is forthcoming: Offer information about your mental state and talk through your questions and concerns. If your exhaustion, depression or anxiety is excessive, now is the time to tell your doctor.
Taking notes: If you’re worried that you’ll forget important details or find it difficult to talk to your doctor about how you’re feeling, a handy way to avoid this issue is to bring notes with your questions and concerns.
How to support healing between postpartum exams
Your body is a self-healing organism, but that doesn’t mean it doesn’t benefit from a little help along the way. Ways you can encourage healing between postpartum appointments include:
- Taking a postpartum vitamin: OBGYNs recommend postpartum vitamins for at least six months after giving birth—and nursing mothers should continue as long as they breastfeed or express breast milk. Us Total postnatal gums it’s a delicious way to get vital nutrients for postpartum health and lactation support.
- Prioritize your recovery: Us Postpartum recovery tea is a great addition to your recovery strategy. With essential herbs to support you postpartum – such as red mulberry leaf to stimulate the uterus and relieve postpartum cramps and ginger to promote healing and reduce inflammation.
- Calm down: Don’t overdo it between appointments, a quick way to reset your postpartum recovery is to go really hard. It’s perfectly okay to jump back into everyday life at a brisk pace, and please accept help whenever possible.
If you are interested in learning more about the postpartum period of pregnancy, read on:
What is labor and how long does it last?
Postpartum recovery tips she wants you to know
Understanding Your Fourth Trimester: Just the Facts
