Postnatal checkups are an essential part of after-birth care, yet a surprising number of women don’t realize their importance. Bodies don’t just spring back to normal after giving birth, and many new moms need help to get things up and running again. If this is your fourth or fifth pregnancy, you might think you don’t need a checkup, but every pregnancy, for better or worse, is different.
Your postnatal checkups might be done by your ob-gyn or the family physician. They also include the extremely important full examination of your new baby, which covers essential screening tests. Either your pediatrician or your family doctor will run these. Whoever you choose to see, make sure they are someone you trust to answer your questions at this fragile time.
When should you have your postpartum checkup?
Postpartum checkups take place around 6 to 8 weeks after delivery. In the past, The American College of Obstetricians and Gynecologists (ACOG) recommended that women get their postpartum checkup 4-6 weeks following childbirth. It has since updated the guidelines, advocating for ongoing postpartum care instead of a one-time checkup. Moms are supposed to get in contact with their ob-gyn as early as 3 weeks after giving birth, get ongoing medical care during this period, and have a complete postpartum checkup no later than 12 weeks after delivery.
No one expects you to wait until then if you are having problems, so do visit your doctor earlier if you need to. First-time parents often have lots of questions about what is normal or not with babies.
Every pediatrician and family physician has had new moms on the phone asking about the color of poo in breastfed babies. Health care professionals more or less expect you to call about this kind of stuff at some point, so don’t feel guilty if you need to ring up your doctor for help to find your feet.
What happens at a postnatal checkup?
The answer is anything, depending on what’s most important to you. Many new moms arrive calm and happy, seeing this as nothing more than a routine checkup. Others have anxieties and need to discuss things, be it various baby-related stuff or a difficult delivery. It’s nice if your doctor allows you to start with your own priorities.
A mom with postpartum depression might struggle to take in what’s happening during the appointment if her focus is on trying not to burst into tears. In these circumstances, it’s much more productive to have anxiety or depression out in the open first and ensure that any struggling mom feels heard.
At a minimum, postnatal enquiries should cover the following areas in relation to moms:
- Mood, mental health, and support systems: New babies can bring great joy but also struggles with sleep, isolation, bonding, and identity. Postnatal mental health problems are common. Untreated, they can affect the mother-infant bond, so it’s important to discuss issues and seek treatment.
- Pelvic floor issues: Lingering incontinence is not an inevitability after birth. If you’re unsure about the state of your episiotomy scar, your doctor can check for you. This is also a good time to discuss any apprehensions about resuming sexual intercourse. An ob-gyn may do a full pelvic exam. In the UK we tend to just enquire about any pain or bleeding and then investigate accordingly.
- C-section scar: Your physician should check for any problems and hopefully give you the green light to resume some regular activities.
- Birth control: This is a good time to discuss the matter, even if only to gather information about your choices in case you’re not yet feeling ready to resume sexual relations.
- Feeding issues: Your doctor should check in with you regarding any feeding problems, particularly breastfeeding. Hopefully, anyone struggling has had professional support with this earlier, but if not, do speak up. Issues such as cracked nipples or thrush (a fungal infection causing a furry white tongue in babies and/or shooting breast pains) can all be managed successfully. Other common difficulties, such as problems with babies latching onto the breast or poor milk supply, should be addressed much earlier.
- Physical assessment: Your doctor should check your blood pressure and look for any problems arising in pregnancy, for example, gestational diabetes or anemia. When it comes to weight, I usually ask mom if she wants to be weighed or not.
What does a 6-week baby checkup include?
This covers general developmental questions about how your baby is interacting with you, things like eye contact and smiling. Questions about other issues you have can arise, for example, minor skin problems common in infants or other things you have noticed and are unsure if they’re normal.
Your pediatrician should conduct a top-to-toe physical examination of your baby. This includes checking skull shape and fontanelles, mouth, heart and lung sounds, abdominal exam, spine, and genitalia.
Other key check points include:
- Weight, length, and head circumference
- With boys, checking whether the testicles are in the right place-occasionally, they have developed higher up in the groin and need corrective surgery.
- Eye exam for congenital cataracts
- Determining that both pulses in the groin are present (femoral pulses)-their absence may mean a problem with one of the larger blood vessels.
- Hip checks for signs of congenital hip dislocation-babies may cry at this point, which is normal. Do mention if you have a family history of this.
- Neurological tone-known as the Moro Reflex. Sitting the baby up and then allowing them to drop back slightly should prompt them to spread their arms out wide, as if slightly surprised.
- Shots – sometimes postnatal checks are timed to coincide with the first round of baby immunizations.
The importance of the postnatal checkup
Although many moms and infants do well postpartum, scheduling a postnatal checkup provides an opportunity to address any questions you may have and also get a physical examination. These appointments are often enjoyable for both moms and doctors, who like meeting babies.