10 Questions to Ask at Your 6-Week Postpartum Check Up
January 17, 2020
You’ve spent the past 9 months preparing for the arrival of your beautiful baby. Labor and delivery has come and gone. Now its time for your 6-week postpartum check up. So much of life after delivery is focused on your new bundle of joy that you can sometimes forget to care for yourself. This is exactly why I believe the postpartum appointment is so important to you as a new momma – because it’s all about you!
Sure, your provider loves to fawn over your sweet baby, but this appointment is about mom. How are YOU doing? Self-care is so important to your health and recovery after having a baby, so let this appointment focus on your well-being.
These are some helpful questions to ask when you see your provider at your 6-week postpartum check up. Your provider will likely cover most or all of these topics on her or his own, but use this as a guide to remind you to ask anything she or he doesn’t cover.
10 Questions to Ask at Your 6-Week Postpartum Appointment
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 pre-term 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 pre-eclampsia, they may recommend taking a baby aspirin in the future.
Your provider may have discussed some of these things before or during your delivery. However, it is likely that with the excitement, and sometimes chaos, surrounding the birth you may have forgotten much of what they said. Therefore, it is good to have the discussion again at your postpartum appointment when the distractions are less.
Also, don’t forget to ask your provider what your complications were, why they happened, and if there is anything that can be done to help prevent it in the future.
2. Is my bleeding normal?
In the weeks following your delivery, it is normal to have bleeding and discharge, 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. During this time, some days bleeding will be heavier (like a period) and 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. If you are exclusively breastfeeding, your cycles will likely remain absent or irregular until you wean your baby.
3. Are there any medications, vaccinations or blood tests I need?
Your provider might recommend receiving the MMR vaccine if you were found to be non-immune to rubella. Or if you were started on any medications (such as blood pressure or thyroid medication) during pregnancy, your provider may recommend to continue, adjust the dosing, or stop completely at your 6-week check up. Also, if you were diagnosed with gestational diabetes, you will need postpartum testing as you continue to have an increased risk for 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 very 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 provider 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 depression at your 6-week postpartum appointment. The Edinburgh Postnatal Depression Scale is a common survey that is used. Approximately 70% of women will develop postpartum blues, so the importance is knowing the difference between blues and depression. Both have similar symptoms of anxiety, depression, crying, and insecurity regarding care of infant. However, the severity and timing of symptoms can distinguish them. It is so important to have an open discussion with your provider regarding your thoughts and feelings in order to receive proper care. 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 moms who are breastfeeding, there are many options to choose from! Condoms, pills, implants and IUDs represent the most common reversible options available, yet there are many more. Because there are risks and benefits to each option, a discussion with your provider considering your pre-existing conditions, personal and family planning goals will help you determine what method is best for you.
7. How can I help prevent pelvic organ prolapse?
Unfortunately, pregnancy and vaginal birth is one of the biggest risk factors for developing pelvic organ prolapse in the future. Most women don’t develop symptoms such as pelvic pressure, vaginal bulge, urinary incontinence, and difficulty emptying your bladder/bowels until after menopause. However, you can take action now to prevent the occurrence! The most commonly recommended practice are Kegel exercises. However, many women do not perform this effectively without proper coaching. Ask you provider to help you learn how to perform Kegel exercises correctly. Also ask if they would recommend consultation with a pelvic floor physical therapist. Other lifestyle changes for prevention include avoiding constipation, maintaining a healthy bodyweight, and smoking cessation.
8. How do I get my pre-baby body back?
First, recognize the beauty of your postpartum body. All of the changes of 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, and those changes should be welcomed as a reminder of the accomplishment of your body. If you notice a bulge in your abdomen, ask your provider about diastases recti (separate of your abdominal muscles) which can be treated 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 (you’ll typically be cleared to begin exercise at your 6-week postpartum check up).
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 the time is less than 6 months. Yet an increased risk has been reported with an interval 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 6 weeks without them. Believe it or not, your provider and their office staff likely feel the same way! Make sure to 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. However, it is still recommended to have a yearly breast and pelvic exam, routine blood testing, and STI testing. The timing of your next appointment will vary based on factors including recent lab results, your pre-existing conditions, and your age.
Hopefully, these questions will help you plan a list of topics to bring up at your 6-week postpartum check up. Remember, there are no silly questions and your provider will be happy to provide support.
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