You’ve spent the past nine months preparing for the arrival of your beautiful baby. Labor and delivery have come and gone. Now it’s time for your 6-week postpartum checkup. So much of life after delivery focuses on your new bundle of joy that you can sometimes forget to care for yourself. This is why I believe the postpartum appointment is necessary for you as a new mom – it’s all about you!
Your provider loves to fawn over your sweet baby, but this appointment is about mom. How are YOU doing? Postpartum self-care is essential to your health and recovery after having a baby, so let this appointment focus on your well-being.
Questions to Ask at Your 6-Week Postpartum Appointment
These are helpful questions to ask when you see your provider at your 6-week postpartum checkup. Your provider will likely cover most or all of these topics on their own. So, use this as a guide to remind you to ask anything they don’t cover.
1. Do You Have Any Recommendations for My Future Pregnancies?
Based on how smooth or complicated your pregnancy and delivery were, your provider will likely have recommendations for a future pregnancy. For example, if you experienced preterm labor, your provider may recommend progesterone supplementation, additional ultrasounds to monitor your cervical length, and/or cerclage placement in a future pregnancy. If you developed gestational hypertension or preeclampsia, they might recommend taking baby aspirin in the future.
Your provider may have discussed some of these before or during your delivery. However, with the excitement and sometimes chaos surrounding the birth, you may have forgotten much of what they said. Therefore, discussing this again at your postpartum appointment is good when fewer distractions exist.
Also, don’t forget to ask your provider what your complications were, why they happened, and if there is anything you can do to help prevent them in the future.
2. Is My Bleeding Normal?
It is normal to have bleeding and discharge in the weeks following your delivery, called lochia. The majority of the bleeding will resolve by three weeks postpartum. However, many women will continue to pass lochia until 6-8 weeks postpartum. On some days, bleeding will be heavier (like a period), and on others with only spotting. It is important to discuss with your provider the quantity of bleeding you are experiencing. Your provider will perform a pelvic exam to ensure the bleeding is normal. Your cycles will likely remain absent or irregular until you wean your baby if you are exclusively breastfeeding.
3. Do I Need Any Medications, Vaccinations, or Blood Tests?
Your provider might recommend receiving the MMR vaccine if you are non-immune to rubella. Or, if you started any medications (such as blood pressure or thyroid medication) during pregnancy, your provider may recommend continuing, adjusting the dosing, or stopping entirely at your 6-week checkup. Also, if you were diagnosed with gestational diabetes, you will need postpartum testing as you continue to have an increased risk of developing diabetes after pregnancy. This is an important discussion to enhance your overall well-being and optimize your health for the future.
4. What Can I Do About My Vaginal Dryness?
Vaginal dryness is a common complaint in the postpartum period. This is especially true in women who are breastfeeding. This is also an issue that many women forget to ask their providers about. Sometimes, over-the-counter lubricants are not enough. Your provider may recommend a non-hormonal option such as hyaluronic acid or an estrogen cream to improve your symptoms while breastfeeding.
5. How Do I Know if I Have Postpartum Depression?
Your provider should perform a screening for postpartum depression at your 6-week postpartum appointment. The Edinburgh Postnatal Depression Scale is a commonly used survey.1 Approximately 70% of women will develop postpartum blues, so knowing the difference between baby blues and postpartum depression is important.2 Both have similar symptoms of anxiety, depression, crying, and insecurity regarding the care of an infant. However, the severity and timing of symptoms can distinguish them. To receive proper care, openly discussing your thoughts and feelings with your provider is important. Initial treatment can range from counseling to lifestyle modifications to medications as determined by your provider.
6. What Are My Options for Birth Control?
Your 6-week postpartum visit is a great time to ask about birth control. Even for breastfeeding moms, there are many options to choose from! Condoms, pills, implants, and IUDs represent the most common reversible options available, yet many more exist. Because each option has risks and benefits, discussing it with your provider will help you determine the best method for you. They will consider pre-existing conditions and personal and family planning goals.
7. How Can I Help Prevent Pelvic Organ Prolapse?
Unfortunately, pregnancy and vaginal birth are some of the biggest risk factors for developing pelvic organ prolapse in the future. Most women don’t develop pelvic pressure, vaginal bulge, urinary incontinence, and difficulty emptying their bladder/bowels until after menopause. However, you can take action now to prevent the occurrence! The most commonly recommended practice is Kegel exercises. However, many women do not perform this effectively without proper coaching. Ask your provider to help you learn how to perform Kegel exercises correctly. Also, ask if they recommend consultation with a pelvic floor physical therapist. Other lifestyle changes for prevention include avoiding constipation, maintaining a healthy body weight, and smoking cessation.
8. How Do I Get My Pre-baby Body Back?
First, recognize the beauty of your postpartum body. All the changes in your body represent the miracle of bringing life into this world. Every scar, stretch mark, and pound is worth the beauty of life. Some changes will be permanent. A helpful way to think about these changes is they are a reminder of the accomplishment of your body. If you notice a bulge in your abdomen, ask your provider about diastasis recti (the separation of your abdominal muscles), which you can treat with physical therapy. Breastfeeding can help you get back to your pre-pregnancy weight faster. And make sure to ask when you can start to exercise again (they will typically clear you to begin exercise at your 6-week postpartum checkup).
9. How Long Do I Need to Wait to Get Pregnant Again?
This may be the last question on your mind, but it is an important one! A short interval between pregnancies has been associated with significant adverse outcomes, particularly if less than six months.3 Yet an increased risk has been reported at intervals of up to 18 months. These potential complications include maternal anemia, preterm labor, premature rupture of membranes, and placental abruption. Based on the circumstances of your delivery, your provider may recommend a modified timing.
10. When Will I See You Again?
By the end of your pregnancy, you have likely developed a relationship with your provider. It can be bittersweet going from seeing them weekly (or even more often) at the end of pregnancy to suddenly going six weeks without them. Believe it or not, your provider and office staff likely feel the same! Ask when your next well-woman exam and/or Pap smear is due. ACOG recently changed the recommended guidelines for how often Pap smears are needed.4 However, it is still recommended to have a yearly pelvic and breast exam, routine blood testing, and STI testing. The timing of your next appointment will vary based on factors including recent lab results, pre-existing conditions, and age.
Hopefully, these questions will help you plan a list of topics to bring up at your 6-week postpartum checkup. Remember, no silly questions exist, and your provider will happily provide support.
