Attitudes and practices surrounding postpartum care have shifted in recent years. Previously, a one-time visit to your healthcare provider for a routine six-week checkup was all you could expect. In 2018, however, the American College of Obstetricians and Gynecologists began an increased effort to optimize postpartum care, advising that aftercare following delivery should be an ongoing process, tailored to a patient’s individual needs. It is now recommended patients first get in touch with their practitioner as soon as three weeks after delivery for a check-in and to make a plan for care going forward. That visit gives your healthcare provider a chance to find out how you’re feeling and assist with any problems you’re having early on. If you had hypertension during pregnancy, you should have a checkup sooner, around 3 to 10 days after delivery. Then additional visits should be scheduled as needed, before a final checkup around 12 weeks after birth. That final postpartum screening will cover your entire physical, social, and psychological well-being, including:

• How your body is physically recovering
• Sex, birth control, and spacing of future children
• Your mental and emotional state
• Newborn care and feeding
• Exhaustion and sleep quality
• Managing any chronic diseases you may have
• Continued preventive care and health maintenance

Let’s take a closer look at what to expect at your postpartum screening.

Have a Physical Examination

You will undergo a complete physical exam. Your provider may examine your vagina and perineum and do a Pap smear if it’s time for one. They’ll also check your uterus and other reproductive organs for tenderness or infection and to ensure they are returning to their pre-pregnancy state. You may have additional screenings to check for things like anemia. Discuss any soreness or pain you’re still having and ask when you’ll be able to have sex again. Your provider will also talk to you about nursing and plans for your newborn’s care. Mention any questions you may have about your diet, vitamins, weight gain or loss, and healing. (It’s helpful to make a list.)

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Get Cleared for Sex and Talk About Contraception

At six weeks, your provider will typically give you the green light to resume sexual activity. This simply means your body can physically handle it. You may not be emotionally ready for it yet. Sometimes new moms just feel too tired or “touched out” for sexual intimacy, so rely on your own instincts. If you’re feeling ready but are anxious about it being painful, your doctor may suggest a prescription lubricant to help out.

Of course, getting the all-clear to have sex means thinking about contraception. Even if you are planning to have more children, you’ll need to give your body time to recover first. Many people are surprised to learn that they can still become pregnant even when nursing. Talk to your doctor about adjustments you may need to make to your birth control plans. For instance, breastfeeding parents who previously took birth control pills might need a lower hormone pill or an alternate method that’s safe for the baby and milk supply. Common contraception options include:

• Birth control pills
• Condoms
• Diaphragm
• Injectable birth control
• Intrauterine devices (IUD)

Talk About Your Labor and Delivery Experience

During this appointment, you can talk to your provider about what happened during your childbirth experience and ask questions about things you didn’t understand at the time. It’s also good to ask for a copy of your medical record from your provider’s office. You may want to obtain a copy of the hospital’s record of the event as well. If you had difficulty or complications during your childbirth experience, talk to your provider about how that may impact future pregnancies or deliveries. For instance, if you had a C-section then you may want to inquire whether VBAC (vaginal birth after cesarean) is an option in the future.

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Screening for Postpartum Depression 

Though some providers may not inquire about your emotional state, a postpartum depression screening is essential. If your doctor forgets to address this, make sure you bring up any questions or concerns you may have. Though mood swings and “baby blues” are perfectly normal after delivery, depressed feelings that persist beyond two weeks may indicate a more serious problem.

During the screening for postpartum depression, you'll answer a series of questions. Your doctor may ask the questions, or you may complete a questionnaire to discuss with your provider later. One of the most common questionnaires is called the Edinburgh Postnatal Depression Scale (EPDS). This postpartum depression scale includes 10 questions about your mood and thoughts. Your provider may also order a blood test to find out if a physical condition, such as hyperthyroidism or hypothyroidism, may be contributing to your depression.

Postpartum depression is a very treatable condition, and most people begin feeling relief soon after initiating treatment. However, your doctor cannot help you if they don't know that you're struggling. Be sure to talk about it if you're having a hard time.

Bid Them Farewell

It can feel a little strange to walk out of your provider’s office for the last time (even if it’s only until next year). Let’s face it, the two of you have spent a great deal of time together over the past year! Consider bringing your baby along for the visit, as well as a partner or helper to assist you with the baby while you’re being examined. If you had a challenging pregnancy or birth experience, your provider may recommend a few additional appointments to monitor your recovery.

The Bottom Line

Though you may be tempted to bail on your final postpartum screening (especially if you’re feeling overwhelmed with having a newborn around), it’s essential to see your provider and take care of yourself. Your baby deserves a healthy parent, and you deserve to practice self-care so keep your appointment. Besides, skipping that final appointment could have serious health impacts. For example, you could experience a lingering infection or an unplanned pregnancy. If you’re feeling overwhelmed, get someone to go to the appointment with you and prepare a list of questions or concerns ahead of time.

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