The Postpartum Checkup
You have probably heard all about the “postpartum checkup” or “postpartum follow up” or “postnatal visit” already. Whatever you call it, there’s a plethora of stigma surrounding this pivotal appointment with your OBGYN or Midwife. In true Indiana Birth & Parenting fashion, we’re here to peel back the layers and shed light on what you can really expect…and what feelings might pop up unexpectedly.
Once your follow up appointment is on your calendar- usually set by calling your provider’s office just days after giving birth- you will find yourself thinking and talking about this visit dozens of times leading up to it. Every practice is different, but typically you will see your OBGYN or Midwife around 6 weeks. For uncomplicated vaginal deliveries and postpartum recoveries, this could be the first time you will see your doctor since you had your baby. Moms with a complicated vaginal delivery, cesarean birth, or postpartum complications will see their provider earlier, and then again around 6 weeks. NOTE- the ACOG recently changed their timeline recommendations. You might see this reflected when scheduling your appointment.
This appointment is a date on your calendar. Many parents put a lot of stock in this visit. Here’s the deal- any physical or emotional issues you are experiencing before you walk into the exam room won’t magically disappear when you walk out. You still might have some healing to do. And that’s okay.
Whenever a nonemergent question pops into your head, put it in the notes app on your phone or write it down the old school way. Then go over your questions the day before your appointment and make a list of what you want to talk about.
Your appointment has multiple purposes. It serves as your final visit for this pregnancy, along with getting your annual gynecological exam. It’s so much fun…HA! Here’s what you can expect:
Breast Exam- Unlike your breast exams in the past, this one will be performed to check for lumps and bumps that might be clogged milk ducts.
Abdominal Exam- Your provider will press on your belly to check for tenderness. If you had a cesarean, then your incision will be checked as well.
External Exam- They will take a close look at everything to confirm your perineum is healed properly, especially if you had vaginal tearing requiring stitches or an episiotomy.
Speculum Exam- Your OBGYN will want to take a look at your cervix and vagina with a speculum to make sure everything is healed internally. They will also take care of your yearly Pap smear at this time if it’s due.
Internal Pelvic Exam- Your provider will be checking the size of your uterus to make sure it’s back to an appropriate size. It will still have some shrinking to do and won’t be back to normal size for a few more weeks. They’ll also check your ovaries and cervix to confirm everything is normal.
This isn’t the most comfortable thing you’ll ever do…but it’s not the worst thing either. Your provider will be extremely gentle with you, and if it hurts too much, speak up and tell them. They don’t want to cause you pain, but they can’t read your mind either. If it hurts, say something!
Know going into it that it’s not pleasant. If you want to know more about "the whys" behind any part of the physical exam, ask your provider. They care about you and they want you to feel comfortable and safe.
When you check in for your appointment, you will be asked to fill out a questionnaire. It’s a tool providers use to screen for signs of Postpartum Depression. You will get your results during your appointment.
First, YOU HAVE TO ANSWER THE QUESTIONS HONESTLY! If you don’t have regular contact with people trained to spot the early signs of Perinatal Mood Disorders (therapists, support groups, postpartum doulas, etc.) then this might be the first time you have talked to anyone about how you’re feeling. Some women fear medication, and believe if they bring up their mental health struggles or concerns, then they will be automatically prescribed something. Here’s the deal- the treatment for Perinatal Mood Disorders should be multidisciplinary. The combination can involve therapy, medications, and techniques that work for you. You and your doctor might want to try everything all at once, or decide to take small steps. You have a say here. And if your treatment plan isn’t working for you, don’t give up. Your doctor won’t quit until the right treatment is found for you.
We encourage you to go into this part of your appointment with an open mind.
Your provider will go over the results of your physical exam as soon as it’s over. If everything is within a normal range, you will likely be released to resume normal physical activity, and your fitness routine again.
This is usually the best news for moms! Most of us don’t like restrictions, even when we know they are needed. The idea of getting back to your favorite yoga class or lacing up your running shoes for the first time is absolutely dreamy! And then reality hits when you plank for the first time or jog two blocks, and your body feels like it’s been mixed with concrete. It feels foreign. And you feel defeated. Here’s the thing…you were pregnant for ¾ of a year, and the body you had before isn’t there anymore. IT. WILL. TAKE. TIME. Be kind to yourself.
Order something cute ahead of time from lululemon, CALIA, Nike, etc. to wear- something that feels like butter on your new body. Invest in a couple of great sports bras if you are breastfeeding. And while you’re at it, pick up a new pair of tennis shoes too. The more confident and comfortable you feel on the outside makes a HUGE difference when you’re working out. It’s not superficial- it legit makes you feel better. Also, give yourself some grace and set realistic goals. A workout partner with another new mom is a great option for those needing some extra encouragement and accountability.
the birth control chat
During your postpartum follow up, the topic of contraception will come up for most women.
This is a personal choice. Some women want their partner’s input while others decide to make the decision on their own. Your OBGYN or Midwife will answer any questions you have and go over the options available. The decision will be yours to make.
It’s a strange mental swing going from all thing’s pregnancy and baby, to suddenly thinking about birth control. It’s a good idea to think about what might be best for you and your body before your appointment so you can ask questions while you’re there.
the sex talk
This is probably the most anticipated part of a post-delivery checkup…for you and your partner. We have an entire blog post coming up on this very topic! For now, expect your doctor to give you the go-ahead (or discuss waiting if they feel it’s best) during your appointment.
Friends, there’s an incredible amount of tea to spill when talking about having sex again after birth so get your mugs ready for our next post!
And we’ll do our best to help you, and your partner, feel prepared.