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Your Postpartum (Postnatal) Check-Up: What to Expect and Ask

A check for your recovery, mood, contraception and general health after the birth.

Before you use this guide: This is general educational information, not an individual medical assessment. We do not identify a clinician reviewer on this page, so please confirm personal health decisions with your doctor, midwife or paediatrician.

A postnatal check is usually offered around six to eight weeks after the birth, although some health services also check in earlier. In the US, doctors now recommend contact within the first three weeks and a full check no later than 12 weeks. It is a check for you, not just for your baby, and it is a chance to ask anything that has been on your mind.

What may be checked

• How you are healing, including any stitches or caesarean wound
• Your bleeding, which usually lessens over the first weeks and may last up to six weeks
• Your blood pressure, weight and general health
• Your mood and emotional wellbeing, often using a short questionnaire
• Your pelvic floor and any leaking of urine or stool
• Your breasts and breastfeeding, if you are feeding
• Pain, tiredness, sleep and how you are coping at home
• Contraception and, if due, a cervical screening test
• Your vaccination needs, if any

Contraception

Fertility can return sooner than you expect, before your first period, and as early as about three to four weeks after the birth if you are not breastfeeding exclusively. Talk about contraception even if you are breastfeeding. Options that are generally suitable include condoms, the progestogen-only pill, the implant, the injection and coil or intrauterine devices. Methods with oestrogen, such as the combined pill, are usually avoided in the first six weeks, and some doctors advise avoiding them while breastfeeding. The lactational amenorrhoea method works only if your baby is under six months, you are feeding fully day and night and your periods have not returned. Our guide to contraception after birth has more.

Your health after pregnancy conditions

• After gestational diabetes, you will usually be offered a blood test to check your sugar levels, often within about 4 to 13 weeks of the birth, and a regular check in the years ahead because the risk of type 2 diabetes is higher.
• After high blood pressure or pre-eclampsia, ask about follow-up for your blood pressure. These conditions are linked to a higher risk of heart disease later, so a regular check is worthwhile.
• After a difficult or frightening birth, ask for a birth debrief with a midwife or doctor to go through what happened and to talk about how you feel.

Intimacy and sex

There is no right time to have sex again. Wait until you feel ready and comfortable, and use contraception if you do not want to become pregnant. Vaginal dryness is common, especially while breastfeeding, and a water-based lubricant can help. If sex is painful after several weeks, or you have leaking or a feeling of heaviness, tell your doctor. These problems are common and can be treated.

Questions you might ask

• When can I start exercising again, and is it safe to run or do abdominal exercises?
• Is it normal that I still feel low, tired or anxious?
• When can I have sex without pain, and which contraception suits me?
• Do I need any follow-up tests, for example after gestational diabetes or high blood pressure?
• Is my bleeding, my wound or my scar healing as it should?
• Can I be referred to a women's health physiotherapist for my pelvic floor?
• How can I get more help with feeding, sleep or mental health?

Getting the most from your appointment

• Write your questions and symptoms down beforehand. It is easy to forget them with a baby in tow.
• Ask for a longer appointment if you need one, and for a part of it to be about you.
• Be honest about how you are feeling, both physically and emotionally. Doctors hear all of it.
• Bring your baby, a feed and a change of nappy, or ask a partner or friend to come along.

Do not wait for the appointment if you have

• Very heavy bleeding, such as soaking a pad in an hour, or passing large clots
• A fever, a foul-smelling discharge or a wound that is red, swollen, oozing or opening
• Pain, swelling or redness in a calf, or chest pain or breathlessness, which can be signs of a blood clot and need emergency care
• A severe headache, changes in your vision or sudden swelling in your face or hands, particularly in the first weeks, which can be signs of pre-eclampsia
• Severe abdominal pain, or pain or burning when passing urine
• Low mood or anxiety that is getting worse, or any thoughts of harming yourself or your baby. Seek help straight away.

You are not a burden for asking for help. Looking after your own health is part of looking after your baby.

Where to check current advice

Schedules differ between countries, so check with your own health service, such as the NHS in the UK, the HSE in Ireland, ACOG in the US, the SOGC in Canada and RANZCOG in Australia.

This content is for general information only and is not medical advice. Every pregnancy and every baby is different. Always talk to your doctor, midwife or paediatrician about your own situation, and seek urgent care if you are worried.