Essential reads & resources

The first 6-8 weeks postpartum can be a period full of rapid changes as the whole family adjusts to life with a newborn. This is when primary healing occurs for anyone who has given birth or had any procedures related to pregnancy and childbirth, and the energy demands of sleep, nourishment and caring for a baby can be high. In addition to the postpartum preparation and planning we overview here, you’ll want to consider the following in making the most of the medical care that takes place after birth and learn what to expect in your 6 week postpartum checkup.

Recovering from pregnancy and childbirth

Being pregnant for months is no small task, and delivering a baby is a feat of strength, endurance and resilience. Some first-time or experienced birthing people report feeling strong, grounded and calm after birth - especially when they had a peaceful, comfortable home space in which to recover. Other times birth can take an immense toll on someone’s body, and they may have a slower healing process or feel destabilized by the intensity of the experience. If you’ve experienced a less frequent but still common complication, such as a 3rd-degree or higher tear, or any kind of surgical procedure, you may require healing time and medical check-ins beyond six weeks. 

For some people, six weeks feels like a long time - after a few nights of good rest, hearty meals, cuddling and breastfeeding, they feel ready to get back into action. It is still advised that everyone prioritize moving slowly, focusing on rest, and leaning into the physiological and psychological benefits of newborn bonding and skin-to-skin, because an energized and focused start to healing is a more efficient path to full function and recovery than a process interrupted by stress, labor or work that somehow puts strain on the person’s joints, muscles, circulatory healing, and more.

If you are experiencing symptoms between birth and your next care visit that do not match the expectations discussed with your prenatal health care providers, it is important to either write them down or - if severe or triggering an intuitive sense of urgency - seek medical attention. For non-urgent questions, you might also speak to a doula with expertise in postpartum recovery, a pregnancy support group, or the hotline at the facility where you had your baby. Bring your notes of any such occurrences to your formal checkup so that you can get appropriate aftercare as needed - and if something does feel important, don’t wait around for that six week date to receive care.

One word of wisdom: you might not feel 100% yourself at this point and that is perfectly okay. Don’t hold the 6-week checkup as a magical point in time in which you feel completely normal again. It is common to feel weakness and pelvic pain beyond 6 weeks postpartum, and the details of someone’s health history, pregnancy, labor and birth can make a difference in what exactly they feel, where, and for how long. It’s worth seeking out additional support from a pelvic floor specialist, physical therapist or other practitioner if you have concerns about your longer-term recovery or more specified support around functions like elimination, sexual comfort or future pregnancy fitness and mobility.

What is the 6 week postpartum check-up?

Your 6 week postpartum visit is your time to ask questions, address concerns, and get medical guidance on any lingering recovery issues you are experiencing after pregnancy. This appointment usually takes place with whoever gave you prenatal medical care. As researchers continue to explore what creates the healthiest and most satisfying outcomes for all kinds of families, practitioners are starting to recommend a more individualized approach to postpartum care, but for now 6 weeks is the standard scheduled appointment offered to low-risk patients. You might also have additional check-ups if you had a surgery, pre-existing health condition, or a high-risk complication related to pregnancy, such as pre-eclampsia. Typically, during a standard follow-up, your provider will:‍

Provide physical health care assessments and treatment

• Assess any repairs and removal of sutures
• For episiotomy or tears, if there is a problem it usually shows up in the first two weeks, so if you notice unusual redness, swelling, new pain, or fluids, contact your provider before your scheduled appointment
• For Cesarean section incisions, you should also receive incision care instructions and a have an earlier physical appointment around two weeks
• Perform internal and external exams as needed, with your permission, to assess uterine and ovary health, inflammation, and possible perform a Pap smear
• Examine breasts for blocked milk ducts, lumps, any painful areas
• Assess vitals such as bleeding and blood pressure, as their status indicates good health or could signal the need for more rest or additional care or treatment

Provide guidance and resources for lifestyle and family planning

• Give you the okay to exercise and/or have sex again, or participate in whatever movement practices are a part of your normal lifestyle
• Discuss options for contraception if you have not already done so
• Help you to understand the normal range of postpartum moods and mental health in early parenting, including the difference between the common “baby blues” and more serious problems like postpartum depression and anxiety
• Answer questions you may have about the care you already received, your birth, and your experience going forward

Conduct mental health screening and provide follow up resources

• Assess how you're feeling and screen you for common perinatal mood and anxiety disorders like Postpartum Depression and Anxiety
• Discuss options for support, which can include therapy, peer support, and  medication

IMPORTANT: If you feel that changes in your mood are significantly impacting you, it's important to raise this to your provider or reach out for help.

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Common questions for the 6 week postpartum visit

Your prenatal health care provider may or may not be the person who helped you deliver your baby, but they should have access to your health records and be able to answer most questions about your pregnancy-related health during this visit. Typically, after the 6-week visit, patients return to seeing their regular primary care provider for general health care, so this may be the last time you see this midwife or OB/GYN for this pregnancy. 

Depending on how your care was set up, you might also be able to consult directly with the person who helped you deliver your baby, but if you can’t, your providers might work as a team to answer questions about your birth as well as these common inquiries for postpartum patients:

• What should I do if I am struggling with incontinence?
• What can I do if sex is painful?
• Do you recommend physical therapy after childbirth?
• Are there any restrictions to the type of exercise I can do? Is there anything to watch out for or be cautious of when I start exercising again?
• Can you check for signs of prolapse during the physical exam?
• Can you help me assess my abdominal muscles for diastasis recti?
• What follow-up care can I do at home to support my continued healing?
• How do I reach you if my symptoms change or I have a question?

Maternal and reproductive health outcomes are best when people have access to early and regular medical care. Utilize these questions and guidelines to make the most of your 6-week postpartum check up, knowing that you are taking full advantage of one of the most important preventative measures for women’s and family health. If you forget or think of other questions later, follow up! It could save your health, and at the very least, your comfort and confidence during this incredibly unique and often vulnerable postpartum period.

*For adults and children, serious symptoms such as bleeding (beyond expected recovery bleeding as discussed with your care provider), signs of infection (fever, shaking, odor, swelling, discoloration), or other significant symptoms that come on suddenly, severely, persistently, or seem to threaten breathing, circulation, or consciousness, call 9-1-1 or local emergency services. ‍

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Selected Sources

• ‍Optimizing postpartum care. ACOG Committee Opinion No. 736. American College of Obstetricians and Gynecologists. Obstet Gynecol 2018;131:e140–50.‍
• Perinatal Depression. U.S. Department of Health and Human Services, National Institutes of Health, National Institute of Mental Health. (2021)‍
• An approach to the postpartum office visit. Blenning CE, Paladine H. Am Fam Physician. 2005;72(12):2491–2496.